Mutations of are commonly seen in human cancers, especially in lung, colorectal, and pancreatic adenocarcinoma. Despite huge effort for decades, targeting mutations has been "undruggable" because of the molecular instability of RAS protein inhibition. However, the recent discovery of the G12C inhibitor paved the way to expand therapeutic options for patients with cancer harboring the G12C mutation. At the same time, the successful development of immune checkpoint inhibitors (ICIs) drastically changed the paradigm of cancer treatment and resulted in a better understanding of the tumor immune microenvironment in patients with -mutant cancer. This review describes the following: the clinical characteristics of cancer with mutation; successful development of the G12C inhibitor and its impact on the tumor immune microenvironment; and potential new avenues such as the combination strategy using inhibitor and ICI, with preclinical and clinical rationales for overcoming resistance to inhibition of to improve therapeutic efficacy for patients with cancer harboring mutations.
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http://dx.doi.org/10.36401/JIPO-22-5 | DOI Listing |
J Med Chem
January 2025
Chief executive officer, Jacobio Pharmaceuticals Group Co., Ltd., Beijing100176, P. R. China.
KRAS is the most frequently mutated driver oncogene in human cancer, and KRAS mutation is commonly found in non-small-cell lung cancer (NSCLC), colorectal cancer (CRC), and pancreatic ductal adenocarcinoma (PDAC). Inhibitors that covalently modify the mutated codon 12 cysteine have completed proof-of-concept studies in the clinic. Here, we describe structure-based design and cocrystal-aided drug optimization of a series of compounds with the 1,8-naphthyridine-3-carbonitrile scaffold.
View Article and Find Full Text PDFPol J Pathol
January 2025
Department of Pulmonary Medicine, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China.
Mutations in the KRAS gene in non-small cell lung cancer (NSCLC) are common drivers. Gene expression and mutation data of NSCLC were collected from the TCGA dataset. DEGs between KRAS mutations and wild type were identified, and enrichment analysis was performed.
View Article and Find Full Text PDFPharmacoepidemiol Drug Saf
February 2025
Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Purpose: The p.G12C mutation in KRAS is commonly found in many cancers and was previously untreatable until drugs like sotorasib were developed. However, up to 15% of patients treated with sotorasib have experienced hepatobiliary adverse events.
View Article and Find Full Text PDFSwiss Med Wkly
January 2025
Cancer Center und Research Center, Cantonal Hospital Graubünden, Chur, Switzerland.
Background And Objective: Because of the lack of effective targeted treatment options, docetaxel has long been the standard second-line therapy for patients with advanced non-small cell lung cancer, including the Kirsten rat sarcoma virus (KRAS) G12C mutation. The CodeBreak 200 trial demonstrated that sotorasib, a new drug targeting the G12C-mutated KRAS protein, modestly improved progression-free survival compared with docetaxel in patients whose cancer had progressed after receiving platinum chemotherapy and programmed cell death protein 1 (PD-1) / programmed death ligand 1 (PD-L1) inhibitors as first-line treatment. Consequently, sotorasib received temporary approval in Switzerland.
View Article and Find Full Text PDFAnn Pancreat Cancer
June 2024
Department of Oncology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Background: Pancreatic ductal adenocarcinoma (PDAC) is predicted to be the second leading cause of cancer-related death by 2030. This is driven by a high case-fatality rate with most patients even with radiologically localized PDAC at diagnosis ultimately relapsing with metastatic disease. mutations present in 90% to 95% of PDAC drive these poor statistics through its role in driving cellular growth, inhibition of apoptosis, and immunosuppression.
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