Ontology highlight
ABSTRACT: Unlabelled
First-generation EGFR tyrosine kinase inhibitors (EGFR TKI) provide significant clinical benefit in patients with advanced EGFR-mutant (EGFRm(+)) non-small cell lung cancer (NSCLC). Patients ultimately develop disease progression, often driven by acquisition of a second T790M EGFR TKI resistance mutation. AZD9291 is a novel oral, potent, and selective third-generation irreversible inhibitor of both EGFRm(+) sensitizing and T790M resistance mutants that spares wild-type EGFR. This mono-anilino-pyrimidine compound is structurally distinct from other third-generation EGFR TKIs and offers a pharmacologically differentiated profile from earlier generation EGFR TKIs. Preclinically, the drug potently inhibits signaling pathways and cellular growth in both EGFRm(+) and EGFRm(+)/T790M(+) mutant cell lines in vitro, with lower activity against wild-type EGFR lines, translating into profound and sustained tumor regression in EGFR-mutant tumor xenograft and transgenic models. The treatment of 2 patients with advanced EGFRm(+) T790M(+) NSCLC is described as proof of principle.Significance
We report the development of a novel structurally distinct third-generation EGFR TKI, AZD9291, that irreversibly and selectively targets both sensitizing and resistant T790M(+) mutant EGFR while harboring less activity toward wild-type EGFR. AZD9291 is showing promising responses in a phase I trial even at the first-dose level, with first published clinical proof-of-principle validation being presented.
SUBMITTER: Cross DA
PROVIDER: S-EPMC4315625 | biostudies-literature | 2014 Sep
REPOSITORIES: biostudies-literature
Cross Darren A E DA Ashton Susan E SE Ghiorghiu Serban S Eberlein Cath C Nebhan Caroline A CA Spitzler Paula J PJ Orme Jonathon P JP Finlay M Raymond V MR Ward Richard A RA Mellor Martine J MJ Hughes Gareth G Rahi Amar A Jacobs Vivien N VN Red Brewer Monica M Ichihara Eiki E Sun Jing J Jin Hailing H Ballard Peter P Al-Kadhimi Katherine K Rowlinson Rachel R Klinowska Teresa T Richmond Graham H P GH Cantarini Mireille M Kim Dong-Wan DW Ranson Malcolm R MR Pao William W
Cancer discovery 20140603 9
<h4>Unlabelled</h4>First-generation EGFR tyrosine kinase inhibitors (EGFR TKI) provide significant clinical benefit in patients with advanced EGFR-mutant (EGFRm(+)) non-small cell lung cancer (NSCLC). Patients ultimately develop disease progression, often driven by acquisition of a second T790M EGFR TKI resistance mutation. AZD9291 is a novel oral, potent, and selective third-generation irreversible inhibitor of both EGFRm(+) sensitizing and T790M resistance mutants that spares wild-type EGFR. T ...[more]