Abstract
Aberrant activation of signaling through the RAS-RAF-MEK-ERK (MAPK) pathway is implicated in numerous cancers, making it an attractive therapeutic target. Although BRAF and MEK-targeted combination therapy has demonstrated significant benefit beyond single-agent options, the majority of patients develop resistance and disease progression after approximately 12 months. Reactivation of ERK signaling is a common driver of resistance in this setting. Here we report the discovery of BVD-523 (ulixertinib), a novel, reversible, ATP-competitive ERK1/2 inhibitor with high potency and ERK1/2 selectivity. In vitro BVD-523 treatment resulted in reduced proliferation and enhanced caspase activity in sensitive cells. Interestingly, BVD-523 inhibited phosphorylation of target substrates despite increased phosphorylation of ERK1/2. In in vivo xenograft studies, BVD-523 showed dose-dependent growth inhibition and tumor regression. BVD-523 yielded synergistic antiproliferative effects in a BRAFV600E-mutant melanoma cell line xenograft model when used in combination with BRAF inhibition. Antitumor activity was also demonstrated in in vitro and in vivo models of acquired resistance to single-agent and combination BRAF/MEK-targeted therapy. On the basis of these promising results, these studies demonstrate BVD-523 holds promise as a treatment for ERK-dependent cancers, including those whose tumors have acquired resistance to other treatments targeting upstream nodes of the MAPK pathway. Assessment of BVD-523 in clinical trials is underway (NCT01781429, NCT02296242, and NCT02608229). Mol Cancer Ther; 16(11); 2351-63. ©2017 AACR.
Highlights
Through aberrant activation of ERK signaling, genetic alterations in RAS or RAF family members result in rapid tumorNote: Supplementary data for this article are available at Molecular Cancer Therapeutics Online.S
Reactivation and dependence on ERK1/2 signaling is a common feature of acquired resistance to BRAF/MEK inhibition [26, 27]; we evaluated the activity of BVD523 in in vitro models of acquired resistance
BVD-523 elicited changes in downstream target and effector proteins, including inhibition of direct substrate of ERK1/2, pRSK, and total DUSP6 protein levels. These findings are in line with those of previous studies of other ERK1/2 inhibitors, which demonstrated effective suppression of pRSK with ERK1/2 inhibition [26, 27]
Summary
Through aberrant activation of ERK signaling, genetic alterations in RAS or RAF family members result in rapid tumor. Note: Supplementary data for this article are available at Molecular Cancer Therapeutics Online (http://mct.aacrjournals.org/). S. Saha and D.J. Welsch contributed to this article. Current address for U.A. Germann: OnKognos Scientific Consulting, Newton, Massachusetts and InnovaTID Pharmaceuticals Incorporated, Cambridge, Massachusetts; current address for J.J. Roix, PhoreMost Ltd, Cambridge, United Kingdom; current address for M. Ra Pharmaceuticals, Cambridge, Massachusetts; current address for G. Martinez-Botella, Praxis Precision Medicines Incorporated, Cambridge, Massachusetts; current address for R. MedImmune, Gaithersburg, Maryland; current address for M. Alkermes, Waltham, Massachusetts; and current address for S.
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