Disease Information
General Information of the Disease (ID: DIS00084)
| Name |
Breast cancer
|
|---|---|
| ICD |
ICD-11: 2C60
|
| Resistance Map |
Type(s) of Resistant Mechanism of This Disease with Structure Alteration
Drug Resistance Data Categorized by Drug
Approved Drug(s)
14 drug(s) in total
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [1], [2] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Anastrozole | ||||||||||||
| Molecule Alteration | Missense mutation | p.Y537S |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.50 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
M
-
D
-
P
-
M
-
I
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
-
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
-
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
-
K
K
N
N
V
V
V
V
P
P
L
L
Y
S
D
D
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Droplet digital polymerase chain reaction assay; Whole-genome sequencing assay | ||||||||||||
| Experiment for Drug Resistance |
Chest x-ray assay; Computed tomography assay; Magnetic resonance imaging assay; Positron emission tomography assay | ||||||||||||
| Mechanism Description | We have developed a ddPCR-based method for the sensitive detection and quantification of 4 representative ESR1 mutations, Y537S, Y537N, Y537C, and D538G, in 325 breast cancer specimens, in which 270 primary breast cancer and 55 MBC specimens. Whole-exome and transcriptome analysis showed that six cases harbored mutations of ESR1 affecting its ligand-binding domain (LBD), all of whom had been treated with anti-estrogens and estrogen deprivation therapies. | ||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [2] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Anastrozole | ||||||||||||
| Molecule Alteration | Missense mutation | p.D538G |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.90 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
V
-
D
-
L
-
G
-
T
-
E
290
|
-
N
-
L
-
Y
-
F
-
Q
-
S
-
N
-
A
-
M
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
C
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
C
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
C
K
K
N
N
V
V
V
V
P
P
L
L
Y
Y
D
G
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Droplet digital polymerase chain reaction assay | ||||||||||||
| Experiment for Drug Resistance |
Chest x-ray assay; Computed tomography assay; Magnetic resonance imaging assay; Positron emission tomography assay | ||||||||||||
| Mechanism Description | We have developed a ddPCR-based method for the sensitive detection and quantification of 4 representative ESR1 mutations, Y537S, Y537N, Y537C, and D538G, in 325 breast cancer specimens, in which 270 primary breast cancer and 55 MBC specimens. | ||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [3] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Anastrozole | ||||||||||||
| Molecule Alteration | Missense mutation | p.D538G |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.90 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
V
-
D
-
L
-
G
-
T
-
E
290
|
-
N
-
L
-
Y
-
F
-
Q
-
S
-
N
-
A
-
M
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
C
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
C
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
C
K
K
N
N
V
V
V
V
P
P
L
L
Y
Y
D
G
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Deep sequencing assay | ||||||||||||
| Experiment for Drug Resistance |
MTT assay | ||||||||||||
