Targeting KRAS Mutant Non-Small-Cell Lung Cancer: Past, Present and Future

Lung cancer is the most frequent cancer with an aggressive clinical course and high mortality rates. Most cases are diagnosed at advanced stages when treatment options are limited and the efficacy of chemotherapy is poor. The disease has a complex and heterogeneous background with non-small-cell lung cancer (NSCLC) accounting for 85% of patients and lung adenocarcinoma being the most common histological subtype. Almost 30% of adenocarcinomas of the lung are driven by an activatingKirsten rat sarcoma viral oncogene homolog(KRAS) mutation. The ability to inhibit the oncogenicKRAShas been the holy grail of cancer research and the search for inhibitors is immensely ongoing asKRAS-mutated tumors are among the most aggressive and refractory to treatment. Therapeutic strategies tailored forKRAS(+)NSCLC rely on the blockage of KRAS functional output, cellular dependencies, metabolic features, KRAS membrane associations, direct targeting ofKRASand immunotherapy. In this review, we provide an update on the most recent advances in anti-KRAS therapy for lung tumors with mechanistic insights into biological diversity and potential clinical implications.