Abstract How we get cancer, a process termed tumor initiation, remains an enigma, which has crucial clinical implications for early detection, prevention, and interception. Backtracking to catch the moment a specific mutagenic event in a single gene from an individual cell occurred decades before manifesting as cancer is challenging. However, the RAS family of small GTPases thate are commonly mutated in cancer provide some insight. Despite over 50 possible oncogenic RAS mutations, each cancer type exhibits a predilection or ‘tropism’ towards a distinct and often unique subset of these mutations. For example, most pancreatic ductal adenocarcinomas are driven by a G12D/V mutation in KRAS. As RAS mutations are often initiating, this tropism ostensibly reflects the fundamental biology underlying tumor initiation, which becomes embedded in the genome of the resulting tumors. Fortunately, the process of RAS mutation tropism can be studied in mice exposed to the environmental carcinogen urethane. Such carcinogenesis both captures the moment of tumor initiation (the point of carcinogen exposure) and displays RAS mutation tropism (lung lesions are induced by a specific RAS mutation). By using ultra-sensitive sequencing to detect mutations immediately after urethane exposure in different mouse genetic backgrounds, we find that the mutagenic bias of this carcinogen influences the type of RAS mutations generated. However, biological selection for an optimal or ‘sweet spot’ of oncogenic signaling ultimately appears to dictate which mutations go on to initiate tumorigenesis. Analysis of sequence datasets from human lung cancer suggests a similar dominant role for biological selection in the RAS mutation tropism of this cancer. In summary, RAS mutation tropism appears to be a combination of mutational bias, and even more so, biological selection, providing critical insights into the origins of cancers like pancreatic. Citation Format: Christopher M Counter. RAS mutation tropism: insight into tumor initation [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr IA-07.
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