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齐德萨姆提尼布选择性向多种ROS1耐药突变

Anupong Tangpeerachaikul¹, Scot Mente², Joe Magrino³

¹Nuvalent, Inc., Cambridge, United States.

Molecular cancer therapeutics

|April 29, 2025

概括

齐德萨米提尼 (NVL-520) 有效地抑制了超过1500个ROS1突变,具有最小的抗性,优于其他抑制剂. 这种新型药物对治疗ROS1阳性癌症,包括大脑转移的治疗有前途.

科学领域:

在瘤学瘤学.
药理学药理学是指药理学的学科.
分子生物学分子生物学

背景情况:

非小细胞肺癌 (NSCLC) 和其他癌症可以由ROS1融合驱动.
新兴的耐药性突变和大脑转移在ROS1阳性癌症治疗中构成重大挑战.
一些抑制剂的非目标TRK抑制可以导致限制中枢神经系统不良事件.

研究的目的:

评价一种新的ROS1选择性抑制剂齐德萨米丁 (NVL-520) 对ROS1抵抗突变和大脑转移的作用.
为了将齐德萨米提尼的疗效和耐药性与现有的ROS1抑制剂进行比较.
阐明齐德萨米提尼布选择性和疗效背后的分子机制.

主要方法:

加速突变发生查以评估耐药性发展.
内异种移植模型来评估对脑转移的疗效.
共同晶体结构的确定和计算建模,以了解药物标相互作用.

主要成果:

齐德萨米提尼抑制了超过1500种具有≤1%抗性的ROS1突变,表现优于克里佐替尼布,恩特雷克提尼布和雷波特雷克提尼布.
在积极的内ROS1 G2032R异种移植模型中,齐德萨米提尼比Repotrectinib和Taletrectinib表现出更持久的反应.
结构分析显示,齐德萨米替尼独特地适应ROS1 G2032R突变,同时可能与TRK发生冲突,支持其选择性设计.

结论:

齐德萨米提尼表现出广泛的ROS1耐药性突变的强有力的抑制,耐药性的出现最小.
与其他ROS1抑制剂相比,该药在脑转移的临床前模型中显示出更高的疗效.
齐德萨米提尼的选择性向机制表明,它有可能成为ROS1-融合阳性癌症的最佳治疗方法.

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