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Wasko UN, Jiang J, Curiel-Garcia A, Wang Y, Lee B, Orlen M, Drizyte-Miller K, Menard M, Dilly J, Sastra SA, Palermo CF, Dalton T, Hasselluhn MC, Decker-Farrell AR, Chang S, Jiang L, Wei X, Yang YC, Helland C, Courtney H, Gindin Y, Zhao R, Kemp SB, Clendenin C, Sor R, Vostrejs W, Amparo AA, Hibshman PS, Rees MG, Ronan MM, Roth JA, Bakir B, Badgley MA, Chabot JA, Kluger MD, Manji GA, Quintana E, Wang Z, Smith JAM, Holderfield M, Wildes D, Aguirre AJ, Der CJ, Vonderheide RH, Stanger BZ, Singh M, Olive KP. Tumor-selective effects of active RAS inhibition in pancreatic ductal adenocarcinoma. bioRxiv 2023:2023.12.03.569791. [PMID: 38105998 PMCID: PMC10723304 DOI: 10.1101/2023.12.03.569791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Broad-spectrum RAS inhibition holds the potential to benefit roughly a quarter of human cancer patients whose tumors are driven by RAS mutations. However, the impact of inhibiting RAS functions in normal tissues is not known. RMC-7977 is a highly selective inhibitor of the active (GTP-bound) forms of KRAS, HRAS, and NRAS, with affinity for both mutant and wild type (WT) variants. As >90% of human pancreatic ductal adenocarcinoma (PDAC) cases are driven by activating mutations in KRAS, we assessed the therapeutic potential of RMC-7977 in a comprehensive range of PDAC models, including human and murine cell lines, human patient-derived organoids, human PDAC explants, subcutaneous and orthotopic cell-line or patient derived xenografts, syngeneic allografts, and genetically engineered mouse models. We observed broad and pronounced anti-tumor activity across these models following direct RAS inhibition at doses and concentrations that were well-tolerated in vivo. Pharmacological analyses revealed divergent responses to RMC-7977 in tumor versus normal tissues. Treated tumors exhibited waves of apoptosis along with sustained proliferative arrest whereas normal tissues underwent only transient decreases in proliferation, with no evidence of apoptosis. Together, these data establish a strong preclinical rationale for the use of broad-spectrum RAS inhibition in the setting of PDAC.
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Affiliation(s)
- Urszula N. Wasko
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | | | - Alvaro Curiel-Garcia
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | | | - Bianca Lee
- Revolution Medicines, Inc., Redwood City, CA
| | - Margo Orlen
- University of Pennsylvania Perelman School of Medicine, Department of Medicine
| | - Kristina Drizyte-Miller
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Julien Dilly
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
| | - Stephen A. Sastra
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Carmine F. Palermo
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Tanner Dalton
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Marie C. Hasselluhn
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Amanda R. Decker-Farrell
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | | | | | - Xing Wei
- Revolution Medicines, Inc., Redwood City, CA
| | - Yu C. Yang
- Revolution Medicines, Inc., Redwood City, CA
| | | | | | | | | | - Samantha B. Kemp
- University of Pennsylvania Perelman School of Medicine, Department of Medicine
| | - Cynthia Clendenin
- University of Pennsylvania Perelman School of Medicine, Abramson Cancer Center
| | - Rina Sor
- University of Pennsylvania Perelman School of Medicine, Abramson Cancer Center
| | - Will Vostrejs
- University of Pennsylvania Perelman School of Medicine, Department of Medicine
| | - Amber A. Amparo
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Priya S. Hibshman
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | | | - Basil Bakir
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - Michael A. Badgley
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | - John A. Chabot
- Department of Surgery, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
| | - Michael D. Kluger
- Department of Surgery, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
| | - Gulam A. Manji
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
| | | | | | | | | | | | - Andrew J. Aguirre
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Boston, MA
- The Broad Institute of Harvard and MIT, Cambridge, MA
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA
| | - Channing J. Der
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Pharmacology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Robert H. Vonderheide
- University of Pennsylvania Perelman School of Medicine, Department of Medicine
- University of Pennsylvania Perelman School of Medicine, Abramson Cancer Center
- Parker Institute for Cancer Immunotherapy
| | - Ben Z. Stanger
- University of Pennsylvania Perelman School of Medicine, Department of Medicine
- University of Pennsylvania Perelman School of Medicine, Abramson Cancer Center
| | | | - Kenneth P. Olive
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY
- Herbert Irving Comprehensive Cancer Center, Columbia University Irving Medical Center, New York, NY
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