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.

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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