# Understanding and harnessing immune-modulatory effects of covalent KRASG12C inhibitors in KRASG12C-mutant non-small cell lung cancer

> **NIH NIH R01** · UNIVERSITY OF TX MD ANDERSON CAN CTR · 2021 · $370,575

## Abstract

PROJECT SUMMARY/ABSTRACT
Oncogenic KRASG12C (KG12C) mutations underpin the development of ~13% of non-squamous non-small cell lung
cancer (NSCLC) and account for ~10,000 deaths annually in the U.S. The development of potent, selective and
clinically active covalent inhibitors of the KG12C oncoprotein represents one of the most exciting recent advances
in the field of targeted cancer therapy, yet strategies to circumvent the development of adaptive resistance and
improve the durability of individual responses to KG12C inhibitors are urgently needed in order to transform clinical
outcomes for patients. In addition to their tumor cell-intrinsic effects, KG12C inhibitors recondition the tumor
immune microenvironment in preclinical models and synergize with anti-PD-1 therapy to promote long-term
tumor regressions and immunological memory. The mechanisms that underpin KG12C inhibitor-triggered immune
pathway activation in KG12C NSCLC are poorly understood. Furthermore, the optimal combinations of KG12C
inhibitors with standard of care (SOC) first-line NSCLC systemic therapies including platinum-doublet
chemotherapy, PD-1 inhibitor monotherapy and chemo-immunotherapy in order to maximize antitumor immunity
have not been established. Furthermore, the impact of co-occurring genomic alterations in STK11/LKB1, KEAP1,
TP53 and RBM10 – that shape the immune contexture of KRAS-mutant NSCLC and modify its response to PD-
1 axis blockade – on the clinical efficacy and immunological sequelae of KG12C inhibitor-based therapeutic
combinations has not been systematically examined. Based on our preliminary findings and previous work we
hypothesize that: 1. Induction of immunogenic cell death contributes to KG12C inhibitor-triggered immune pathway
activation in KG12C NSCLC; 2. KG12C inhibitors exhibit immune-sensitizing effects that can be further enhanced
with the addition of chemotherapy and/or immune checkpoint inhibitors (ICI); 3. Co-occurring genomic alterations
impact both clinical and immunological responses to KG12C inhibitor mono- and combination therapy in KG12C
NSCLC. In Aim 1, we will dissect mechanisms and molecular determinants of KG12C inhibitor-mediated immune
sensitization in KG12C NSCLC. In Aim 2, we will evaluate synergistic KG12C inhibitor interactions with standard of
care first-line systemic therapies (including platinum-doublet chemotherapy, PD-(L)1 inhibitor monotherapy and
chemo-immunotherapy) in immune-competent mouse models of KG12C-mutant NSCLC. In Aim 3, we will validate
treatment-induced changes in the KG12C NSCLC immune contexture at whole-tumor and single-cell resolution
using clinical samples from patients with surgically resected KG12C NSCLC who were treated with neo-adjuvant
AMG 510 in combination with platinum-doublet chemotherapy in an investigator-initiated phase 2 clinical trial.
Clinical significance: This work will yield fresh insights into mechanisms and determinants of immune pathway
activation in response to KG12C inhibitor ...

## Key facts

- **NIH application ID:** 10276919
- **Project number:** 1R01CA262469-01
- **Recipient organization:** UNIVERSITY OF TX MD ANDERSON CAN CTR
- **Principal Investigator:** Ferdinandos Skoulidis
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $370,575
- **Award type:** 1
- **Project period:** 2021-09-01 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10276919

## Citation

> US National Institutes of Health, RePORTER application 10276919, Understanding and harnessing immune-modulatory effects of covalent KRASG12C inhibitors in KRASG12C-mutant non-small cell lung cancer (1R01CA262469-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10276919. Licensed CC0.

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