| Mechanism Description | We report here on a novel mutation of ERalpha, in which an A to G substitution at position 1,613 resulted in substitution of aspartic acid at position 538 to glycine (D538G). The mutation was identified in liver metastases obtained from patients who developed endocrine resistance, but not in samples of primary tumors obtained prior to commencing endocrine treatment. Structural modeling indicates that D538G substitution creates a conformational change that disrupts the interaction between the receptor and either estrogen or tamoxifen, but mimics the conformation of the activated receptor. Studies in cell lines confirmed ligand-independent, constitutive activity of the mutated receptor. Taken together, these data indicate the mutation D538G as a novel mechanism conferring acquired endocrine resistance. | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Fibroblast growth factor receptor 4 (FGFR4) | [4] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Erdafitinib | ||||||||||||
| Molecule Alteration | Missense mutation | p.V550M |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 2.35 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 3.25 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
G
G
P
P
L
L
L
L
A
A
G
G
L
L
450
|
V
V
S
S
L
L
D
D
L
L
P
P
L
L
D
D
P
P
L
L
460
|
W
W
E
E
F
F
P
P
R
R
D
D
R
R
L
L
V
V
L
L
470
|
G
G
K
K
P
P
L
L
G
G
E
E
G
G
A
A
F
F
G
G
480
|
Q
Q
V
V
V
V
R
R
A
A
E
E
A
A
F
F
G
G
M
M
490
|
D
D
P
P
A
A
R
R
P
P
D
D
Q
Q
A
A
S
S
T
T
500
|
V
V
A
A
V
V
K
K
M
M
L
L
K
K
D
D
N
N
A
A
510
|
S
S
D
D
K
K
D
D
L
L
A
A
D
D
L
L
V
V
S
S
520
|
E
E
M
M
E
E
V
V
M
M
K
K
L
L
I
I
G
G
R
R
530
|
H
H
K
K
N
N
I
I
I
I
N
N
L
L
L
L
G
G
V
V
540
|
C
C
T
T
Q
Q
E
E
G
G
P
P
L
L
Y
Y
V
V
I
I
550
|
V
M
E
E
C
C
A
A
A
A
K
K
G
G
N
N
L
L
R
R
560
|
E
E
F
F
L
L
R
R
A
A
R
R
R
R
P
P
P
P
G
G
570
|
P
P
D
D
L
L
S
S
P
P
D
D
G
G
P
P
R
R
S
S
580
|
S
S
E
E
G
G
P
P
L
L
S
S
F
F
P
P
V
V
L
L
590
|
V
V
S
S
C
C
A
A
Y
Y
Q
Q
V
V
A
A
R
R
G
G
600
|
M
M
Q
Q
Y
Y
L
L
E
E
S
S
R
R
K
K
C
C
I
I
610
|
H
H
R
R
D
D
L
L
A
A
A
A
R
R
N
N
V
V
L
L
620
|
V
V
T
T
E
E
D
D
N
N
V
V
M
M
K
K
I
I
A
A
630
|
D
D
F
F
G
G
L
L
A
A
R
R
G
G
V
V
H
H
H
H
640
|
I
I
D
D
Y
Y
Y
Y
K
K
K
K
T
T
S
S
N
N
G
G
650
|
R
R
L
L
P
P
V
V
K
K
W
W
M
M
A
A
P
P
E
E
660
|
A
A
L
L
F
F
D
D
R
R
V
V
Y
Y
T
T
H
H
Q
Q
670
|
S
S
D
D
V
V
W
W
S
S
F
F
G
G
I
I
L
L
L
L
680
|
W
W
E
E
I
I
F
F
T
T
L
L
G
G
G
G
S
S
P
P
690
|
Y
Y
P
P
G
G
I
I
P
P
V
V
E
E
E
E
L
L
F
F
700
|
S
S
L
L
L
L
R
R
E
E
G
G
H
H
R
R
M
M
D
D
710
|
R
R
P
P
P
P
H
H
C
C
P
P
P
P
E
E
L
L
Y
Y
720
|
G
G
L
L
M
M
R
R
E
E
C
C
W
W
H
H
A
A
A
A
730
|
P
P
S
S
Q
Q
R
R
P
P
T
T
F
F
K
K
Q
Q
L
L
740
|
V
V
E
E
A
A
L
L
D
D
K
K
V
V
L
L
L
L
A
A
750
|
V
V
S
S
E
E
E
E
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| Mechanism Description | The mutations V550L and V550E in the FGFR4 kinase domain have been demonstrated to confer clinical resistance to erdafitinib in rhabdomyosarcoma, while V550M is associated with erdafitinib resistance in breast cancer. | ||||||||||||
| Key Molecule: Fibroblast growth factor receptor 4 (FGFR4) | [4] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Erdafitinib | ||||||||||||
| Molecule Alteration | Missense mutation | p.V550M |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 2.35 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 3.25 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
G
G
P
P
L
L
L
L
A
A
G
G
L
L
450
|
V
V
S
S
L
L
D
D
L
L
P
P
L
L
D
D
P
P
L
L
460
|
W
W
E
E
F
F
P
P
R
R
D
D
R
R
L
L
V
V
L
L
470
|
G
G
K
K
P
P
L
L
G
G
E
E
G
G
A
A
F
F
G
G
480
|
Q
Q
V
V
V
V
R
R
A
A
E
E
A
A
F
F
G
G
M
M
490
|
D
D
P
P
A
A
R
R
P
P
D
D
Q
Q
A
A
S
S
T
T
500
|
V
V
A
A
V
V
K
K
M
M
L
L
K
K
D
D
N
N
A
A
510
|
S
S
D
D
K
K
D
D
L
L
A
A
D
D
L
L
V
V
S
S
520
|
E
E
M
M
E
E
V
V
M
M
K
K
L
L
I
I
G
G
R
R
530
|
H
H
K
K
N
N
I
I
I
I
N
N
L
L
L
L
G
G
V
V
540
|
C
C
T
T
Q
Q
E
E
G
G
P
P
L
L
Y
Y
V
V
I
I
