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Expanding control of the tumor cell cycle with a CDK2/4/6 inhibitor
Kevin Freeman-Cook1, Robert L Hoffman1, Nichol Miller1
1Pfizer Global Research and Development La Jolla, 10770 Science Center Drive, San Diego, CA 92121, USA.
Abstract:
The CDK4/6 inhibitor, palbociclib (PAL), significantly improves progression-free survival in HR+/HER2- breast cancer when combined with anti-hormonals. We sought to discover PAL resistance mechanisms in preclinical models and through analysis of clinical transcriptome specimens, which coalesced on induction of MYC oncogene and Cyclin E/CDK2 activity. We propose that targeting the G1 kinases CDK2, CDK4, and CDK6 with a small-molecule overcomes resistance to CDK4/6 inhibition. We describe the pharmacodynamics and efficacy of PF-06873600 (PF3600), a pyridopyrimidine with potent inhibition of CDK2/4/6 activity and efficacy in multiple in vivo tumor models. Together with the clinical analysis, MYC activity predicts (PF3600) efficacy across multiple cell lineages. Finally, we find that CDK2/4/6 inhibition does not compromise tumor-specific immune checkpoint blockade responses in syngeneic models. We anticipate that (PF3600), currently in phase 1 clinical trials, offers a therapeutic option to cancer patients in whom CDK4/6 inhibition is insufficient to alter disease progression.
Insights
Palbociclib resistance in breast cancer involves MYC and Cyclin E/CDK2. A new drug, PF-06873600, targets CDK2/4/6 to overcome this resistance, showing promise in preclinical models.
Area of Science:
- Oncology
- Molecular Biology
- Pharmacology
Background:
- Hormone receptor-positive/HER2-negative breast cancer treatment often involves CDK4/6 inhibitors like palbociclib.
- Resistance to palbociclib limits its long-term efficacy, necessitating the exploration of alternative therapeutic strategies.
Purpose of the Study:
- To identify mechanisms of palbociclib resistance in breast cancer.
- To evaluate a novel small molecule inhibitor targeting CDK2, CDK4, and CDK6 to overcome palbociclib resistance.
Main Methods:
- Preclinical models and clinical transcriptome analysis were used to investigate resistance mechanisms.
- Pharmacodynamics and in vivo efficacy of PF-06873600 (PF3600) were assessed in multiple tumor models.
Main Results:
- Palbociclib resistance was linked to the induction of the MYC oncogene and Cyclin E/CDK2 activity.
- PF-06873600 demonstrated potent inhibition of CDK2/4/6 and efficacy in preclinical models.
- MYC activity predicted PF3600 efficacy across various cell types.
- CDK2/4/6 inhibition did not impede anti-tumor immune responses.
Conclusions:
- Targeting CDK2/4/6 with PF-06873600 offers a potential strategy to overcome palbociclib resistance in breast cancer.
- PF-06873600 shows therapeutic potential for patients with insufficient response to CDK4/6 inhibitors.
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