13
|
Wang E, Mi X, Thompson MC, Montoya S, Notti RQ, Afaghani J, Durham BH, Penson A, Witkowski MT, Lu SX, Bourcier J, Hogg SJ, Erickson C, Cui D, Cho H, Singer M, Totiger TM, Chaudhry S, Geyer M, Alencar A, Linley AJ, Palomba ML, Coombs CC, Park JH, Zelenetz A, Roeker L, Rosendahl M, Tsai DE, Ebata K, Brandhuber B, Hyman DM, Aifantis I, Mato A, Taylor J, Abdel-Wahab O. Mechanisms of Resistance to Noncovalent Bruton's Tyrosine Kinase Inhibitors. N Engl J Med 2022; 386:735-743. [PMID: 35196427 PMCID: PMC9074143 DOI: 10.1056/nejmoa2114110] [Citation(s) in RCA: 109] [Impact Index Per Article: 54.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Covalent (irreversible) Bruton's tyrosine kinase (BTK) inhibitors have transformed the treatment of multiple B-cell cancers, especially chronic lymphocytic leukemia (CLL). However, resistance can arise through multiple mechanisms, including acquired mutations in BTK at residue C481, the binding site of covalent BTK inhibitors. Noncovalent (reversible) BTK inhibitors overcome this mechanism and other sources of resistance, but the mechanisms of resistance to these therapies are currently not well understood. METHODS We performed genomic analyses of pretreatment specimens as well as specimens obtained at the time of disease progression from patients with CLL who had been treated with the noncovalent BTK inhibitor pirtobrutinib. Structural modeling, BTK-binding assays, and cell-based assays were conducted to study mutations that confer resistance to noncovalent BTK inhibitors. RESULTS Among 55 treated patients, we identified 9 patients with relapsed or refractory CLL and acquired mechanisms of genetic resistance to pirtobrutinib. We found mutations (V416L, A428D, M437R, T474I, and L528W) that were clustered in the kinase domain of BTK and that conferred resistance to both noncovalent BTK inhibitors and certain covalent BTK inhibitors. Mutations in BTK or phospholipase C gamma 2 (PLCγ2), a signaling molecule and downstream substrate of BTK, were found in all 9 patients. Transcriptional activation reflecting B-cell-receptor signaling persisted despite continued therapy with noncovalent BTK inhibitors. CONCLUSIONS Resistance to noncovalent BTK inhibitors arose through on-target BTK mutations and downstream PLCγ2 mutations that allowed escape from BTK inhibition. A proportion of these mutations also conferred resistance across clinically approved covalent BTK inhibitors. These data suggested new mechanisms of genomic escape from established covalent and novel noncovalent BTK inhibitors. (Funded by the American Society of Hematology and others.).
Collapse
Affiliation(s)
- Eric Wang
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Xiaoli Mi
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Meghan C Thompson
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Skye Montoya
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Ryan Q Notti
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Jumana Afaghani
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Benjamin H Durham
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Alex Penson
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Matthew T Witkowski
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Sydney X Lu
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Jessie Bourcier
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Simon J Hogg
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Caroline Erickson
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Dan Cui
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Hana Cho
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Michael Singer
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Tulasigeri M Totiger
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Sana Chaudhry
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Mark Geyer
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Alvaro Alencar
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Adam J Linley
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - M Lia Palomba
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Catherine C Coombs
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Jae H Park
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Andrew Zelenetz
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Lindsey Roeker
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Mary Rosendahl
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Donald E Tsai
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Kevin Ebata
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Barbara Brandhuber
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - David M Hyman
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Iannis Aifantis
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Anthony Mato
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Justin Taylor
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| | - Omar Abdel-Wahab
- From the Human Oncology and Pathogenesis Program (E.W., X.M., B.H.D., A.P., S.X.L., J.B., S.J.H., C.E., D.C., H.C., M.S., O.A.-W.), the Leukemia Service (M.C.T., M.G., J.H.P., L.R., A.M., O.A.-W.), and the Lymphoma Service (M.L.P., A.Z.), Department of Medicine, and the Department of Pathology (B.H.D.), Memorial Sloan Kettering Cancer Center, the Laboratory of Molecular Electron Microscopy, Rockefeller University (R.Q.N.), and the Department of Pathology and Laura and Isaac Perlmutter Cancer Center, New York University School of Medicine (M.T.W., I.A.) - all in New York; Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine, Miami (S.M., J.A., T.M.T., S.C., A.A., J.T.); the Department of Molecular Physiology and Cell Signaling, Institute of Systems, Molecular, and Integrative Biology, University of Liverpool, Liverpool, United Kingdom (A.J.L.); University of North Carolina Medical Center, Chapel Hill (C.C.C.); and Loxo Oncology at Lilly, Boulder, CO (M.R., D.E.T., K.E., B.B., D.M.H.)
| |
Collapse
|