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Updated: Aug 6, 2026

Genome-Wide CRISPR Screen for Unveiling Radiosensitive and Radioresistant Genes
Published on: May 23, 2025
RAS signaling at the crossroads of radioresistance and tumor immunity
Clément Quevrin1, Michele Mondini1, Lydia Meziani1
1Inserm U1355, Radiothérapie moléculaire et innovations thérapeutiques (RAMO-IT), Gustave Roussy, Université Paris-Saclay, Villejuif, France.
Abstract:
RAS mutations are among the most prevalent oncogenic drivers in solid tumors and are consistently associated with suboptimal responses to radiation therapy (RT). Within this family, KRAS is the dominant isoform and a central regulator of tumor stress adaptation. Increasing evidence indicates that oncogenic KRAS orchestrates radioresistance through coordinated tumor-intrinsic and microenvironmental mechanisms. Cell-intrinsically, KRAS enhances DNA damage repair, replication stress tolerance, redox buffering, and ferroptosis defense. The KRAS-NRF2-53BP1 axis exemplifies this program by accelerating non-homologous end joining and enabling rapid repair of radiation-induced DNA double-strand breaks. Concurrently, KRAS reshapes the tumor microenvironment by promoting myeloid recruitment, metabolic rewiring, impaired antigen presentation, and immune checkpoint upregulation, thereby constraining the immunogenic effects of RT. The rapid evolution of RAS-directed therapeutics, including allele-specific, ON-state, dual-state, and pan-RAS inhibitors, as well as emerging degraders and molecular reprogramming strategies, has transformed a historically "undruggable" target into a clinically actionable vulnerability. Preclinical evidence indicates that KRAS inhibition can restore radiosensitivity and partially recondition antitumor immunity. However, adaptive resistance frequently converges on MAPK pathway reactivation and persistent immune suppression. Integrating next-generation RAS inhibitors with RT and immune-directed therapies may therefore represent a critical strategy for achieving durable tumor control in KRAS-mutant cancers.
Insights
RAS mutations drive cancer radioresistance by enhancing DNA repair and suppressing immunity. KRAS inhibitors may restore radiation sensitivity and improve tumor control when combined with other therapies.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Therapeutics
Background:
- RAS mutations, particularly KRAS, are key drivers in solid tumors.
- KRAS mutations are linked to poor outcomes with radiation therapy (RT).
- KRAS influences tumor adaptation to stress, contributing to radioresistance.
Purpose of the Study:
- To elucidate the mechanisms by which KRAS promotes radioresistance.
- To explore the therapeutic potential of targeting KRAS in combination with RT.
- To understand resistance mechanisms and immune evasion in KRAS-mutant cancers.
Main Methods:
- Review of preclinical and clinical evidence on KRAS and radioresistance.
- Analysis of KRAS-intrinsic pathways (DNA repair, redox, ferroptosis).
- Investigation of KRAS-mediated tumor microenvironment modulation (immune cells, metabolism).
Main Results:
- KRAS enhances DNA damage repair (e.g., via KRAS-NRF2-53BP1 axis) and stress tolerance.
- KRAS reprograms the tumor microenvironment, impairing anti-tumor immunity and RT efficacy.
- Emerging KRAS-targeted therapies show potential to restore radiosensitivity.
- Adaptive resistance often involves MAPK reactivation and immune suppression.
Conclusions:
- KRAS is a critical mediator of radioresistance through intrinsic and microenvironmental effects.
- Targeting KRAS with novel inhibitors may overcome resistance to RT.
- Combination strategies integrating KRAS inhibitors, RT, and immunotherapy are promising for durable tumor control.
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