Evidence map›Paper›PMID 41899524›Full record

ArticleCancers2026

The Combination of a BCL-xL PROTAC and an mTOR Inhibitor Sensitizes Pancreatic Ductal Adenocarcinoma to KRAS

Javed Miyan, Vignesh Vudatha, Lin Cao, Peiyi Zhang, Guangrong Zheng, Lei Zheng, Jose Trevino, Daohong Zhou, Sajid Khan

Abstract read
In one paragraph

Article in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Javed MiyanDepartment of Biochemistry & Structural Biology, UT Health San Antonio, The University of Texas at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
Vignesh VudathaDepartment of Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA.ORCID 0000-0002-3624-3771
Lin CaoDepartment of Biochemistry & Structural Biology, UT Health San Antonio, The University of Texas at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
Peiyi ZhangDepartment of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA.
Guangrong ZhengDepartment of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA.ORCID 0000-0002-8106-6663
Lei ZhengMays Cancer Center, UT Health San Antonio, The University of Texas at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.
Jose TrevinoDepartment of Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA.
Daohong ZhouDepartment of Biochemistry & Structural Biology, UT Health San Antonio, The University of Texas at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.ORCID 0000-0002-2400-6461
Sajid KhanDepartment of Biochemistry & Structural Biology, UT Health San Antonio, The University of Texas at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.ORCID 0000-0003-1331-8846

Funding

Use of BCL-xL Proteolysis targeting chimeras to treat pancreatic cancerR01CA242003 · NCI · UNIVERSITY OF FLORIDA · PI TREVINO, JOSE G., ZHENG, GUANGRONG · 2019 to 2023
$2.6M
American Cancer Society (ACS)-Institutional Research Grant n/aMays Cancer Center at UT Health San Antonio n/aMike-Hogg Fund N/ANCI NIH HHS R01 CA242003William and Ella Owens Medical Foundation Grant n/a
6 · The paper itself

Abstract

BACKGROUND/

objectivesPancreatic ductal adenocarcinoma (PDAC) is a highly aggressive cancer with a five-year survival rate of approximately 13%, partly because of limited treatment options and resistance to therapies. Although the recently discovered KRAS G12D inhibitor MRTX1133 has shown promising efficacy in preclinical models, its clinical efficacy as a single agent is expected to be limited, as is the case with KRAS G12C inhibitors. Therefore, in this study, we evaluated potential combination strategies to enhance the therapeutic effect of MRTX1133. We combined MRTX1133 with the BCL-xL proteolysis-targeting chimera (PROTAC) DT2216 and the mTOR inhibitor everolimus.

methodsThe sensitization of MRTX1133 by the combination of DT2216 + everolimus was tested in KRAS G12D-mutant PDAC cell lines using colony formation and apoptosis assays. The effects of MRTX1133 and/or DT2216 + everolimus on KRAS signaling and BCL-2 family proteins were assessed by immunoblotting and/or RT-PCR. The functional roles of BIM/NOXA were elucidated via immunoprecipitation (IP) and siRNA knockdown. Triple combination efficacy was evaluated in AsPC1 parental and MRTX1133-resistant xenografts, with pharmacodynamic effects confirmed by immunoblotting and immunohistochemistry.

resultsThe triple combination leads to significantly greater colony growth inhibition and apoptosis induction as compared with single agents or two-drug combinations in multiple KRAS G12D-mutant PDAC cell lines. Mechanistically, MRTX1133 treatment increased BIM and decreased NOXA levels, and the combination of DT2216/everolimus simultaneously enhanced BIM release and stabilized NOXA. In vivo, DT2216/everolimus combination significantly potentiated the anti-tumor activity of MRTX1133 in the AsPC1 PDAC xenograft model. Furthermore, the triple combination effectively overcame acquired MRTX1133 resistance in vitro and in the AsPC1 xenograft model.

conclusionsCollectively, our findings suggest that the combination of DT2216/everolimus potentiates the anti-tumor efficacy of MRTX1133 associated with enhanced apoptosis induction and inhibition of compensatory survival signaling.

Indexed as

apoptosisBCL-xLDrug resistanceKRAS G12DmTORpancreatic ductal adenocarcinoma (PDAC)PROTAC

Identifiers

PMID41899524
PMCPMC13025216

What Socratic holds

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LicenceCC BY
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.