1. Academic Validation
  2. 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

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

  • J Med Chem. 2014 Oct 23;57(20):8249-67. doi: 10.1021/jm500973a.
M Raymond V Finlay 1 Mark Anderton Susan Ashton Peter Ballard Paul A Bethel Matthew R Box Robert H Bradbury Simon J Brown Sam Butterworth Andrew Campbell Christopher Chorley Nicola Colclough Darren A E Cross Gordon S Currie Matthew Grist Lorraine Hassall George B Hill Daniel James Michael James Paul Kemmitt Teresa Klinowska Gillian Lamont Scott G Lamont Nathaniel Martin Heather L McFarland Martine J Mellor Jonathon P Orme David Perkins Paula Perkins Graham Richmond Peter Smith Richard A Ward Michael J Waring David Whittaker Stuart Wells Gail L Wrigley
Affiliations

Affiliation

  • 1 Oncology Innovative Medicines, ‡Drug Safety and Metabolism, §Global Medicines Development, and ∥Discovery Sciences, AstraZeneca , Mereside, Alderley Park, Macclesfield, Cheshire SK10 4TG, U.K.
Abstract

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.

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