Publications
Nature communicationsAug 2024 |
15
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1
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7554
DOI:
10.1038/s41467-024-51828-2

RAS-ON inhibition overcomes clinical resistance to KRAS G12C-OFF covalent blockade

Nokin, Marie-Julie; Mira, Alessia; Patrucco, Enrico; Ricciuti, Biagio; Cousin, Sophie; Soubeyran, Isabelle; San José, Sonia; Peirone, Serena; Caizzi, Livia; Vietti Michelina, Sandra; Bourdon, Aurelien; Wang, Xinan; Alvarez-Villanueva, Daniel; Martínez-Iniesta, María; Vidal, August; Rodrigues, Telmo; García-Macías, Carmen; Awad, Mark M; Nadal, Ernest; Villanueva, Alberto; Italiano, Antoine; Cereda, Matteo; Santamaría, David; Ambrogio, Chiara
Product Used
Variant Libraries
Abstract
Selective KRASG12C inhibitors have been developed to covalently lock the oncogene in the inactive GDP-bound state. Two of these molecules, sotorasib and adagrasib, are approved for the treatment of adult patients with KRASG12C-mutated previously treated advanced non-small cell lung cancer. Drug treatment imposes selective pressures leading to the outgrowth of drug-resistant variants. Mass sequencing from patients' biopsies identified a number of acquired KRAS mutations -both in cis and in trans- in resistant tumors. We demonstrate here that disease progression in vivo can also occur due to adaptive mechanisms and increased KRAS-GTP loading. Using the preclinical tool tri-complex KRASG12C-selective covalent inhibitor, RMC-4998 (also known as RM-029), that targets the active GTP-bound (ON) state of the oncogene, we provide a proof-of-concept that the clinical stage KRASG12C(ON) inhibitor RMC-6291 alone or in combination with KRASG12C(OFF) drugs can be an alternative potential therapeutic strategy to circumvent resistance due to increased KRAS-GTP loading.
Product Used
Variant Libraries

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