TRK inhibitor binding to acquired resistance mutations.

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TRK inhibitor binding to acquired resistance mutations. TRK inhibitor binding to acquired resistance mutations. A, Structural models showing steric interactions (circled red dashes) between larotrectinib (top) and solvent-front (i.e., G595R, G623R) or xDFG (i.e., G667C, G696A) resistance mutations in TRKA and TRKC. In contrast, LOXO-195 (bottom) can accommodate solvent-front and xDFG resistance mutations. B, IC50 values for each agent in purified kinase assays at KM ATP are shown as mean ± SD of the indicated replicates. The ratio of IC50 values for each mutant IC50 to the corresponding unmutated kinase is shown in parentheses. The IC50 values for LOXO-195 for TRKC WT and G696A were below the lower limit of the assay (2.5 nmol/L). WT, wild-type. Alexander Drilon et al. Cancer Discov 2017;7:963-972 ©2017 by American Association for Cancer Research