Evidence map›Paper›PMID 40849341›Full record

ArticleScientific reports2025

The RASAL2 variant promotes aberrant RAS signaling and resistance to anti-EGFR therapy in colorectal cancer.

Yu-Min Yeh, Yi-Hsuan Hsu, Yi-Ting Huang, Peng-Chan Lin, Ya-Ting Hsu, Pei-Ying Wu, Meng-Ru Shen

Abstract read
In one paragraph

Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Yu-Min YehDepartment of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Yi-Hsuan HsuDepartment of Pharmacology, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan.
Yi-Ting HuangDepartment of Pharmacology, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan.
Peng-Chan LinDepartment of Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Ya-Ting HsuInstitute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Pei-Ying WuDepartment of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Meng-Ru ShenDepartment of Pharmacology, College of Medicine, National Cheng Kung University, Tainan, 701, Taiwan. mrshen@mail.ncku.edu.tw.

Funding

Ministry of Health and Welfare MOHW-114-TDU-B-221-144005National Science and Technology Council 113-2640-B-006-004
6 · The paper itself

Abstract

Anti-EGFR monoclonal antibodies are essential for metastatic colorectal cancer (CRC) treatment, however, resistance remains problematic in KRAS/NRAS/BRAF wild-type patients. RAS protein activator-like 2 (RASAL2) regulates RAS signaling by catalyzing the conversion of RAS. This study investigates the pathogenicity of the germline RASAL2 c.2423 A > G variant, identified in a high-risk family, and its potential role in CRC progression and therapy resistance. Population analysis reveals its rarity in East Asians (0.01%) but an increased prevalence in Taiwanese CRC patients (1.63%). Functional studies demonstrate that RASAL2 c.2423 A > G enhances RAS signaling, causing sustained ERK phosphorylation and increased CRC cell proliferation. Additionally, RASAL2-mutant cells require higher doses of cetuximab for ERK suppression and growth inhibition, indicating resistance to anti-EGFR therapy via abnormal RAS activation. According to the American College of Medical Genetics and Genomics criteria, the variant is likely pathogenic. Our study highlights RASAL2 c.2423 A > G as a potential biomarker for CRC risk and therapy response.

Indexed as

Colorectal NeoplasmsDrug Resistance, NeoplasmGTPase-Activating Proteinsras ProteinsCell Line, TumorCell ProliferationCetuximabErbB ReceptorsFemaleHumansMaleMiddle AgedSignal TransductionCetuximabEGFR protein, humanErbB ReceptorsGTPase-Activating ProteinsRASAL2 protein, humanras ProteinsAnti-EGFRColorectal cancerGermline variantPathogenicRASAL2RAS signalingResistance

Identifiers

PMID40849341
PMCPMC12375080

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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 OpenQuestion graph.