NTRK kinase domain mutations in cancer variably impact sensitivity to type I and type II inhibitors Journal Article


Authors: Somwar, R.; Hofmann, N. E.; Smith, B.; Odintsov, I.; Vojnic, M.; Linkov, I.; Tam, A.; Khodos, I.; Mattar, M. S.; de Stanchina, E.; Flynn, D.; Ladanyi, M.; Drilon, A.; Shinde, U.; Davare, M. A.
Article Title: NTRK kinase domain mutations in cancer variably impact sensitivity to type I and type II inhibitors
Abstract: Tyrosine kinase domains dynamically fluctuate between two main structural forms that are referred to as type I (DFG-in) or type II (DFG-out) conformations. Comprehensive data comparing type I and type II inhibitors are currently lacking for NTRK fusion-driven cancers. Here we used a type II NTRK inhibitor, altiratinib, as a model compound to investigate its inhibitory potential for larotrectinib (type I inhibitor)-resistant mutations in NTRK. Our study shows that a subset of larotrectinib-resistant NTRK1 mutations (V573M, F589L and G667C) retains sensitivity to altiratinib, while the NTRK1V573M and xDFG motif NTRK1G667C mutations are highly sensitive to type II inhibitors, including altiratinib, cabozantinib and foretinib. Moreover, molecular modeling suggests that the introduction of a sulfur moiety in the binding pocket, via methionine or cysteine substitutions, specifically renders the mutant kinase hypersensitive to type II inhibitors. Future precision treatment strategies may benefit from selective targeting of these kinase mutants based on our findings. © 2020, The Author(s).
Journal Title: Communications Biology
Volume: 3
ISSN: 2399-3642
Publisher: Springer Nature  
Date Published: 2020-12-16
Start Page: 776
Language: English
DOI: 10.1038/s42003-020-01508-w
PROVIDER: scopus
PMCID: PMC7745027
PUBMED: 33328556
DOI/URL:
Notes: Article -- Export Date: 4 January 2021 -- Source: Scopus
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MSK Authors
  1. Marc Ladanyi
    1326 Ladanyi
  2. Romel Somwar
    110 Somwar
  3. Alexander Edward Drilon
    632 Drilon
  4. Irina Linkov
    73 Linkov
  5. Inna   Khodos
    36 Khodos
  6. Marissa   Mattar
    56 Mattar
  7. Morana Vojnic
    17 Vojnic