Tipifarnib is the only targeted therapy breakthrough for
HRAS-mutant (
HRASmt) recurrent or metastatic head and neck squamous cell carcinoma (HNSCC). The molecular profiles of
HRASmt cancers are difficult to explore given the low frequency of
HRASmt. This study
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Tipifarnib is the only targeted therapy breakthrough for
HRAS-mutant (
HRASmt) recurrent or metastatic head and neck squamous cell carcinoma (HNSCC). The molecular profiles of
HRASmt cancers are difficult to explore given the low frequency of
HRASmt. This study aims to understand the molecular co-alterations, immune profiles, and clinical outcomes of 524
HRASmt solid tumors including urothelial carcinoma (UC), breast cancer (BC), non-small-cell lung cancer (NSCLC), melanoma, and HNSCC.
HRASmt was most common in UC (3.0%), followed by HNSCC (2.82%), melanoma (1.05%), BC (0.45%), and NSCLC (0.44%).
HRASmt was absent in Her2+ BC regardless of hormone receptor status.
HRASmt was more frequently associated with squamous compared to non-squamous NSCLC (60% vs. 40% in
HRASwt,
p = 0.002). The tumor microenvironment (TME) of
HRASmt demonstrated increased M1 macrophages in triple-negative BC (TNBC), HNSCC, squamous NSCLC, and UC; increased M2 macrophages in TNBC; and increased CD8+ T-cells in HNSCC (all
p < 0.05). Finally,
HRASmt was associated with shorter overall survival in HNSCC (HR: 1.564, CI: 1.16–2.11,
p = 0.003) but not in the other cancer types examined. In conclusion, this study provides new insights into the unique molecular profiles of
HRASmt tumors that may help to identify new targets and guide future clinical trial design.
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