550
|
V
M
E
E
C
C
A
A
A
A
K
K
G
G
N
N
L
L
R
R
560
|
E
E
F
F
L
L
R
R
A
A
R
R
R
R
P
P
P
P
G
G
570
|
P
P
D
D
L
L
S
S
P
P
D
D
G
G
P
P
R
R
S
S
580
|
S
S
E
E
G
G
P
P
L
L
S
S
F
F
P
P
V
V
L
L
590
|
V
V
S
S
C
C
A
A
Y
Y
Q
Q
V
V
A
A
R
R
G
G
600
|
M
M
Q
Q
Y
Y
L
L
E
E
S
S
R
R
K
K
C
C
I
I
610
|
H
H
R
R
D
D
L
L
A
A
A
A
R
R
N
N
V
V
L
L
620
|
V
V
T
T
E
E
D
D
N
N
V
V
M
M
K
K
I
I
A
A
630
|
D
D
F
F
G
G
L
L
A
A
R
R
G
G
V
V
H
H
H
H
640
|
I
I
D
D
Y
Y
Y
Y
K
K
K
K
T
T
S
S
N
N
G
G
650
|
R
R
L
L
P
P
V
V
K
K
W
W
M
M
A
A
P
P
E
E
660
|
A
A
L
L
F
F
D
D
R
R
V
V
Y
Y
T
T
H
H
Q
Q
670
|
S
S
D
D
V
V
W
W
S
S
F
F
G
G
I
I
L
L
L
L
680
|
W
W
E
E
I
I
F
F
T
T
L
L
G
G
G
G
S
S
P
P
690
|
Y
Y
P
P
G
G
I
I
P
P
V
V
E
E
E
E
L
L
F
F
700
|
S
S
L
L
L
L
R
R
E
E
G
G
H
H
R
R
M
M
D
D
710
|
R
R
P
P
P
P
H
H
C
C
P
P
P
P
E
E
L
L
Y
Y
720
|
G
G
L
L
M
M
R
R
E
E
C
C
W
W
H
H
A
A
A
A
730
|
P
P
S
S
Q
Q
R
R
P
P
T
T
F
F
K
K
Q
Q
L
L
740
|
V
V
E
E
A
A
L
L
D
D
K
K
V
V
L
L
L
L
A
A
750
|
V
V
S
S
E
E
E
E
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| Mechanism Description | The mutations V550L and V550E in the FGFR4 kinase domain have been demonstrated to confer clinical resistance to erdafitinib in rhabdomyosarcoma, while V550M is associated with erdafitinib resistance in breast cancer. | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [1], [2] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Exemestane | ||||||||||||
| Molecule Alteration | Missense mutation | p.Y537S |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.50 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
M
-
D
-
P
-
M
-
I
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
-
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
-
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
-
K
K
N
N
V
V
V
V
P
P
L
L
Y
S
D
D
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Droplet digital polymerase chain reaction assay | ||||||||||||
| Experiment for Drug Resistance |
Chest x-ray assay; Computed tomography assay; Magnetic resonance imaging assay; Positron emission tomography assay | ||||||||||||
| Mechanism Description | We have developed a ddPCR-based method for the sensitive detection and quantification of 4 representative ESR1 mutations, Y537S, Y537N, Y537C, and D538G, in 325 breast cancer specimens, in which 270 primary breast cancer and 55 MBC specimens. | ||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [2], [3] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Exemestane | ||||||||||||
| Molecule Alteration | Missense mutation | p.D538G |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.90 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
V
-
D
-
L
-
G
-
T
-
E
290
|
-
N
-
L
-
Y
-
F
-
Q
-
S
-
N
-
A
-
M
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
C
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
C
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
C
K
K
N
N
V
V
V
V
P
P
L
L
Y
Y
D
G
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Droplet digital polymerase chain reaction assay | ||||||||||||
| Experiment for Drug Resistance |
Chest x-ray assay; Computed tomography assay; Magnetic resonance imaging assay; Positron emission tomography assay | ||||||||||||
| Mechanism Description | We have developed a ddPCR-based method for the sensitive detection and quantification of 4 representative ESR1 mutations, Y537S, Y537N, Y537C, and D538G, in 325 breast cancer specimens, in which 270 primary breast cancer and 55 MBC specimens. | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [3], [5], [6] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Fulvestrant | ||||||||||||
