1 research outputs found
Discovery of a Potent and Selective EGFR Inhibitor (AZD9291) of Both Sensitizing and T790M Resistance Mutations That Spares the Wild Type Form of the Receptor
Epidermal growth factor receptor
(EGFR) inhibitors have been used clinically in the treatment of non-small-cell
lung cancer (NSCLC) patients harboring sensitizing (or activating)
mutations for a number of years. Despite encouraging clinical efficacy
with these agents, in many patients resistance develops leading to
disease progression. In most cases, this resistance is in the form
of the T790M mutation. In addition, EGFR wild type receptor inhibition
inherent with these agents can lead to dose limiting toxicities of
rash and diarrhea. We describe herein the evolution of an early, mutant
selective lead to the clinical candidate AZD9291, an irreversible
inhibitor of both EGFR sensitizing (EGFRm+) and T790M resistance mutations
with selectivity over the wild type form of the receptor. Following
observations of significant tumor inhibition in preclinical models,
the clinical candidate was administered clinically to patients with
T790M positive EGFR-TKI resistant NSCLC and early efficacy has been
observed, accompanied by an encouraging safety profile