Cited by 21Protein Kinase Regulation and GTPase SignalingLung Cancer Treatments and MutationsColorectal Cancer Treatments and Studies

One Step at a Time — Clinical Evidence That KRAS Is Indeed Druggable

LoRusso, Patricia M., Sebolt-Leopold, Judith S.·2020·New England Journal of Medicine

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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Crossref · 10.1056/nejme2026372

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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]

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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.).
Venue
New England Journal of Medicine
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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