Axitinib overcomes multiple imatinib resistant cKIT mutations including the gatekeeper mutation T670I in

Feiyang Liu1, Fengming Zou1, Cheng Chen2

  • 1High Magnetic Field Laboratory, Key Laboratory of High Magnetic Field and Ion Beam Physical Biology, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, P. R. China Precision Medicine Research Laboratory of Anhui Province, Hefei, Anhui, P. R. China.

Abstract

Insights

Axitinib shows potent activity against various KIT mutations in gastrointestinal stromal tumors (GISTs), including those resistant to current therapies. This suggests axitinib as a potential new treatment option for GIST patients.

Area of Science:

  • Oncology
  • Molecular Biology
  • Pharmacology

Background:

  • Gastrointestinal stromal tumors (GISTs) are driven by KIT kinase mutations.
  • Approved therapies like imatinib face limitations due to acquired resistance mutations in KIT.
  • Novel therapeutic strategies are needed to overcome treatment resistance in GIST.

Purpose of the Study:

  • To investigate the KIT inhibitory activity of axitinib in preclinical GIST models.
  • To evaluate axitinib's efficacy against primary and secondary KIT mutations.
  • To assess axitinib's potential as a treatment for GIST patients resistant to existing therapies.

Main Methods:

  • Assessed axitinib activity against wild-type and mutant KIT using protein-based assays.
  • Utilized engineered and GIST-derived cell lines to evaluate drug response.
  • Analyzed axitinib binding modes to KIT and its mutants.
  • Tested axitinib in GIST patient-derived primary cells and preclinical models.

Main Results:

  • Axitinib demonstrated potent inhibition of various primary and secondary KIT mutations.
  • Axitinib showed superior activity against certain KIT mutations compared to imatinib, sunitinib, and regorafenib.
  • Axitinib effectively inhibited imatinib-resistant KIT mutants (T670I, V654A) in vitro and in vivo.

Conclusions:

  • Axitinib exhibits significant anti-tumor activity in preclinical GIST models.
  • Results support the potential use of axitinib for GIST patients unresponsive or intolerant to current treatments.
  • Axitinib represents a promising therapeutic candidate for overcoming resistance in GIST.

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