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RAS mutations in cutaneous squamous-cell carcinomas in patients treated with BRAF inhibitors.


ABSTRACT: Cutaneous squamous-cell carcinomas and keratoacanthomas are common findings in patients treated with BRAF inhibitors.We performed a molecular analysis to identify oncogenic mutations (HRAS, KRAS, NRAS, CDKN2A, and TP53) in the lesions from patients treated with the BRAF inhibitor vemurafenib. An analysis of an independent validation set and functional studies with BRAF inhibitors in the presence of the prevalent RAS mutation was also performed.Among 21 tumor samples, 13 had RAS mutations (12 in HRAS). In a validation set of 14 samples, 8 had RAS mutations (4 in HRAS). Thus, 60% (21 of 35) of the specimens harbored RAS mutations, the most prevalent being HRAS Q61L. Increased proliferation of HRAS Q61L-mutant cell lines exposed to vemurafenib was associated with mitogen-activated protein kinase (MAPK)-pathway signaling and activation of ERK-mediated transcription. In a mouse model of HRAS Q61L-mediated skin carcinogenesis, the vemurafenib analogue PLX4720 was not an initiator or a promoter of carcinogenesis but accelerated growth of the lesions harboring HRAS mutations, and this growth was blocked by concomitant treatment with a MEK inhibitor.Mutations in RAS, particularly HRAS, are frequent in cutaneous squamous-cell carcinomas and keratoacanthomas that develop in patients treated with vemurafenib. The molecular mechanism is consistent with the paradoxical activation of MAPK signaling and leads to accelerated growth of these lesions. (Funded by Hoffmann-La Roche and others; ClinicalTrials.gov numbers, NCT00405587, NCT00949702, NCT01001299, and NCT01006980.).

SUBMITTER: Su F 

PROVIDER: S-EPMC3724537 | biostudies-literature | 2012 Jan

REPOSITORIES: biostudies-literature

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RAS mutations in cutaneous squamous-cell carcinomas in patients treated with BRAF inhibitors.

Su Fei F   Viros Amaya A   Milagre Carla C   Trunzer Kerstin K   Bollag Gideon G   Spleiss Olivia O   Reis-Filho Jorge S JS   Kong Xiangju X   Koya Richard C RC   Flaherty Keith T KT   Chapman Paul B PB   Kim Min Jung MJ   Hayward Robert R   Martin Matthew M   Yang Hong H   Wang Qiongqing Q   Hilton Holly H   Hang Julie S JS   Noe Johannes J   Lambros Maryou M   Geyer Felipe F   Dhomen Nathalie N   Niculescu-Duvaz Ion I   Zambon Alfonso A   Niculescu-Duvaz Dan D   Preece Natasha N   Robert Lídia L   Otte Nicholas J NJ   Mok Stephen S   Kee Damien D   Ma Yan Y   Zhang Chao C   Habets Gaston G   Burton Elizabeth A EA   Wong Bernice B   Nguyen Hoa H   Kockx Mark M   Andries Luc L   Lestini Brian B   Nolop Keith B KB   Lee Richard J RJ   Joe Andrew K AK   Troy James L JL   Gonzalez Rene R   Hutson Thomas E TE   Puzanov Igor I   Chmielowski Bartosz B   Springer Caroline J CJ   McArthur Grant A GA   Sosman Jeffrey A JA   Lo Roger S RS   Ribas Antoni A   Marais Richard R  

The New England journal of medicine 20120101 3


<h4>Background</h4>Cutaneous squamous-cell carcinomas and keratoacanthomas are common findings in patients treated with BRAF inhibitors.<h4>Methods</h4>We performed a molecular analysis to identify oncogenic mutations (HRAS, KRAS, NRAS, CDKN2A, and TP53) in the lesions from patients treated with the BRAF inhibitor vemurafenib. An analysis of an independent validation set and functional studies with BRAF inhibitors in the presence of the prevalent RAS mutation was also performed.<h4>Results</h4>A  ...[more]

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