Drug Information

Drug (ID: DG00358) and It's Reported Resistant Information

• Name: Tyrosine kinase inhibitor
• Synonyms: Tyrosine kinase inhibitor; 1021950-26-4; 1-N'-(4-fluorophenyl)-1-N-[4-[[2-(2-morpholin-4-ylethylcarbamoyl)-1H-pyrrolo[2,3-b]pyridin-4-yl]oxy]phenyl]cyclopropane-1,1-dicarboxamide; SCHEMBL10108314; C31H31FN6O5; DTXSID40648066; BCP04781; EX-A2282; MDK-0264; 4136AH; NSC757436; ZINC43195804; CS-0524; NSC-757436; NCGC00390567-01; HY-10421; DB-058774; FT-0753909; EC-000.2366; 1,1-Cyclopropanedicarboxamide, N-(4-fluorophenyl)-N-[4-[[2-[[[2-(4-morpholinyl)ethyl]amino]carbonyl]-1H-pyrrolo[2,3-b]pyridin-4-yl]oxy]phenyl]-; N'1-(4-fluorophenyl)-N1-{4-[(2-{[2-(morpholin-4-yl)ethyl]carbamoyl}-1H-pyrrolo[2,3-b]pyridin-4-yl)oxy]phenyl}cyclopropane-1,1-dicarboxamide; N~1~-(4-Fluorophenyl)-N'~1~-{4-[(2-{[2-(morpholin-4-yl)ethyl]carbamoyl}-1H-pyrrolo[2,3-b]pyridin-4-yl)oxy]phenyl}cyclopropane-1,1-dicarboxamide
• Drug Resistance Disease(s):
  Disease(s) with Clinically Reported Resistance for This Drug (2 diseases)
  Acute myeloid leukemia [ICD-11: 2A60]; [1]
  Chronic myeloid leukemia [ICD-11: 2A20]; [2], [3]
• Formula: C31H31FN6O5
• IsoSMILES: C1CC1(C(=O)NC2=CC=C(C=C2)OC3=C4C=C(NC4=NC=C3)C(=O)NCCN5CCOCC5)C(=O)NC6=CC=C(C=C6)F
• InChI: 1S/C31H31FN6O5/c32-20-1-3-21(4-2-20)35-29(40)31(10-11-31)30(41)36-22-5-7-23(8-6-22)43-26-9-12-33-27-24(26)19-25(37-27)28(39)34-13-14-38-15-17-42-18-16-38/h1-9,12,19H,10-11,13-18H2,(H,33,37)(H,34,39)(H,35,40)(H,36,41)
• InChIKey: PKOVTRMHYNEBDU-UHFFFAOYSA-N
• PubChem CID: 24956525

Type(s) of Resistant Mechanism of This Drug

  ADTT: Aberration of the Drug's Therapeutic Target

Drug Resistance Data Categorized by Their Corresponding Diseases

ICD-02: Benign/in-situ/malignant neoplasm

Chronic myeloid leukemia [ICD-11: 2A20]

Drug Resistance Data Categorized by Their Corresponding Mechanisms

Aberration of the Drug's Therapeutic Target (ADTT)

Key Molecule: BCR-ABL1 e8a2 variant (BCR-ABL1) [4]

• Molecule Alteration: Missense mutation; p.L324Q
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• In Vivo Model: A retrospective survey in conducting clinical studies; Homo sapiens
• Experiment for Molecule Alteration: Pyrosequencing analysis
• Experiment for Drug Resistance: Progression-free survival assay; Overall survival assay
• Mechanism Description: Imatinib resistance in chronic myeloid leukemia (CML) is commonly due to BCR-ABL kinase domain mutations (kDMs).

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [5]

• Molecule Alteration: Missense mutation; p.M351T
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• In Vivo Model: A retrospective survey in conducting clinical studies; Homo sapiens
• Experiment for Molecule Alteration: Sanger sequencing assay
• Mechanism Description: Ponatinib was highly active in heavily pretreated patients with Ph-positive leukemias with resistance to tyrosine kinase inhibitors, including patients with the BCR-ABL T315I mutation, other mutations, or no mutations.

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [2], [3]

• Molecule Alteration: Missense mutation; p.F317L
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• In Vivo Model: A retrospective survey in conducting clinical studies; Homo sapiens
• Experiment for Molecule Alteration: Direct sequencing assay
• Mechanism Description: We confirmed the high frequency of SFks involvement in Tyrosine kinase inhibitor-resistant CML (52% of the cases) and even further in progressive disease and blast crises (60% of the cases). The SFks deregulation is also observed in patients harboring BCR-ABL mutations. In T315I and F317L mutated patients, CML-resistance appears to be promoted by SFks kinase protein reactivation once the BCR-ABL mutated clone has decreased on Omacetaxine.

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [3]

• Molecule Alteration: Missense mutation; p.M244V
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: There are several identified mechanisms of resistance to TkIs. The presence of ABL kinase domain point mutation, which could be detected by molecular methods is one of them. ABL mutation was detected in 19 (31,6%) patients. In four cases with detected mutation the disease has progressed to blast crisis.

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [3]

• Molecule Alteration: Missense mutation; p.V299L
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: There are several identified mechanisms of resistance to TkIs. The presence of ABL kinase domain point mutation, which could be detected by molecular methods is one of them. ABL mutation was detected in 19 (31,6%) patients. In four cases with detected mutation the disease has progressed to blast crisis.

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [3]

• Molecule Alteration: Missense mutation; p.V289A
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: There are several identified mechanisms of resistance to TkIs. The presence of ABL kinase domain point mutation, which could be detected by molecular methods is one of them. ABL mutation was detected in 19 (31,6%) patients. In four cases with detected mutation the disease has progressed to blast crisis.

