Tackling Crizotinib Resistance: The Pathway from Drug Discovery to the Pediatric Clinic
Elizabeth R Tucker1, Laura S Danielson1, Paolo Innocenti2
1Paediatric Solid Tumour Biology and Therapeutics Team, Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom.
Abstract:
Neuroblastoma is a childhood malignancy that has not yet benefitted from the rapid progress in the development of small-molecule therapeutics for cancer. An opportunity to take advantage of pharmaceutical innovation in this area arose when the identification of ALK fusion proteins in non-small cell lung cancer (NSCLC) occurred in parallel to the discovery of point mutations of ALK in neuroblastomas. ALK is now known to be a marker of poor outcome in neuroblastoma, and therefore, urgent development of specific ALK inhibitors to treat this devastating disease is a necessity. However, the translation of small molecules from adult directly into pediatric practice has thus far been challenging, due to mutation-specific structural variances in the ALK kinase domain. We discuss how the most recent structural and biological characterizations of ALK are directing preclinical and clinical studies of ALK inhibitors for both NSCLC and neuroblastoma.
Insights
Neuroblastoma, a childhood cancer, needs new treatments. Researchers are developing ALK inhibitors, inspired by lung cancer drugs, to target this disease, overcoming challenges in pediatric drug development.
Area of Science:
- Oncology
- Pharmacology
- Pediatric Medicine
Background:
- Neuroblastoma remains a challenging childhood cancer with limited therapeutic advancements.
- Anaplastic Lymphoma Kinase (ALK) mutations are identified as a poor prognostic marker in neuroblastoma.
Purpose of the Study:
- To explore the development of ALK inhibitors for neuroblastoma treatment.
- To address challenges in translating adult cancer therapeutics to pediatric applications.
Main Methods:
- Reviewing structural and biological characterizations of ALK.
- Analyzing ALK inhibitor studies in non-small cell lung cancer (NSCLC) and neuroblastoma.
Main Results:
- ALK is a critical target for neuroblastoma therapy.
- Structural variances in ALK kinase domain pose challenges for direct translation of adult drugs.
Conclusions:
- Recent ALK characterizations are guiding preclinical and clinical development of targeted therapies.
- Development of specific ALK inhibitors is crucial for treating neuroblastoma.
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