Jiang Min, Ma Shaowei, Xuan Ying, Chen Kuanbing
Department of Oncology, Shengjing Hospital of China Medical University, Shenyang, 110004, China.
Department of Interventional Radiology, Shengjing Hospital of China Medical University, Shenyang, China.
Eur J Med Chem. 2025 Jul 5;291:117626. doi: 10.1016/j.ejmech.2025.117626. Epub 2025 Apr 15.
Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations are among the most common oncogenic alterations in various cancers, including pancreatic, colorectal, and non-small cell lung cancer (NSCLC). Targeting KRAS has long been considered a difficult challenge due to its high affinity for guanosine triphosphate (GTP) and the lack of a druggable binding site. However, recent advancements in small-molecule inhibitor design have led to the development of targeted therapies aimed at KRAS mutations, particularly the KRAS mutation. Inhibitors such as Sotorasib and Adagrasib have shown promise in preclinical and clinical studies by irreversibly binding to the mutant KRAS protein, locking it in an inactive state and disrupting downstream signaling pathways critical for tumor growth and survival. These inhibitors have demonstrated clinical efficacy in treating patients with KRAS-mutated cancers, leading to tumor regression, prolonged progression-free survival, and improved patient outcomes. This review discusses the synthetic strategies employed to develop these KRAS inhibitor and also examines the clinical application of these inhibitors, highlighting the challenges and successes encountered during clinical trials. Ultimately, KRAS inhibitors represent a breakthrough in cancer therapy, offering a promising new treatment option for patients with KRAS-driven tumors.
Kirsten 大鼠肉瘤病毒癌基因同源物(KRAS)突变是包括胰腺癌、结直肠癌和非小细胞肺癌(NSCLC)在内的多种癌症中最常见的致癌改变之一。长期以来,由于KRAS对三磷酸鸟苷(GTP)具有高亲和力且缺乏可成药的结合位点,靶向KRAS一直被认为是一项艰巨的挑战。然而,小分子抑制剂设计的最新进展已导致针对KRAS突变,特别是KRAS突变的靶向治疗药物的开发。索托拉西布(Sotorasib)和阿达格拉西布(Adagrasib)等抑制剂通过与突变型KRAS蛋白不可逆结合,将其锁定在非活性状态并破坏对肿瘤生长和存活至关重要的下游信号通路,在临床前和临床研究中显示出前景。这些抑制剂已在治疗KRAS突变癌症患者中证明了临床疗效,导致肿瘤消退、无进展生存期延长和患者预后改善。本文综述讨论了开发这些KRAS抑制剂所采用的合成策略,并研究了这些抑制剂的临床应用,强调了临床试验中遇到的挑战和成功。最终,KRAS抑制剂代表了癌症治疗的一项突破,为KRAS驱动的肿瘤患者提供了一种有前景的新治疗选择。