KRAS G13

We present a 57-year-old man with KRAS G13D-mutant, liver-dominant metastatic rectal adenocarcinoma and recurrent fluoropyrimidine-associated coronary vasospasm precluding 5-fluorouracil and capecitabine. After multimodal first-line therapy and regorafenib, trifluridine/tipiracil (TAS-102) plus bevacizumab was initiated and integrated with liver-directed treatments for oligoprogressive disease. This combined strategy achieved approximately 16.6 months of disease control, substantially exceeding the median progression-free survival reported in the SUNLIGHT trial, with manageable hematological toxicity and preserved performance status. This case highlights the value of TAS-102 plus bevacizumab combined with focal liver-directed therapy as a feasible long-term strategy for selected patients with oligoprogressive mCRC when fluoropyrimidines cannot be used.

Mouse embryonic fibroblasts transformed with KRASG12C also contain more saturated lipids than KRASG12D MEFs. Thus, activities of KRAS mutants depends on lipid acyl chain remodeling in an allele-specific manner.

P1, N=76, Not yet recruiting, Beijing Youcare Kechuang Pharmaceutical Technology Co., Ltd.

P1/2, N=265, Recruiting, Blueprint Medicines Corporation

P3, N=590, Recruiting, Revolution Medicines, Inc. | N=420 --> 590

We review reports of the interaction of cathepsin B with trypsinogen in the pancreas and caspases in inflammasomes and the potential effect of premature activation of trypsin on immune evasion of G12R mutants. We summarize our observations and literature review in a schematic describing the potential role inflammation and the actions of cathepsin B, trypsin, and caspases on the immune evasion of KRas and related Ras family gene products.

KRAS mutations-particularly exon 2 alterations-are associated with inferior OS in CRC. Among KRAS-mutant subtypes, G12A and K117N confer the poorest prognosis, supporting the clinical value of subtype-level risk stratification.

In both univariate and multivariate analysis, detection of mutant KRAS G12, Q61, or G13 in baseline ctDNA by whole-genome sequencing was superiorly predictive of worse OS over pre-therapy serum CA 19-9. Ultra-deep sequencing demonstrates robust detection of pertinent KRAS mutations that support improved prognostic stratification for patients with localized PDAC, demonstrating the potential value of advanced liquid biopsy technology to tailor treatment decisions and improve patient outcomes.

Hence, trametinib constitutes a promising precision therapeutic approach for severe KRAS-related NOFs.

P1, N=364, Recruiting, Astellas Pharma Inc

Molecular docking against oncogenic targets (PIK3CA-E545K, ERBB4-Y1242C, KRAS-G13D, PIK3CA-H1047R, and ATM-A112V) identified meta- and para-substituted analogues (4b, 4c, and 4h) as the most favorable binders, while bulky ortho substituents reduced the affinity due to steric effects. Docking against PIK3CA-E545K produced binding energies that qualitatively paralleled several of the measured MCF-7 selectivity indices, with planar aromatic interactions and hydrophobic contacts defining the structure-activity relationships.

These findings underscore the high prevalence of KRAS mutations in Algerian CRC patients and highlight their potential utility in refining therapeutic strategies, particularly for anti-EGFR eligibility. The study provides the first regional dataset from Eastern Algeria, addressing a critical gap in North African oncogenomics.