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Selective Inhibition of KRASG13C Reveals an Increased Dependence on Wild-Type RAS Isoforms in Codon 13 RAS-Mutant
Kyle J Seamon1, Yongxian Zhuang2, Yu Chi Yang1
1Revolution Medicines (United States) Redwood City, CA United States.
Abstract:
Covalent KRAS G12C inhibitors have changed the treatment landscape for NSCLC and CRC patients, but numerous RAS-mutant cancers lack approved targeted therapies. Here we describe RMC-8839, an oral RAS(ON) G13C-selective, covalent, tri-complex inhibitor that induced tumor regressions in selected KRAS G13C-mutant xenograft models. However, one-third of KRAS G13C-mutant human cancer cell lines in vitro showed incomplete RAS pathway suppression despite near-complete KRAS G13C engagement, suggesting a role for wild-type RAS(ON). We find that codon 13-mutant RAS differs from other KRAS mutations, exhibiting decreased stability, increased nucleotide exchange, and substantial intrinsic and GAP-stimulated GTP hydrolysis, which decreases oncogenicity. Furthermore, co-occurring RAS pathway mutations leading to increased wild-type RAS activation are enriched in codon 13 mutant tumors. Consistent with a role for wild-type RAS(ON) signaling, combination of RMC-8839 with a RAS(ON) multi-selective inhibitor resulted in deeper inhibition of KRAS G13C-mutant xenograft tumor growth than either inhibitor alone.
Insights
New covalent KRAS G13C inhibitors show promise for treating cancers. Combining RMC-8839 with other inhibitors may overcome resistance by targeting wild-type RAS(ON) signaling in KRAS G13C-mutant tumors.
Area of Science:
- Oncology
- Molecular Biology
- Drug Discovery
Background:
- Covalent KRAS G12C inhibitors have advanced cancer therapy, but targeted treatments for many RAS-mutant cancers remain limited.
- KRAS G13C mutations represent a distinct subset of RAS alterations lacking specific targeted therapies.
Purpose of the Study:
- To investigate RMC-8839, a novel covalent inhibitor targeting RAS(ON) G13C.
- To explore the mechanisms of resistance to KRAS G13C inhibitors, including the role of wild-type RAS(ON).
Main Methods:
- In vitro studies using KRAS G13C-mutant cancer cell lines.
- Xenograft models of KRAS G13C-mutant cancers.
- Biochemical analysis of KRAS G13C protein stability and nucleotide exchange.
- Combination therapy studies with RMC-8839 and a multi-selective RAS(ON) inhibitor.
Main Results:
- RMC-8839 demonstrated tumor regressions in KRAS G13C-mutant xenografts.
- Incomplete RAS pathway suppression was observed in some cell lines, indicating potential resistance mechanisms.
- KRAS G13C mutations exhibit unique biochemical properties including decreased stability and altered nucleotide exchange.
- Co-occurring mutations enhancing wild-type RAS activation were found in codon 13 mutant tumors.
- Combination therapy significantly enhanced tumor growth inhibition compared to single-agent treatment.
Conclusions:
- RMC-8839 is a potent inhibitor of KRAS G13C.
- Wild-type RAS(ON) signaling contributes to resistance in KRAS G13C-mutant cancers.
- Combination strategies targeting both mutant and wild-type RAS are crucial for effective treatment of KRAS G13C-mutant cancers.
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