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|Ref Type||Journal Article|
|Authors||Sorokin AV, Kanikarla Marie P, Bitner L, Syed M, Woods M, Manyam G, Kwong LN, Johnson B, Morris VK, Jones P, Menter DG, Lee MS, Kopetz S|
|Title||Targeting RAS mutant colorectal cancer with dual inhibition of MEK and CDK4/6.|
|Abstract Text||KRAS and NRAS mutations occur in 45% of colorectal cancers (CRC), with combined MAPK pathway and CDK4/6 inhibition identified as a potential therapeutic strategy. In the current study, this combinatorial treatment approach was evaluated in a co-clinical trial in patient-derived xenografts (PDX), and safety was established in a clinical trial of binimetinib and palbociclib in metastatic CRC patients with RAS mutations. Across 18 PDX models undergoing dual inhibition of MEK and CDK4/6, 60% of tumors regressed, meeting the co-clinical trial primary endpoint. Prolonged duration of response occurred predominantly in TP53 wild-type models. Clinical evaluation of binimetinib and palbociclib in a safety lead-in confirmed safety and provided preliminary evidence of activity. Prolonged treatment in PDX models resulted in feedback activation of receptor tyrosine kinases and acquired resistance, which was reversed with a SHP2 inhibitor. These results highlight the clinical potential of this combination in CRC, along with the utility of PDX-based co-clinical trial platforms for drug development.|
|Molecular Profile||Treatment Approach|
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|Therapy Name||Drugs||Efficacy Evidence||Clinical Trials|
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|Gene||Variant||Impact||Protein Effect||Variant Description||Associated with drug Resistance|
|Molecular Profile||Indication/Tumor Type||Response Type||Therapy Name||Approval Status||Evidence Type||Efficacy Evidence||References|
|NRAS Q61K||colorectal cancer||sensitive||Palbociclib + Trametinib||Preclinical - Pdx||Actionable||In a preclinical study, combination treatment with Ibrance (palbociclib) and Mekinist (trametinib) led to greater inhibition of tumor growth than either agent alone in a patient-derived xenograft (PDX) model of colorectal cancer harboring NRAS Q61K (PMID: 35913398).||35913398|