Paradox-Breaker Pan-RAF Inhibitors Induce an AML-Specific Cytotoxic Response and Synergize with Venetoclax to Display Superior Antileukemic Activity

The RAS-RAF-MEK-ERK (MAPK) pathway is deregulated in many cancers including acute myeloid leukemia (AML), where it facilitates cancer progression, chemo-resistance and cancer relapse. Therefore, the inhibition of this pathway has been explored for the treatment of AML, especially in the ~10% of AML cases where the leukemic cells carry activating mutations of the NRAS or KRAS oncogenes. However, MEK inhibitors, the best explored class of MAPK inhibitors, have not proven effective in the clinical setting. A novel clinically investigated drug class in this context are the paradox-breaker pan-RAF inhibitors that prevent the reactivation of the MAPK-pathway and have exhibited single agent efficacy in preclinical testing for solid cancers. Therefore, it is relevant to explore the utility of this class of drugs for AML treatment.