Targeting KRAS(G12C): From Inhibitory Mechanism to Modulation of Antitumor Effects in Patients
Open accessAbstract
KRAS mutations are among the most common genetic alterations in lung, colorectal, and pancreatic cancers. Direct inhibition of KRAS oncoproteins has been a long-standing pursuit in precision oncology, one established shortly after the discovery of RAS mutations in human cancer cells nearly 40 years ago. Recent advances in medicinal chemistry have established inhibitors targeting KRAS(G12C), a mutation found in ∼13% of lung adenocarcinomas and, at a lower frequency, in other cancers. Preclinical studies describing their discovery and mechanism of action, coupled with emerging clinical data from patients treated with these drugs, have sparked a renewed enthusiasm in the study of KRAS and its therapeutic potential. Here, we discuss how these advances are reshaping the fundamental aspects of KRAS oncoprotein biology and the strides being made toward improving patient outcomes in the clinic.
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Christensen, J. G., Fell, J. B., Hallin, J. F., Baer, B. R., Engstrom, L. D., Blake, J. F., Briere, D. M., Ballard, J., Burkhard, M. R., Fischer, J., et al. (2019) · Molecular Cancer Therapeutics · doi:10.1158/1535-7163.targ-19-c069 · Cited by 6 · see citing works
Hofmann, M. H., Gmachl, M., Ramharter, J., Savarese, F., Gerlach, D., Marszalek, J. R., Sanderson, M. P., Trapani, F., Kessler, D., Rumpel, K., et al. (2019) · Molecular Cancer Therapeutics · doi:10.1158/1535-7163.targ-19-pl06-01 · Cited by 5 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Pancreatic cancer: Advances and challenges
Halbrook, C. J., Lyssiotis, C. A., Pasca di Magliano, M., & Maitra, A. (2023) · Cell · doi:10.1016/j.cell.2023.02.014 · Cited by 1,321 · see citing works
Acquired Resistance to KRAS <sup>G12C</sup> Inhibition in Cancer
Awad, M. M., Liu, S., Rybkin, I. I., Arbour, K. C., Dilly, J., Zhu, V. W., Johnson, M. L., Heist, R. S., Patil, T., Riely, G. J., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2105281 · Cited by 1,247 · see citing works
Self-citationDiverse alterations associated with resistance to KRAS(G12C) inhibition
Zhao, Y., Murciano-Goroff, Y. R., Xue, J. Y., Ang, A., Lucas, J., Mai, T. T., Da Cruz Paula, A. F., Saiki, A. Y., Mohn, D., Achanta, P., et al. (2021) · Nature · doi:10.1038/s41586-021-04065-2 · Cited by 479 · see citing works
Self-citationExpanding the Reach of Precision Oncology by Drugging All <i>KRAS</i> Mutants
Hofmann, M. H., Gerlach, D., Misale, S., Petronczki, M., & Kraut, N. (2022) · Cancer Discovery · doi:10.1158/2159-8290.cd-21-1331 · Cited by 336 · see citing works
Koga, T., Suda, K., Fujino, T., Ohara, S., Hamada, A., Nishino, M., Chiba, M., Shimoji, M., Takemoto, T., Arita, T., et al. (2021) · Journal of Thoracic Oncology · doi:10.1016/j.jtho.2021.04.015 · Cited by 265 · see citing works
Blair, H. A. (2021) · Drugs · doi:10.1007/s40265-021-01574-2 · Cited by 241 · see citing works
Lee, J. K., Sivakumar, S., Schrock, A. B., Madison, R., Fabrizio, D., Gjoerup, O., Ross, J. S., Frampton, G. M., Napalkov, P., Montesion, M., et al. (2022) · npj Precision Oncology · doi:10.1038/s41698-022-00334-z · Cited by 187 · see citing works
KRASG12C-independent feedback activation of wild-type RAS constrains KRASG12C inhibitor efficacy
Ryan, M. B., Coker, O., Sorokin, A., Fella, K., Barnes, H., Wong, E., Kanikarla, P., Gao, F., Zhang, Y., Zhou, L., et al. (2022) · Cell Reports · doi:10.1016/j.celrep.2022.110993 · Cited by 177 · see citing works
Adeno-to-squamous transition drives resistance to KRAS inhibition in LKB1 mutant lung cancer
Tong, X., Patel, A. S., Kim, E., Li, H., Chen, Y., Li, S., Liu, S., Dilly, J., Kapner, K. S., Zhang, N., et al. (2024) · Cancer Cell · doi:10.1016/j.ccell.2024.01.012 · Cited by 142 · see citing works
Mukhopadhyay, S., Huang, H.-Y., Lin, Z., Ranieri, M., Li, S., Sahu, S., Liu, Y., Ban, Y., Guidry, K., Hu, H., et al. (2023) · Cancer Research · doi:10.1158/0008-5472.can-23-2729 · Cited by 105 · see citing works
