Department of Cancer Biology, Dana-Farber Cancer Institute, 44 Binney Street, Boston, Massachusetts 02115, USA.
Nature. 2009 Dec 24;462(7276):1070-4. doi: 10.1038/nature08622.
The clinical efficacy of epidermal growth factor receptor (EGFR) kinase inhibitors in EGFR-mutant non-small-cell lung cancer (NSCLC) is limited by the development of drug-resistance mutations, including the gatekeeper T790M mutation. Strategies targeting EGFR T790M with irreversible inhibitors have had limited success and are associated with toxicity due to concurrent inhibition of wild-type EGFR. All current EGFR inhibitors possess a structurally related quinazoline-based core scaffold and were identified as ATP-competitive inhibitors of wild-type EGFR. Here we identify a covalent pyrimidine EGFR inhibitor by screening an irreversible kinase inhibitor library specifically against EGFR T790M. These agents are 30- to 100-fold more potent against EGFR T790M, and up to 100-fold less potent against wild-type EGFR, than quinazoline-based EGFR inhibitors in vitro. They are also effective in murine models of lung cancer driven by EGFR T790M. Co-crystallization studies reveal a structural basis for the increased potency and mutant selectivity of these agents. These mutant-selective irreversible EGFR kinase inhibitors may be clinically more effective and better tolerated than quinazoline-based inhibitors. Our findings demonstrate that functional pharmacological screens against clinically important mutant kinases represent a powerful strategy to identify new classes of mutant-selective kinase inhibitors.
表皮生长因子受体 (EGFR) 激酶抑制剂在 EGFR 突变型非小细胞肺癌 (NSCLC) 中的临床疗效受到耐药突变的限制,包括守门人 T790M 突变。针对 EGFR T790M 的不可逆抑制剂的策略虽然取得了一定的成功,但由于同时抑制野生型 EGFR,因此存在毒性。所有目前的 EGFR 抑制剂都具有结构相关的喹唑啉核心骨架,被鉴定为野生型 EGFR 的 ATP 竞争性抑制剂。在这里,我们通过针对 EGFR T790M 特异性筛选不可逆激酶抑制剂文库,鉴定出一种共价嘧啶 EGFR 抑制剂。这些药物在体外对 EGFR T790M 的活性比基于喹唑啉的 EGFR 抑制剂高 30 至 100 倍,对野生型 EGFR 的活性低 100 倍。它们在由 EGFR T790M 驱动的肺癌小鼠模型中也有效。共结晶研究揭示了这些药物增加效力和突变体选择性的结构基础。与基于喹唑啉的抑制剂相比,这些突变体选择性不可逆 EGFR 激酶抑制剂可能在临床上更有效且耐受性更好。我们的研究结果表明,针对临床重要突变激酶的功能药理学筛选代表了一种识别新型突变体选择性激酶抑制剂的强大策略。