Rapid non-uniform adaptation to conformation-specific KRAS(G12C) inhibition Journal Article
| Authors: | Xue, J. Y.; Zhao, Y.; Aronowitz, J.; Mai, T. T.; Vides, A.; Qeriqi, B.; Kim, D.; Li, C.; de Stanchina, E.; Mazutis, L.; Risso, D.; Lito, P. |
| Article Title: | Rapid non-uniform adaptation to conformation-specific KRAS(G12C) inhibition |
| Abstract: | KRAS GTPases are activated in one-third of cancers, and KRAS(G12C) is one of the most common activating alterations in lung adenocarcinoma1,2. KRAS(G12C) inhibitors3,4 are in phase-I clinical trials and early data show partial responses in nearly half of patients with lung cancer. How cancer cells bypass inhibition to prevent maximal response to therapy is not understood. Because KRAS(G12C) cycles between an active and inactive conformation4–6, and the inhibitors bind only to the latter, we tested whether isogenic cell populations respond in a non-uniform manner by studying the effect of treatment at a single-cell resolution. Here we report that, shortly after treatment, some cancer cells are sequestered in a quiescent state with low KRAS activity, whereas others bypass this effect to resume proliferation. This rapid divergent response occurs because some quiescent cells produce new KRAS(G12C) in response to suppressed mitogen-activated protein kinase output. New KRAS(G12C) is maintained in its active, drug-insensitive state by epidermal growth factor receptor and aurora kinase signalling. Cells without these adaptive changes—or cells in which these changes are pharmacologically inhibited—remain sensitive to drug treatment, because new KRAS(G12C) is either not available or exists in its inactive, drug-sensitive state. The direct targeting of KRAS oncoproteins has been a longstanding objective in precision oncology. Our study uncovers a flexible non-uniform fitness mechanism that enables groups of cells within a population to rapidly bypass the effect of treatment. This adaptive process must be overcome if we are to achieve complete and durable responses in the clinic. © 2020, The Author(s), under exclusive licence to Springer Nature Limited. |
| Keywords: | signal transduction; mitogen activated protein kinase; controlled study; oncoprotein; nonhuman; drug targeting; cell proliferation; animal cell; mouse; enzyme inhibition; protein targeting; epidermal growth factor receptor; animal experiment; animal model; enzyme activity; cell population; chemosensitivity; oncology; cancer cell; gefitinib; dactinomycin; k ras protein; enzyme specificity; cysteine; glycine; personalized medicine; enzyme conformation; adaptation; trametinib; afatinib; 8 [4 (1 aminocyclobutyl)phenyl] 9 phenyl 1,2,4 triazolo[3,4 f][1,6]naphthyridin 3(2h) one; aurora kinase; alisertib; female; priority journal; article; alpelisib; tozasertib; malignant neoplasm |
| Journal Title: | Nature |
| Volume: | 577 |
| Issue: | 7790 |
| ISSN: | 0028-0836 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2020-01-16 |
| Start Page: | 421 |
| End Page: | 425 |
| Language: | English |
| DOI: | 10.1038/s41586-019-1884-x |
| PUBMED: | 31915379 |
| PROVIDER: | scopus |
| PMCID: | PMC7308074 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 February 2020 -- Source: Scopus |
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