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Li Y, An ZJ, Tan BB, Zhao Q, Fan LQ, Zhao XF. Research status and progress of drug resistance in gastrointestinal stromal tumors. Shijie Huaren Xiaohua Zazhi 2020; 28:999-1003. [DOI: 10.11569/wcjd.v28.i20.999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Targeted drug therapy is another effective treatment for gastrointestinal stromal tumors (GISTs) in addition to surgical treatment, which has significantly improved the prognosis of GIST patients, but drug resistance in some patients is still a tough problem in clinical work. This article reviews the mechanism of primary and secondary drug resistance in first-line treatment of GIST patients and the progress of second-line and third-line treatment, and describes the current problems faced by drug-resistant GIST patients and the direction of future efforts.
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Affiliation(s)
- Yong Li
- Department of General Surgery, the Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Zhao-Jie An
- Department of General Surgery, the Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Bi-Bo Tan
- Department of General Surgery, the Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Qun Zhao
- Department of General Surgery, the Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Li-Qiao Fan
- Department of General Surgery, the Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
| | - Xue-Feng Zhao
- Department of General Surgery, the Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China
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Hamid AB, Petreaca RC. Secondary Resistant Mutations to Small Molecule Inhibitors in Cancer Cells. Cancers (Basel) 2020; 12:cancers12040927. [PMID: 32283832 PMCID: PMC7226513 DOI: 10.3390/cancers12040927] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 04/05/2020] [Accepted: 04/07/2020] [Indexed: 12/14/2022] Open
Abstract
Secondary resistant mutations in cancer cells arise in response to certain small molecule inhibitors. These mutations inevitably cause recurrence and often progression to a more aggressive form. Resistant mutations may manifest in various forms. For example, some mutations decrease or abrogate the affinity of the drug for the protein. Others restore the function of the enzyme even in the presence of the inhibitor. In some cases, resistance is acquired through activation of a parallel pathway which bypasses the function of the drug targeted pathway. The Catalogue of Somatic Mutations in Cancer (COSMIC) produced a compendium of resistant mutations to small molecule inhibitors reported in the literature. Here, we build on these data and provide a comprehensive review of resistant mutations in cancers. We also discuss mechanistic parallels of resistance.
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Apsel Winger B, Cortopassi WA, Garrido Ruiz D, Ding L, Jang K, Leyte-Vidal A, Zhang N, Esteve-Puig R, Jacobson MP, Shah NP. ATP-Competitive Inhibitors Midostaurin and Avapritinib Have Distinct Resistance Profiles in Exon 17-Mutant KIT. Cancer Res 2019; 79:4283-4292. [PMID: 31270078 DOI: 10.1158/0008-5472.can-18-3139] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 05/05/2019] [Accepted: 06/26/2019] [Indexed: 01/08/2023]
Abstract
KIT is a type-3 receptor tyrosine kinase that is frequently mutated at exon 11 or 17 in a variety of cancers. First-generation KIT tyrosine kinase inhibitors (TKI) are ineffective against KIT exon 17 mutations, which favor an active conformation that prevents these TKIs from binding. The ATP-competitive inhibitors, midostaurin and avapritinib, which target the active kinase conformation, were developed to inhibit exon 17-mutant KIT. Because secondary kinase domain mutations are a common mechanism of TKI resistance and guide ensuing TKI design, we sought to define problematic KIT kinase domain mutations for these emerging therapeutics. Midostaurin and avapritinib displayed different vulnerabilities to secondary kinase domain substitutions, with the T670I gatekeeper mutation being selectively problematic for avapritinib. Although gatekeeper mutations often directly disrupt inhibitor binding, we provide evidence that T670I confers avapritinib resistance indirectly by inducing distant conformational changes in the phosphate-binding loop. These findings suggest combining midostaurin and avapritinib may forestall acquired resistance mediated by secondary kinase domain mutations. SIGNIFICANCE: This study identifies potential problematic kinase domain mutations for next-generation KIT inhibitors midostaurin and avapritinib.
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Affiliation(s)
- Beth Apsel Winger
- Division of Hematology/Oncology, Department of Pediatrics, University of California San Francisco, San Francisco, California
| | - Wilian A Cortopassi
- Department of Pharmaceutical Chemistry, University of California San Francisco, San Francisco, California
| | - Diego Garrido Ruiz
- Department of Pharmaceutical Chemistry, University of California San Francisco, San Francisco, California
| | - Lucky Ding
- Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, San Francisco, California
| | - Kibeom Jang
- Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, San Francisco, California
| | - Ariel Leyte-Vidal
- Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, San Francisco, California
| | - Na Zhang
- Department of Pharmaceutical Chemistry, University of California San Francisco, San Francisco, California.,Beijing Key Laboratory of Environmental & Viral Oncology, College of Life Science and Bioengineering, Beijing University of Technology, Beijing, China
| | - Rosaura Esteve-Puig
- Department of Dermatology, University of California San Francisco, San Francisco, California
| | - Matthew P Jacobson
- Department of Pharmaceutical Chemistry, University of California San Francisco, San Francisco, California
| | - Neil P Shah
- Department of Medicine, Division of Hematology/Oncology, University of California San Francisco, San Francisco, California.
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Wang JL, Wu JH, Hong C, Wang YN, Zhou Y, Long ZW, Zhou Y, Qin HS. Involvement of Bmi-1 gene in the development of gastrointestinal stromal tumor by regulating p16 Ink4A /p14 ARF gene expressions: An in vivo and in vitro study. Pathol Res Pract 2017; 213:1542-1551. [DOI: 10.1016/j.prp.2017.09.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 09/05/2017] [Accepted: 09/15/2017] [Indexed: 12/31/2022]
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