On target: Rational approaches to KRAS inhibition for treatment of non-small cell lung carcinoma
Colin R. Lindsay, Marina Chiara Garassino, Ernest Nadal, Katarina Öhrling, Matthias Scheffler, Julien Mazières
Abstract
Non-small cell lung carcinoma (NSCLC) is a leading cause of cancer death. Approximately one-third of patients with NSCLC have a KRAS mutation. KRAS G12C , the most common mutation, is found in ~13% of patients. While KRAS was long considered 'undruggable', several novel direct KRAS G12C inhibitors have shown encouraging signs of efficacy in phase I/II trials and one of these (sotorasib) has recently been approved by the US Food and Drug Administration. This review examines the role of KRAS mutations in NSCLC and the challenges in targeting KRAS. Based on specific KRAS biology, it reports exciting progress, exploring the use of novel direct KRAS inhibitors as monotherapy or in combination with other targeted therapies, chemotherapy, and immunotherapy.