ワンツーパンチ: 新規薬剤の組み合わせが膵臓癌を克服する可能性(One-Two Punch: Novel Drug Pairing Could Beat Pancreatic Cancer)

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2023-06-28 カリフォルニア大学サンディエゴ校(UCSD)

mouse pancreatic tumorsMouse pancreatic tumors were significantly smaller after being treated with a combination of KRAS inhibitor MRTX1133 and ERBB inhibitor Afatinib (bottom row), compared to no treatment (top row) or being treated with Afatinib (second row) or MRTX1133 (third and fourth rows) alone.

◆膵臓癌の主な原因であるKRAS遺伝子の変異を阻害する新薬が開発されました。しかし、膵臓癌は薬剤耐性が高いため、単独の薬では効果が限定的でした。そこで、KRASとERBBの薬剤を組み合わせた治療法が研究されました。
◆この組み合わせは、KRAS阻害剤単独よりも効果的であり、耐性も少ないことが示されました。この組み合わせ治療法は、臨床試験で検証されるべきであり、膵臓癌患者にとって有望な選択肢となる可能性があります。

<関連情報>

膵管腺癌におけるKRASG12Dと汎ERBBの二重阻害が相乗効果を示す Dual inhibition of KRASG12D and pan-ERBB is synergistic in pancreatic ductal adenocarcinoma

Kevin Christian Montecillo. Gulay,Xinlian Zhang,Vasiliki Pantazopoulou,Jay Patel,Edgar Esparza,Deepa Sheik. Pran Babu,Satoshi Ogawa,Jonathan Weitz,Isabella Ng,Evangeline S. Mose,Minya Pu,Dannielle D. Engle,Andrew M. Lowy,Hervé Tiriac
Cancer Research  Published:JUNE 28 2023
DOI:https://doi.org/10.1158/0008-5472.CAN-23-1313

Abstract

Pancreatic ductal adenocarcinoma (PDAC) is a lethal cancer with a low survival rate. Recently, new drugs that target KRASG12D, a common mutation in PDAC, have been developed. We studied one of these compounds, MRTX1133, and found it was specific and effective at low nanomolar concentrations in patient-derived organoid models and cell lines harboring KRASG12D mutations. Treatment with MRTX1133 upregulated the expression and phosphorylation of EGFR and HER2, indicating that inhibition of ERBB signaling may potentiate MRTX1133 anti-tumor activity. Indeed, the irreversible pan-ERBB inhibitor, afatinib, potently synergized with MRTX1133 in vitro, and cancer cells with acquired resistance to MRTX1133 in vitro remained sensitive to this combination therapy. Finally, the combination of MRTX1133 and afatinib led to tumor regression and longer survival in orthotopic PDAC mouse models. These results suggest that dual inhibition of ERBB and KRAS signaling may be synergistic and circumvent the rapid development of acquired resistance in patients with KRAS mutant pancreatic cancer.

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有機化学・薬学
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