New method of targeting mutant RAS provides hope for cancer patients

As a 10-year journey comes to fruition, MUSC Hollings Cancer Center researcher John O’Bryan, Ph.D., and colleagues have demonstrated a new therapeutic way to block a protein that is frequently mutated in cancers. These proof-of-principle findings were published on Feb. 8 in Cell Reports. This work, which involves inhibiting the oncogenic protein RAS using small molecules, lays a strong foundation for the development of clinical anti-cancer therapies.

The American Cancer Society estimates that 1.9 million new cancer cases will be diagnosed this year. Based on the urgent need for more effective therapies, researchers are always on the search for elusive treatments that can affect many cancers.

O’Bryan, who is a professor in the Department of Cell and Molecular Pharmacology and Experimental Therapeutics at the Medical University of South Carolina, said, “RAS is one of the most central and critical regulators of cell proliferation, and it is also the most mutated in cancers. Mutated RAS drives the growth of tumors. This makes it an attractive therapeutic target.”

The RAS family of proteins are mutated in nearly 20% of human tumors; however, there has been little progress in drug development for this target. “Think of RAS as a slick ball that does not let anything bind to it. Until recently, it was thought that mutant RAS could not be targeted with drugs. Now there is one FDA-approved drug for mutant RAS in lung cancer, which demonstrates that it is possible to target mutant RAS in some cases,” said O’Bryan.

The new drug sotorasib targets a mutant form of RAS that only occurs in less than 3% of all human cancers, so the new drug is not very useful across multiple types of cancers, O’Bryan said. His new method of therapeutically targeting mutant RAS is more promising because it has the potential to work with numerous mutant forms of RAS in multiple cancers.

“Pancreatic, lung and colorectal cancers are three of the four most deadly cancers, and their growth is driven by mutations in RAS proteins. Therefore, successfully targeting mutant RAS has big implications for patients,” said O’Bryan.

The challenge with targeting RAS is due to the way it functions. It has “on” and “off” states that are regulated by binding to other molecules called nucleotides. There is also a third state called the nucleotide-free state when it is switching between on and off modes. However, RAS proteins are in their nucleotide-free states for such short amounts of time that it was previously thought that RAS could not be targeted during this very short-lived state.

O’Bryan’s collaborator Shohei Koide, Ph.D., from the Perlmutter Cancer Center at New York University, developed the monobody technology that overcomes the challenges with targeting nucleotide-free RAS. Monobodies are small synthetic binding proteins that can be designed to attach to cellular targets inside or outside of cells. Previously, targeting nucleotide-free RAS mutants was thought to be an impossible undertaking.

Targeting nucleotide-free RAS with the R15 monobody has allowed the researchers to understand RAS biochemistry more fully and discover opportunities to disrupt its cancer-promoting activity. Using a mixture of biochemistry techniques, cell culture work and animal models, they found that the R15 monobody blocks multiple forms of RAS mutants.

“We were surprised to find that many RAS mutants unlock nucleotides, and the R15 monobody can block these,” said O’Bryan. “It is a good sign that more than 50% of oncogenic RAS mutants may be susceptible to inhibitors binding nucleotide-free RAS. This makes targeting nucleotide-free RAS a viable approach for inhibiting many mutant RAS-driven tumors.”

There is often serendipity in a research career, O’Bryan said. “We got stuck by our early data because it did not make immediate sense. However, it turned out to be an exciting finding. There is a skill in discerning between insignificant artifacts in the data and something novel that is real discovery.”

This work provides a framework for other groups to target RAS in more effective ways. “The RAS protein, which was considered undruggable, is in fact able to be targeted by drugs,” said O’Bryan.

The researchers are very hopeful that this discovery can be used more comprehensively in the future. While cancers do adapt and mutate to become resistant to therapeutics, new drugs based on this concept might serve as additional tools in the arsenal to treat cancer, he said.

The next step in the journey will be to find small molecules in MUSC’s compound library that can be used to target mutant RAS in the same way as the R15 monobody. Since the R15 monobody cannot easily get into cells, O’Bryan explained that a small molecule targeting nucleotide-free mutant RAS proteins will be a more effective therapy.

“We are at a really good stage to exploit this mechanism,” said O’Bryan. “MUSC and Hollings have a really great culture of collaboration, which has helped to push this project forward. MUSC’s access to the massive library of small molecules helps to provide a lot of chemical diversity and intellectual property potential.”

The researchers feel that this research reveals a new window of opportunity for the development of novel anti-cancer agents necessary to improve patient outcomes.

_______________________________________________________________________________________________________________________________________________________

Funding for this project was provided by: NCI P30 CA138313, NCI R01CA212608, Department of Veterans Affairs MERIT Award 1I01BX002095

###

About MUSC

Founded in 1824 in Charleston, MUSC is the oldest medical school in the South as well as the state’s only integrated academic health sciences center with a unique charge to serve the state through education, research and patient care. Each year, MUSC educates and trains more than 3,000 students and nearly 800 residents in six colleges: Dental Medicine, Graduate Studies, Health Professions, Medicine, Nursing and Pharmacy. The state’s leader in obtaining biomedical research funds, in fiscal year 2019, MUSC set a new high, bringing in more than $284 million. For information on academic programs, visit musc.edu.

As the clinical health system of the Medical University of South Carolina, MUSC Health is dedicated to delivering the highest quality patient care available while training generations of competent, compassionate health care providers to serve the people of South Carolina and beyond. Comprising some 1,600 beds, more than 100 outreach sites, the MUSC College of Medicine, the physicians’ practice plan and nearly 275 telehealth locations, MUSC Health owns and operates eight hospitals situated in Charleston, Chester, Florence, Lancaster and Marion counties. In 2020, for the sixth consecutive year, U.S. News & World Report named MUSC Health the No. 1 hospital in South Carolina. To learn more about clinical patient services, visit muschealth.org.

MUSC and its affiliates have collective annual budgets of $3.2 billion. The more than 17,000 MUSC team members include world-class faculty, physicians, specialty providers and scientists who deliver groundbreaking education, research, technology and patient care

About MUSC Hollings Cancer Center

MUSC Hollings Cancer Center is a National Cancer Institute-designated cancer center and the largest academic-based cancer research program in South Carolina. The cancer center comprises more than 100 faculty cancer scientists and 20 academic departments. It has an annual research funding portfolio of more than $44 million and a dedication to reducing the cancer burden in South Carolina. Hollings offers state-of-the-art diagnostic capabilities, therapies and surgical techniques within multidisciplinary clinics that include surgeons, medical oncologists, radiation therapists, radiologists, pathologists, psychologists and other specialists equipped for the full range of cancer care, including more than 200 clinical trials. For more information, visit hollingscancercenter.musc.edu.