# KRAS G12C inhibitor combination therapies: current evidence and challenge

**Authors:** Hirotaka Miyashita, Shumei Kato, David S. Hong

PMC · DOI: 10.3389/fonc.2024.1380584 · 2024-05-02

## TL;DR

KRAS G12C inhibitors show promise in cancer treatment, but combining them with other therapies is key to overcoming resistance and improving efficacy.

## Contribution

The paper reviews current evidence and challenges in combining KRAS G12C inhibitors with other therapies to enhance treatment outcomes.

## Key findings

- Combining KRAS G12C inhibitors with EGFR inhibitors shows promising results in colorectal cancer.
- Ongoing trials are exploring combinations with SOS1, ERK, CDK4/6, and wild-type RAS inhibitors.
- Preclinical studies suggest potential in combining with YAP/TAZ-TEAD and FAK inhibitors.

## Abstract

Although KRAS G12C inhibitors have proven that KRAS is a “druggable” target of cancer, KRAS G12C inhibitor monotherapies have demonstrated limited clinical efficacy due to primary and acquired resistance mechanisms. Multiple combinations of KRAS G12C inhibitors with other targeted therapies, such as RTK, SHP2, and MEK inhibitors, have been investigated in clinical trials to overcome the resistance. They have demonstrated promising efficacy especially by combining KRAS G12C and EGFR inhibitors for KRAS G12C-mutated colorectal cancer. Many clinical trials of combinations of KRAS G12C inhibitors with other targeted therapies, such as SOS1, ERK, CDK4/6, and wild-type RAS, are ongoing. Furthermore, preclinical data have suggested additional promising KRAS G12C combinations with YAP/TAZ-TEAD inhibitors, FAK inhibitors, and farnesyltransferase inhibitors. The combinations of KRAS G12C inhibitors with immunotherapies and chemotherapies have also been investigated, and the preliminary results were reported. More recently, KRAS-targeted therapies not limited to KRAS G12C are being developed, potentially broadening the treatment landscape of KRAS-mutated cancers. Rationally combining KRAS inhibitors with other therapeutics is likely to play a significant role in future treatment for KRAS-mutated solid tumors.

## Linked entities

- **Genes:** KRAS (KRAS proto-oncogene, GTPase) [NCBI Gene 3845], EGFR (epidermal growth factor receptor) [NCBI Gene 1956], SOS1 (SOS Ras/Rac guanine nucleotide exchange factor 1) [NCBI Gene 6654], EPHB2 (EPH receptor B2) [NCBI Gene 2048], Cdk4 (Cyclin-dependent kinase 4) [NCBI Gene 36854], ras (resistance to audiogenic seizures) [NCBI Gene 19412], PTK2 (protein tyrosine kinase 2) [NCBI Gene 5747]
- **Diseases:** cancer (MONDO:0004992), colorectal cancer (MONDO:0005575)

## Full-text entities

- **Genes:** SOS1 (SOS Ras/Rac guanine nucleotide exchange factor 1) [NCBI Gene 6654] {aka GF1, GGF1, GINGF, HGF, NS4, SOS-1}, MAPK1 (mitogen-activated protein kinase 1) [NCBI Gene 5594] {aka ERK, ERK-2, ERK2, ERT1, MAPK2, NS13}, PTK2 (protein tyrosine kinase 2) [NCBI Gene 5747] {aka FADK, FADK 1, FAK, FAK1, FRNK, PPP1R71}, EGFR (epidermal growth factor receptor) [NCBI Gene 1956] {aka ERBB, ERBB1, ERRP, HER1, NISBD2, NNCIS}, MAP2K7 (mitogen-activated protein kinase kinase 7) [NCBI Gene 5609] {aka JNKK2, MAPKK7, MEK, MEK 7, MKK7, PRKMK7}, YAP1 (Yes1 associated transcriptional regulator) [NCBI Gene 10413] {aka COB1, YAP, YAP-1, YAP2, YAP65, YKI}, TAFAZZIN (tafazzin, phospholipid-lysophospholipid transacylase) [NCBI Gene 6901] {aka BTHS, CMD3A, EFE, EFE2, G4.5, LVNCX}, KRAS (KRAS proto-oncogene, GTPase) [NCBI Gene 3845] {aka 'C-K-RAS, C-K-RAS, CFC2, K-RAS2A, K-RAS2B, K-RAS4A}, PTPN11 (protein tyrosine phosphatase non-receptor type 11) [NCBI Gene 5781] {aka BPTP3, CFC, JMML, METCDS, NS1, PTP-1D}
- **Diseases:** cancer (MESH:D009369), colorectal cancer (MESH:D015179)
- **Mutations:** G12C

## Figures

1 figure with captions in the complete paper: https://tomesphere.com/paper/PMC11097198/full.md

---
Source: https://tomesphere.com/paper/PMC11097198