Abstract

Targeting of oncogenic driver mutations with small-molecule inhibitors resulted in powerful treatment options for cancer patients in recent years. The RAS (rat sarcoma) pathway is among the most frequently mutated pathways in human cancer. Whereas targeting mutant Kirsten RAS (KRAS) remains difficult, mutant B rapidly accelerated fibrosarcoma (BRAF) kinase is an established drug target in cancer. Now data show that neuroblastoma RAS (NRAS) and even Harvey RAS (HRAS) mutations could be predictive markers for treatment with mitogen-activated protein kinase (MEK) inhibitors. This review discusses recent preclinical and clinical studies of MEK inhibitors in BRAF and RAS mutant cancer.

Highlights

  • Targeting of oncogenic driver mutations with small-molecule inhibitors resulted in powerful treatment options for cancer patients in recent years

  • Data show that neuroblastoma RAS (NRAS) and even Harvey RAS (HRAS) mutations could be predictive markers for treatment with mitogen-activated protein kinase (MEK) inhibitors

  • In patients with metastatic melanoma harbouring a B rapidly accelerated fibrosarcoma (BRAF) V600E/K mutation, single-agent trametinib compared with dacarbazine showed significantly longer progression-free survival of 4.8 months in the trametinib group compared with 1.5 months in the standard chemotherapy group [23]

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Summary

Summary

Targeting of oncogenic driver mutations with small-molecule inhibitors resulted in powerful treatment options for cancer patients in recent years. The RAS (rat sarcoma) pathway is among the most frequently mutated pathways in human cancer. Whereas targeting mutant Kirsten RAS (KRAS) remains difficult, mutant B rapidly accelerated fibrosarcoma (BRAF) kinase is an established drug target in cancer. Data show that neuroblastoma RAS (NRAS) and even Harvey RAS (HRAS) mutations could be predictive markers for treatment with mitogen-activated protein kinase (MEK) inhibitors. This review discusses recent preclinical and clinical studies of MEK inhibitors in BRAF and RAS mutant cancer

RAS signalling pathway
Common mutations in the RAS pathway
Urinary tract
Approved MEK inhibitors and MEK inhibitors in advanced clinical studies
MEK inhibitors in early clinical development
Toxicity of MEK inhibitors
Resistance to MEK inhibitors
Molecular markers for MEK inhibitors
KRAS mutation is a poor predictive marker for single
Findings
Outlook to the future

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