Noncovalent Mutant
Selective Epidermal Growth Factor
Receptor Inhibitors: A Lead Optimization Case Study
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Abstract
Because
of their increased activity against activating mutants,
first-generation epidermal growth factor receptor (EGFR) kinase inhibitors
have had remarkable success in treating non-small-cell lung cancer
(NSCLC) patients, but acquired resistance, through a secondary mutation
of the gatekeeper residue, means that clinical responses only last
for 8–14 months. Addressing this unmet medical need requires
agents that can target both of the most common double mutants: T790M/L858R
(TMLR) and T790M/del(746-750) (TMdel). Herein we describe how a noncovalent
double mutant selective lead compound was optimized using a strategy
focused on the structure-guided increase in potency without added
lipophilicity or reduction of three-dimensional character. Following
successive rounds of design and synthesis it was discovered that cis-fluoro
substitution on 4-hydroxy- and 4-methoxypiperidinyl groups provided
synergistic, substantial, and specific potency gain through direct
interaction with the enzyme and/or effects on the proximal ligand
oxygen atom. Further development of the fluorohydroxypiperidine series
resulted in the identification of a pair of diastereomers that showed
50-fold enzyme and cell based selectivity for T790M mutants over wild-type
EGFR (wtEGFR) in vitro and pathway knock-down in an in vivo xenograft
model