Stratification of patients with KRAS-mutated advanced non-small cell lung cancer: improving prognostics

Expert Rev Respir Med. 2023 Jul-Dec;17(9):743-751. doi: 10.1080/17476348.2023.2265810. Epub 2023 Oct 27.

Abstract

Introduction: KRAS is the most frequently mutated oncogene in cancer and encodes a key signaling protein in tumors. Due to its high affinity for GTP and the lack of a large binding pocket that allosteric inhibitors can occupy, KRAS has long been considered 'non-druggable.' Finding effective treatment measures for patients with KRAS mutations is our top priority.

Areas covered: In this article, we will provide an overview of the KRAS pathway and review the current state of therapeutic strategies for targeting oncogenic KRAS, as well as their potential to improve outcomes in patients with KRAS-mutant malignancies. We will also discuss the development of these strategies and gave an outlook on prospects.

Expert opinion: KRAS mutations have posed a significant challenge in the treatment of advanced non-small cell lung cancer (NSCLC) over the past few decades. However, the emergence of immunotherapy and KRAS inhibitors, such as Sotorasib (AMG 510) and Adagrasib (MRTX849), has marked a new era in cancer therapy. As more research and clinical trials continue, we anticipate the development of more effective treatment strategies and better options for lung cancer patients.

Keywords: Adagrasib; KRAS mutation; Sotorasib; immunotherapy; lung cancer; targeted therapy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Non-Small-Cell Lung* / drug therapy
  • Carcinoma, Non-Small-Cell Lung* / genetics
  • Humans
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / genetics
  • Mutation
  • Prognosis
  • Proto-Oncogene Proteins p21(ras) / genetics

Substances

  • Proto-Oncogene Proteins p21(ras)
  • adagrasib
  • KRAS protein, human