The complex journey of targeting RAS in oncology

Abstract Given the prevalence of RAS mutations in various cancers, personalized therapeutic approaches, guided by molecular markers, are essential. Farnesyltransferase inhibitors (FTIs) have emerged as potential therapeutic options; however, they also face obstacles such as toxicity and limited effi...

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Main Authors: Katarzyna Wasiak, Damian Ciunowicz, Amelia Kierasińska-Kałka, Marta Węgierska, Marcin Pacholczyk, Piotr Rieske, Ewelina Stoczyńska-Fidelus
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-025-14033-y
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author Katarzyna Wasiak
Damian Ciunowicz
Amelia Kierasińska-Kałka
Marta Węgierska
Marcin Pacholczyk
Piotr Rieske
Ewelina Stoczyńska-Fidelus
author_facet Katarzyna Wasiak
Damian Ciunowicz
Amelia Kierasińska-Kałka
Marta Węgierska
Marcin Pacholczyk
Piotr Rieske
Ewelina Stoczyńska-Fidelus
author_sort Katarzyna Wasiak
collection DOAJ
description Abstract Given the prevalence of RAS mutations in various cancers, personalized therapeutic approaches, guided by molecular markers, are essential. Farnesyltransferase inhibitors (FTIs) have emerged as potential therapeutic options; however, they also face obstacles such as toxicity and limited efficacy. Alternative strategies, such as direct inhibitors combined with pathway modulators, RNA interference, and gene-editing technologies, are under clinical investigation. The targeting of RAS, complicated by its structural nuances, particularly in the G domain, has advanced with the identification of druggable pockets such as the SW-II pocket. This breakthrough has led to the development of targeted therapeutics, such as sotorasib and adagrasib, for KRAS G12C-mutated non-small cell lung cancer (NSCLC). However, these advancements face challenges, including adaptive resistance and the necessity for isoform selectivity. New inhibitors, such as LY3537982 or GDC-6036, are promising, but achieving effective and selective RAS inhibition remains a significant challenge. Additionally, clinical trials have highlighted variability in patient responses, attributing limited treatment efficacy to resistance mechanisms, including on-target mutations and off-target pathway activations. Finally, the RAS oncogene, traditionally viewed as predominantly pro-cancerous, plays a complex role in oncogenesis, with recent evidence suggesting context-dependent effects, such as inducing senescence in certain cells. This shift in understanding underscores the therapeutic potential of manipulating the interplay between RAS and TP53 mutations in cancer. In conclusion, the complexity of effectively targeting the RAS-RAF-ERK pathway is exacerbated by the diverse resistance mechanisms. Challenges such as off-target effects and delivery issues remain significant barriers in the introduction of effective therapies based on RAS inhibitors. This overview highlights the evolving nature of targeting RAS in cancer therapy.
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spelling doaj-art-5c6b7389f09b4b68a0d2052b84fdbaca2025-08-20T03:45:32ZengBMCBMC Cancer1471-24072025-07-0125112910.1186/s12885-025-14033-yThe complex journey of targeting RAS in oncologyKatarzyna Wasiak0Damian Ciunowicz1Amelia Kierasińska-Kałka2Marta Węgierska3Marcin Pacholczyk4Piotr Rieske5Ewelina Stoczyńska-Fidelus6Department of Research and Development, Personather Ltd.Department of Research and Development, Personather Ltd.Department of Research and Development, Personather Ltd.Department of Research and Development, Personather Ltd.Department of Research and Development, Personather Ltd.Department of Research and Development, Personather Ltd.Department of Research and Development, Personather Ltd.Abstract Given the prevalence of RAS mutations in various cancers, personalized therapeutic approaches, guided by molecular markers, are essential. Farnesyltransferase inhibitors (FTIs) have emerged as potential therapeutic options; however, they also face obstacles such as toxicity and limited efficacy. Alternative strategies, such as direct inhibitors combined with pathway modulators, RNA interference, and gene-editing technologies, are under clinical investigation. The targeting of RAS, complicated by its structural nuances, particularly in the G domain, has advanced with the identification of druggable pockets such as the SW-II pocket. This breakthrough has led to the development of targeted therapeutics, such as sotorasib and adagrasib, for KRAS G12C-mutated non-small cell lung cancer (NSCLC). However, these advancements face challenges, including adaptive resistance and the necessity for isoform selectivity. New inhibitors, such as LY3537982 or GDC-6036, are promising, but achieving effective and selective RAS inhibition remains a significant challenge. Additionally, clinical trials have highlighted variability in patient responses, attributing limited treatment efficacy to resistance mechanisms, including on-target mutations and off-target pathway activations. Finally, the RAS oncogene, traditionally viewed as predominantly pro-cancerous, plays a complex role in oncogenesis, with recent evidence suggesting context-dependent effects, such as inducing senescence in certain cells. This shift in understanding underscores the therapeutic potential of manipulating the interplay between RAS and TP53 mutations in cancer. In conclusion, the complexity of effectively targeting the RAS-RAF-ERK pathway is exacerbated by the diverse resistance mechanisms. Challenges such as off-target effects and delivery issues remain significant barriers in the introduction of effective therapies based on RAS inhibitors. This overview highlights the evolving nature of targeting RAS in cancer therapy.https://doi.org/10.1186/s12885-025-14033-yRAS proteinsKRASHRASNRASOncogeneCancer
spellingShingle Katarzyna Wasiak
Damian Ciunowicz
Amelia Kierasińska-Kałka
Marta Węgierska
Marcin Pacholczyk
Piotr Rieske
Ewelina Stoczyńska-Fidelus
The complex journey of targeting RAS in oncology
BMC Cancer
RAS proteins
KRAS
HRAS
NRAS
Oncogene
Cancer
title The complex journey of targeting RAS in oncology
title_full The complex journey of targeting RAS in oncology
title_fullStr The complex journey of targeting RAS in oncology
title_full_unstemmed The complex journey of targeting RAS in oncology
title_short The complex journey of targeting RAS in oncology
title_sort complex journey of targeting ras in oncology
topic RAS proteins
KRAS
HRAS
NRAS
Oncogene
Cancer
url https://doi.org/10.1186/s12885-025-14033-y
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