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [3]

• Molecule Alteration: Missense mutation; p.T315I
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: There are several identified mechanisms of resistance to TkIs. The presence of ABL kinase domain point mutation, which could be detected by molecular methods is one of them. ABL mutation was detected in 19 (31,6%) patients. In four cases with detected mutation the disease has progressed to blast crisis.

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [3]

• Molecule Alteration: Missense mutation; p.R220H
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: There are several identified mechanisms of resistance to TkIs. The presence of ABL kinase domain point mutation, which could be detected by molecular methods is one of them. ABL mutation was detected in 19 (31,6%) patients. In four cases with detected mutation the disease has progressed to blast crisis.

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [3]

• Molecule Alteration: Missense mutation; p.Q252H
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: There are several identified mechanisms of resistance to TkIs. The presence of ABL kinase domain point mutation, which could be detected by molecular methods is one of them. ABL mutation was detected in 19 (31,6%) patients. In four cases with detected mutation the disease has progressed to blast crisis.

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [3]

• Molecule Alteration: Missense mutation; p.L384M
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: There are several identified mechanisms of resistance to TkIs. The presence of ABL kinase domain point mutation, which could be detected by molecular methods is one of them. ABL mutation was detected in 19 (31,6%) patients. In four cases with detected mutation the disease has progressed to blast crisis.

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [3]

• Molecule Alteration: Missense mutation; p.H396R
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: There are several identified mechanisms of resistance to TkIs. The presence of ABL kinase domain point mutation, which could be detected by molecular methods is one of them. ABL mutation was detected in 19 (31,6%) patients. In four cases with detected mutation the disease has progressed to blast crisis.

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [3]

• Molecule Alteration: Missense mutation; p.G250E
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: There are several identified mechanisms of resistance to TkIs. The presence of ABL kinase domain point mutation, which could be detected by molecular methods is one of them. ABL mutation was detected in 19 (31,6%) patients. In four cases with detected mutation the disease has progressed to blast crisis.

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [3]

• Molecule Alteration: Missense mutation; p.F359I
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: There are several identified mechanisms of resistance to TkIs. The presence of ABL kinase domain point mutation, which could be detected by molecular methods is one of them. ABL mutation was detected in 19 (31,6%) patients. In four cases with detected mutation the disease has progressed to blast crisis.

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [3]

• Molecule Alteration: Missense mutation; p.F311L
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: There are several identified mechanisms of resistance to TkIs. The presence of ABL kinase domain point mutation, which could be detected by molecular methods is one of them. ABL mutation was detected in 19 (31,6%) patients. In four cases with detected mutation the disease has progressed to blast crisis.

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [3]

• Molecule Alteration: Missense mutation; p.E282K
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: There are several identified mechanisms of resistance to TkIs. The presence of ABL kinase domain point mutation, which could be detected by molecular methods is one of them. ABL mutation was detected in 19 (31,6%) patients. In four cases with detected mutation the disease has progressed to blast crisis.

Key Molecule: Tyrosine-protein kinase ABL1 (ABL1) [3]

• Molecule Alteration: Missense mutation; p.A399T
• Resistant Disease: Chronic myeloid leukemia [ICD-11: 2A20.0]
• Experimental Note: Identified from the Human Clinical Data
• Mechanism Description: There are several identified mechanisms of resistance to TkIs. The presence of ABL kinase domain point mutation, which could be detected by molecular methods is one of them. ABL mutation was detected in 19 (31,6%) patients. In four cases with detected mutation the disease has progressed to blast crisis.

Acute myeloid leukemia [ICD-11: 2A60]

Drug Resistance Data Categorized by Their Corresponding Mechanisms

Aberration of the Drug's Therapeutic Target (ADTT)

Key Molecule: Receptor-type tyrosine-protein kinase FLT3 (FLT3) [1]

• Molecule Alteration: Mutation; .
• Resistant Disease: Acute myeloid leukemia [ICD-11: 2A60.0]
• Experimental Note: Identified from the Human Clinical Data
• In Vivo Model: A retrospective survey in conducting clinical studies; Homo sapiens
• Experiment for Molecule Alteration: Whole exome capture sequencing assay
• Experiment for Drug Resistance: karyotyping assay
• Mechanism Description: Treatment with TkIs selectively leads to secondary mutations in the activation loop domain of the gene, where those who relapse after exposure to TkI show evolution of secondary FLT3 mutations that are associated with TkI resistance.

References

• Ref 1: Genomic Profiling of Pediatric Acute Myeloid Leukemia Reveals a Changing Mutational Landscape from Disease Diagnosis to Relapse. Cancer Res. 2016 Apr 15;76(8):2197-205. doi: 10.1158/0008-5472.CAN-15-1015. Epub 2016 Mar 3.
• Ref 2: Longitudinal studies of SRC family kinases in imatinib- and dasatinib-resistant chronic myelogenous leukemia patients. Leuk Res. 2011 Jan;35(1):38-43. doi: 10.1016/j.leukres.2010.06.030. Epub 2010 Jul 29.
• Ref 3: [ABL domain kinase point mutations as a cause of resistance to therapy of patients with chronic myeloid leukemia with tyrosine kinase inhibitors. Single center experience]. Przegl Lek. 2011;68(5):253-7.
• Ref 4: Increased genomic instability may contribute to the development of kinase domain mutations in chronic myeloid leukemia. Int J Hematol. 2014 Dec;100(6):567-74. doi: 10.1007/s12185-014-1685-9. Epub 2014 Oct 4.
• Ref 5: Ponatinib in refractory Philadelphia chromosome-positive leukemias. N Engl J Med. 2012 Nov 29;367(22):2075-88. doi: 10.1056/NEJMoa1205127.