Suzuki, S., Yonesaka, K., Teramura, T., Takehara, T., Kato, R., Sakai, H., Haratani, K., Tanizaki, J., Kawakami, H., Hayashi, H., et al. (2021) · Clinical Cancer Research · doi:10.1158/1078-0432.ccr-21-0856 · Cited by 105 · see citing works
Oncogenic KRAS blockade therapy: renewed enthusiasm and persistent challenges
Tang, D., Kroemer, G., & Kang, R. (2021) · Molecular Cancer · doi:10.1186/s12943-021-01422-7 · Cited by 80 · see citing works
Alveolar Differentiation Drives Resistance to <i>KRAS</i> Inhibition in Lung Adenocarcinoma
Li, Z., Zhuang, X., Pan, C.-H., Yan, Y., Thummalapalli, R., Hallin, J., Torborg, S., Singhal, A., Chang, J. C., Manchado, E., et al. (2024) · Cancer Discovery · doi:10.1158/2159-8290.cd-23-0289 · Cited by 74 · see citing works
Santarpia, M., Ciappina, G., Spagnolo, C. C., Squeri, A., Passalacqua, M. I., Aguilar, A., Gonzalez-Cao, M., Giovannetti, E., Silvestris, N., & Rosell, R. (2023) · Translational Lung Cancer Research · doi:10.21037/tlcr-22-639 · Cited by 65 · see citing works
Thatikonda, V., Lyu, H., Jurado, S., Kostyrko, K., Bristow, C. A., Albrecht, C., Alpar, D., Arnhof, H., Bergner, O., Bosch, K., et al. (2024) · Nature Cancer · doi:10.1038/s43018-024-00800-6 · Cited by 76 · see citing works
Zhang, Y., Li, C., Xia, C., Wah To, K. K., Guo, Z., Ren, C., Wen, L., Wang, F., Fu, L., & Liao, N. (2022) · Cell Communication and Signaling · doi:10.1186/s12964-022-00955-8 · Cited by 33 · see citing works
Ferrous iron–activatable drug conjugate achieves potent MAPK blockade in <i>KRAS</i> -driven tumors
Jiang, H., Muir, R. K., Gonciarz, R. L., Olshen, A. B., Yeh, I., Hann, B. C., Zhao, N., Wang, Y.-H., Behr, S. C., Korkola, J. E., et al. (2022) · Journal of Experimental Medicine · doi:10.1084/jem.20210739 · Cited by 33 · see citing works
Non-genetic adaptive resistance to KRASG12C inhibition: EMT is not the only culprit
Ning, W., Marti, T. M., Dorn, P., & Peng, R.-W. (2022) · Frontiers in Oncology · doi:10.3389/fonc.2022.1004669 · Cited by 29 · see citing works
Chen, L., Zhang, J., Wang, X., Li, Y., Zhou, L., Lu, X., Dong, G., & Sheng, C. (2022) · Acta Pharmaceutica Sinica B · doi:10.1016/j.apsb.2021.07.009 · Cited by 20 · see citing works
KRAS, a New Target for Precision Medicine in Colorectal Cancer?
Boilève, A., Smolenschi, C., Lambert, A., Boige, V., Delaye, M., Camilleri, G. M., Tarabay, A., Valéry, M., Fuerea, A., Pudlarz, T., et al. (2024) · Cancers · doi:10.3390/cancers16203455 · Cited by 11 · see citing works
Hedgehog signalling is involved in acquired resistance to KRASG12C inhibitors in lung cancer cells
Lee, C., Yi, J., Park, J., Ahn, B., Won, Y.-W., Jeon, J., Lee, B. J., Cho, W. J., & Park, J. W. (2024) · Cell Death & Disease · doi:10.1038/s41419-024-06436-9 · Cited by 9 · see citing works
- Authors
- Kim, D., Xue, J. Y., & Lito, P.
- Affiliations
- Memorial Sloan Kettering Cancer Center (US)
- Corresponding author
- Lito, Piro
- Venue
- Cell
- Publisher
- Elsevier BV
- Published
- 2020-11
- Volume
- 183
- Issue
- 4
- Pages
- 850-859
- ISSN
- 0092-8674 (ISSN-L)
- PMC
- PMC7669705
- OpenAlex
- W3093242429
- Cited by
- 239
- References
- 82
- Citations by year
- 2026: 30 · 2025: 35 · 2024: 45 · 2023: 44 · 2022: 46 · 2021: 36 · 2020: 3
- FWCI
- 3.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (vor, 376 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
- Locations
- Cell (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Damon Runyon Cancer Research Foundation
- American Lung Association (T32GM007739, F30CA232549)
- Pew Charitable Trusts
- National Cancer Institute (1R01CA23026701A1, 1R01CA23074501, K08CA191082-01A1)
- Amgen
- National Institutes of Health
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Protein Kinase Regulation and GTPase Signaling
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Melanoma and MAPK Pathways
- Keywords
- KRAS G12C, KRAS inhibitors, RAS mutations, lung adenocarcinoma, mechanism of action, anticancer activity, precision oncology, KRAS-driven cancers, clinical outcomes
- MeSH terms
- Antineoplastic Agents, Clinical Trials as Topic, Humans, Mutation, Proto-Oncogene Proteins p21(ras), Drug Resistance, Neoplasm, Molecular Targeted Therapy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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