Abstract

<div>Abstract<p>Kinase inhibitors form the largest class of precision medicine. From 2013 to 2017, 17 have been approved, with 8 different mechanisms. We present a comprehensive profiling study of all 17 inhibitors on a biochemical assay panel of 280 kinases and proliferation assays of 108 cancer cell lines. Drug responses of the cell lines were related to the presence of frequently recurring point mutations, insertions, deletions, and amplifications in 15 well-known oncogenes and tumor-suppressor genes. In addition, drug responses were correlated with basal gene expression levels with a focus on 383 clinically actionable genes. Cell lines harboring actionable mutations defined in the FDA labels, such as mutant BRAF(V600E) for cobimetinib, or <i>ALK</i> gene translocation for ALK inhibitors, are generally 10 times more sensitive compared with wild-type cell lines. This sensitivity window is more narrow for markers that failed to meet endpoints in clinical trials, for instance <i>CDKN2A</i> loss for CDK4/6 inhibitors (2.7-fold) and <i>KRAS</i> mutation for cobimetinib (2.3-fold). Our data underscore the rationale of a number of recently opened clinical trials, such as ibrutinib in <i>ERBB2</i>- or <i>ERBB4</i>-expressing cancers. We propose and validate new response biomarkers, such as mutation in <i>FBXW7</i> or <i>SMAD4</i> for EGFR and HER2 inhibitors, <i>ETV4</i> and <i>ETV5</i> expression for MEK inhibitors, and <i>JAK3</i> expression for ALK inhibitors. Potentially, these new markers could be combined to improve response rates. This comprehensive overview of biochemical and cellular selectivities of approved kinase inhibitor drugs provides a rich resource for drug repurposing, basket trial design, and basic cancer research.</p></div>

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