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Testing Targeted Therapies in Cancer using Structural DNA Alteration Analysis and Patient-Derived Xenografts
Published on: July 25, 2020
A precision therapy against cancers driven by KIT/PDGFRA mutations
Erica K Evans1, Alexandra K Gardino1, Joseph L Kim1
1Blueprint Medicines, Cambridge, MA 02139, USA.
Abstract:
Targeting oncogenic kinase drivers with small-molecule inhibitors can have marked therapeutic benefit, especially when administered to an appropriate genomically defined patient population. Cancer genomics and mechanistic studies have revealed that heterogeneous mutations within a single kinase can result in various mechanisms of kinase activation. Therapeutic benefit to patients can best be optimized through an in-depth understanding of the disease-driving mutations combined with the ability to match these insights to tailored highly selective drugs. This rationale is presented for BLU-285, a clinical stage inhibitor of oncogenic KIT and PDGFRA alterations, including activation loop mutants that are ineffectively treated by current therapies. BLU-285, designed to preferentially interact with the active conformation of KIT and PDGFRA, potently inhibits activation loop mutants KIT D816V and PDGFRA D842V with subnanomolar potency and also inhibits other well-characterized disease-driving KIT mutants both in vitro and in vivo in preclinical models. Early clinical evaluation of BLU-285 in a phase 1 study has demonstrated marked activity in patients with diseases associated with KIT (aggressive systemic mastocytosis and gastrointestinal stromal tumor) and PDGFRA (gastrointestinal stromal tumor) activation loop mutations.
Insights
BLU-285, a novel small-molecule inhibitor, effectively targets oncogenic KIT and PDGFRA mutations, including difficult-to-treat activation loop mutants. Early clinical trials show promising therapeutic activity in patients with specific cancers driven by these mutations.
Area of Science:
- Oncology
- Molecular Biology
- Pharmacology
Background:
- Targeting oncogenic kinase drivers with small-molecule inhibitors offers therapeutic benefits in genomically defined cancer populations.
- Heterogeneous kinase mutations can activate cancer pathways through various mechanisms, necessitating tailored drug development.
- Understanding specific disease-driving mutations is crucial for optimizing patient treatment with selective drugs.
Purpose of the Study:
- To present the rationale and preclinical/clinical evaluation of BLU-285, a novel inhibitor targeting oncogenic KIT and PDGFRA alterations.
- To highlight BLU-285's potential in treating cancers with activation loop mutants of KIT and PDGFRA, which are often resistant to current therapies.
Main Methods:
- BLU-285 was designed to selectively inhibit the active conformation of KIT and PDGFRA.
- In vitro and in vivo preclinical models were used to assess the inhibition of various KIT mutants, including activation loop mutants.
- A Phase 1 clinical study evaluated the early safety and activity of BLU-285 in patients with relevant mutations.
Main Results:
- BLU-285 demonstrated potent inhibition of KIT D816V and PDGFRA D842V activation loop mutants with subnanomolar potency.
- The inhibitor effectively targeted other disease-driving KIT mutants in preclinical settings.
- Phase 1 clinical evaluation showed marked activity in patients with aggressive systemic mastocytosis and gastrointestinal stromal tumors harboring KIT or PDGFRA activation loop mutations.
Conclusions:
- BLU-285 is a potent inhibitor of oncogenic KIT and PDGFRA, including key activation loop mutants.
- The drug exhibits promising activity in early clinical studies for specific hematologic and solid tumors.
- BLU-285 represents a targeted therapeutic strategy for patients with cancers driven by KIT and PDGFRA alterations.
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