One Step at a Time — Clinical Evidence That KRAS Is Indeed Druggable
Abstract
Overall survival among patients with advanced-stage KRASG12C non–small-cell lung cancer (NSCLC) or colorectal cancer is approximately 1 to 2 years; this startling statistic has fueled nearly four decades of research dedicated to the search for a KRAS-targeted drug.1,2 Because RAS has picomolar affinity for guanosine triphosphate (GTP) and intracellular GTP concentrations are exceedingly high, early strategies to find compounds that preferentially bind to the RAS–GTP pocket failed. Other strategies have attempted to interfere with RAS activation by preventing its membrane localization or by inhibiting downstream kinase signaling, but these also failed because of resistance stemming from compensatory signaling. Renewed interest . . .
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Historically, targeting KRAS mutations had been unsuccessful due to high affinity to GTP, a smooth surface without a drug binding groove or pocket, and multiple resistance mechanisms.
“The RAS molecule has a high affinity in picomolar range to abundantly available cytoplasmic GTP making competitive inhibition challenging.”
From Drugging KRAS: Current perspectives and state-of-art review (2022) · cites this paper as [75]
Cites
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- Authors
- LoRusso, P. M., & Sebolt-Leopold, J. S.
- Affiliations
- Yale Cancer Center (US)
- From Yale Cancer Center, New Haven, CT (P.M.L.); and the University of Michigan Rogel Cancer Center, Ann Arbor (J.S.S.-L.).
- ORCID
- LoRusso, Patricia M.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2020-09-24
- Volume
- 383
- Issue
- 13
- Pages
- 1277-1278
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W3087020477
- Cited by
- 21
- References
- 9
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 3 · 2021: 6
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- 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
- Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
- Keywords
- KRAS G12C, KRAS-targeted therapy, drug development, non-small cell lung cancer, colorectal cancer, compensatory signaling, drug resistance, overall survival
- MeSH terms
- Humans, Neoplasms, Proto-Oncogene Proteins p21(ras), ras Proteins
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