KRAS是癌症中最常见的突变癌基因。特别是在各种癌症和腺癌中，缔合物12的活化突变，尤其是G12D，具有最高的患病率。随着KRAS-G12D抑制剂进入临床试验，了解KRAS-G12D癌症的生物学，以及识别预测治疗反应的生物标志物至关重要。在本综述中，我们讨论了KRAS-G12D腺癌的基因组学和生物学，包括组织学特征、转录组景观、免疫微环境，以及这些因素如何影响治疗反应。此外，我们探索了使用新型G12D抑制剂的潜在治疗策略，利用G12C抑制剂的临床试验所获得的知识。版权所有©2023作者。由Elsevier Inc.发表。保留所有权利。

KRAS is the most frequently mutated oncogene in cancer. Activating mutations in codon 12, especially G12D, have the highest prevalence across a range of carcinomas and adenocarcinomas. With inhibitors to KRAS-G12D now entering clinical trials, understanding the biology of KRAS-G12D cancers, and identifying biomarkers that predict therapeutic response is crucial. In this Review, we discuss the genomics and biology of KRAS-G12D adenocarcinomas, including histological features, transcriptional landscape, the immune microenvironment, and how these factors influence response to therapy. Moreover, we explore potential therapeutic strategies using novel G12D inhibitors, leveraging knowledge gained from clinical trials using G12C inhibitors.Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.