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Weiss A, Lorthiois E, Barys L, Beyer KS, Bomio-Confaglia C, Burks H, Chen X, Cui X, de Kanter R, Dharmarajan L, Fedele C, Gerspacher M, Guthy DA, Head V, Jaeger A, Núñez EJ, Kearns JD, Leblanc C, Maira SM, Murphy J, Oakman H, Ostermann N, Ottl J, Rigollier P, Roman D, Schnell C, Sedrani R, Shimizu T, Stringer R, Vaupel A, Voshol H, Wessels P, Widmer T, Wilcken R, Xu K, Zecri F, Farago AF, Cotesta S, Brachmann SM. Discovery, Preclinical Characterization, and Early Clinical Activity of JDQ443, a Structurally Novel, Potent, and Selective Covalent Oral Inhibitor of KRASG12C. Cancer Discov 2022; 12:1500-1517. [PMID: 35404998 PMCID: PMC9394399 DOI: 10.1158/2159-8290.cd-22-0158] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 03/14/2022] [Accepted: 04/01/2022] [Indexed: 01/07/2023]
Abstract
Covalent inhibitors of KRASG12C have shown antitumor activity against advanced/metastatic KRASG12C-mutated cancers, though resistance emerges and additional strategies are needed to improve outcomes. JDQ443 is a structurally unique covalent inhibitor of GDP-bound KRASG12C that forms novel interactions with the switch II pocket. JDQ443 potently inhibits KRASG12C-driven cellular signaling and demonstrates selective antiproliferative activity in KRASG12C-mutated cell lines, including those with G12C/H95 double mutations. In vivo, JDQ443 induces AUC exposure-driven antitumor efficacy in KRASG12C-mutated cell-derived (CDX) and patient-derived (PDX) tumor xenografts. In PDX models, single-agent JDQ443 activity is enhanced by combination with inhibitors of SHP2, MEK, or CDK4/6. Notably, the benefit of JDQ443 plus the SHP2 inhibitor TNO155 is maintained at reduced doses of either agent in CDX models, consistent with mechanistic synergy. JDQ443 is in clinical development as monotherapy and in combination with TNO155, with both strategies showing antitumor activity in patients with KRASG12C-mutated tumors. SIGNIFICANCE JDQ443 is a structurally novel covalent KRASG12C inhibitor with a unique binding mode that demonstrates potent and selective antitumor activity in cell lines and in vivo models. In preclinical models and patients with KRASG12C-mutated malignancies, JDQ443 shows potent antitumor activity as monotherapy and in combination with the SHP2 inhibitor TNO155. This article is highlighted in the In This Issue feature, p. 1397.
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Affiliation(s)
- Andreas Weiss
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Louise Barys
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Kim S. Beyer
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Heather Burks
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Xueying Chen
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Xiaoming Cui
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Ruben de Kanter
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Carmine Fedele
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Marc Gerspacher
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Victoria Head
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Ashley Jaeger
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | | | - Jeffrey D. Kearns
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | | | | | - Jason Murphy
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Helen Oakman
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Nils Ostermann
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Johannes Ottl
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Danielle Roman
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Richard Sedrani
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | - Rowan Stringer
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Andrea Vaupel
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Hans Voshol
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | | | | | - Rainer Wilcken
- Novartis Institutes for BioMedical Research, Basel, Switzerland
| | - Kun Xu
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey
| | - Frederic Zecri
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts
| | - Anna F. Farago
- Novartis Institutes for BioMedical Research, Cambridge, Massachusetts.,Corresponding Authors: Saskia M. Brachman, Novartis Institutes for BioMedical Research (NIBR), WSJ-386/3/13.01, Kohlenstrasse 84, 4056 Basel, Switzerland. Phone: 41-616-9640-63; E-mail: ; Anna F. Farago, NIBR, 250 Massachusetts Avenue, Cambridge, MA 02139. Phone: 617-871-8000; E-mail: ; and Simona Cotesta, NIBR, WSJ-386/13/10, Kohlenstrasse 84, 4056 Basel, Switzerland. Phone: 41-797-9792-70; E-mail:
| | - Simona Cotesta
- Novartis Institutes for BioMedical Research, Basel, Switzerland.,Corresponding Authors: Saskia M. Brachman, Novartis Institutes for BioMedical Research (NIBR), WSJ-386/3/13.01, Kohlenstrasse 84, 4056 Basel, Switzerland. Phone: 41-616-9640-63; E-mail: ; Anna F. Farago, NIBR, 250 Massachusetts Avenue, Cambridge, MA 02139. Phone: 617-871-8000; E-mail: ; and Simona Cotesta, NIBR, WSJ-386/13/10, Kohlenstrasse 84, 4056 Basel, Switzerland. Phone: 41-797-9792-70; E-mail:
| | - Saskia M. Brachmann
- Novartis Institutes for BioMedical Research, Basel, Switzerland.,Corresponding Authors: Saskia M. Brachman, Novartis Institutes for BioMedical Research (NIBR), WSJ-386/3/13.01, Kohlenstrasse 84, 4056 Basel, Switzerland. Phone: 41-616-9640-63; E-mail: ; Anna F. Farago, NIBR, 250 Massachusetts Avenue, Cambridge, MA 02139. Phone: 617-871-8000; E-mail: ; and Simona Cotesta, NIBR, WSJ-386/13/10, Kohlenstrasse 84, 4056 Basel, Switzerland. Phone: 41-797-9792-70; E-mail:
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