In silico search of triple mutant T790M/C797S allosteric inhibitors to conquer acquired resistance problem in non-small cell lung cancer (NSCLC): a combined approach of structure-based virtual screening and molecular dynamics simulation

Author(s):  
Harun M. Patel ◽  
Iqrar Ahmad ◽  
Rahul Pawara ◽  
Matin Shaikh ◽  
Sanjay Surana
2020 ◽  
Vol 15 (3) ◽  
pp. 260-267
Author(s):  
Avirup Ghosh ◽  
Hong Yan

Background: Mutations in a protein called the Epidermal Growth Factor Receptor (EGFR) can cause Non-Small Cell Lung Cancer (NSCLC), which is the most common form of lung cancer. Many NSCLC cases arise from the L858R mutation, where Leucine (L) is replaced by arginine (R) at the 858th position in the EGFR, and that is also recognized as an exon 21 substitution. Moreover, half of the EKFR-mutated lung cancer patients develop acquired resistance to the first-generation EGFR-TKIs due to another mutation T790M. Objective: In this research work, a novel method is used to investigate the possible reason for the EGFR mutation to takes place in the specific 858th and 790th position, and also, we evaluated the hydrogen bonds to measure the overall stability of different structures. Methods: We performed the molecular dynamics simulation and used Amber tool to achieve our primary objectives and later we use CPPTRAJ to analyze other changes in the hydrogen bonds for different mutational structures of EGFR. Results: First, we investigated the hydrogen bonds in different positions in the EGFR kinase domain and estimated why the first stage mutation (L858R) and resistance mutation (L858R/T790M) take place in the 858th and 790th position respectively. We found the hydrogen bond counts in the 858th and 790th position is lesser than the neighborhood positions and that yields to achieve a least stability in that position. Conclusion: Our method represents an important contribution to molecular dynamics analysis for NSCLC studies. The results obtained from this study provide a useful insight into the NSCLC drug resistance.


2020 ◽  
Vol 16 (21) ◽  
pp. 1537-1547
Author(s):  
Fumio Imamura ◽  
Madoka Kimura ◽  
Yukihiro Yano ◽  
Masahide Mori ◽  
Hidekazu Suzuki ◽  
...  

Aim: Osimertinib is a key drug for EGFR mutation-positive non-small-cell lung cancer (NSCLC). As the hazards ratio of overall survival in comparison with first-generation EGFR-tyrosine kinase inhibitors was almost similar between FLAURA and ARCHER 1050, salvage use of osimertinib is still a treatment option. Patients & methods: We retrospectively analyzed the clinical courses of EGFR mutation-positive NSCLC patients who were potential candidates for salvage osimertinib. Results: Among 524 patients enrolled from five hospitals, 302 patients underwent biopsy, with 52.6% detection rate of T790M. Osimertinib was administered in 93.6% of the T790M-positive patients. The overall response rate and median progression-free survival time of osimertinib were calculated with 147 patients, to be 55.6% and 17.2 months, respectively. Conclusion: Osimertinib is active for T790M-driven acquired resistance in EGFR-mutant NSCLC, but the detection of T790M was unsatisfactory. Clinical Trial Registration: UMIN000028989 (UMIN Clinical Trials Registry)


2021 ◽  
Author(s):  
Bo Mi Ku ◽  
Jae Yeong Heo ◽  
Jinchul Kim ◽  
Jong-Mu Sun ◽  
Se-Hoon Lee ◽  
...  

Abstract The emergence of acquired resistance limits the long-term efficacy of EGFR tyrosine kinase inhibitors (EGFR-TKIs). Thus, development of effective strategies to overcome resistance to EGFR-TKI is urgently needed. Multiple mechanisms to reactivate ERK signaling have been successfully demonstrated in acquired resistance models. We found that in EGFR mutant non-small cell lung cancer (NSCLC) patients, acquired resistance to EGFR-TKIs was accompanied by increased activation of ERK. Increased ERK activation was also found in in vitro models of acquired EGFR-TKI resistance. ASN007 is a potent selective ERK1/2 inhibitor with promising antitumor activity in cancers with BRAF and RAS mutations. ASN007 treatment impeded tumor cell growth and the cell cycle in EGFR-TKI-resistant cells. In addition, combination treatment with ASN007 and EGFR-TKIs synergistically decreased the survival of resistant cells, enhanced induction of apoptosis, and effectively inhibited the growth of erlotinib-resistant xenografts, providing the preclinical rationale for testing combinations of ASN007 and EGFR-TKIs in EGFR-mutated NSCLC patients. This study emphasizes the importance of targeting ERK signaling in maintaining the long-term benefits of EGFR-TKIs by overcoming acquired resistance.


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