| Molecule Alteration | Missense mutation | p.Y537S |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.50 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
M
-
D
-
P
-
M
-
I
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
-
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
-
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
-
K
K
N
N
V
V
V
V
P
P
L
L
Y
S
D
D
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vitro Model | MCF-7 cells | Breast | Homo sapiens (Human) | CVCL_0031 | |||||||||
| WHIM16 cells | Breast | Homo sapiens (Human) | N.A. | ||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Whole-gexome sequencing assay | ||||||||||||
| Mechanism Description | The ESR1-Y537S hormone-binding-domain mutation is clearly a potent cause of aromatase-inhibitor resistance. | ||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [1], [7] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Fulvestrant | ||||||||||||
| Molecule Alteration | Missense mutation | p.Y537S |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.50 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
M
-
D
-
P
-
M
-
I
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
-
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
-
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
-
K
K
N
N
V
V
V
V
P
P
L
L
Y
S
D
D
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Next-generation sequencing assay | ||||||||||||
| Experiment for Drug Resistance |
Overall survival assay | ||||||||||||
| Mechanism Description | All 28 patients were found to harbor ESR1 mutations affecting ligand-binding domain with the most common mutations affecting Y537 (17/28, 60.7%) and D538 (9/28, 32.1%). ESR1 mutation was found in 12.1% of a large cohort of advanced breast cancer patients. Exemestane in combination with everolimus might be a reasonable option. Prospective studies are warranted to validate these findings. | ||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [6] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Fulvestrant | ||||||||||||
| Molecule Alteration | Missense mutation | p.D538G |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.90 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
V
-
D
-
L
-
G
-
T
-
E
290
|
-
N
-
L
-
Y
-
F
-
Q
-
S
-
N
-
A
-
M
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
C
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
C
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
C
K
K
N
N
V
V
V
V
P
P
L
L
Y
Y
D
G
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Next-generation sequencing assay | ||||||||||||
| Mechanism Description | In our analysis of frequently mutated oncogenes and tumor suppressors, ESR1 mutations stood out as a common and plausible event that could contribute to resistance. We found that the mutations in both Tyr537 and Asp538 strongly promoted ER signaling in absence of ligand. This was observed biochemically as increased phosphorylation on S118, increased association with AIB1, and diminished sensitivity to HSP90 inhibitors. Functionally, the mutations in vitro promoted the expression of classical ER target genes in the absence of hormone. | ||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [1], [3] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Fulvestrant | ||||||||||||
| Molecule Alteration | Missense mutation | p.D538G |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.90 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
V
-
D
-
L
-
G
-
T
-
E
290
|
-
N
-
L
-
Y
-
F
-
Q
-
S
-
N
-
A
-
M
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
C
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
C
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
C
K
K
N
N
V
V
V
V
P
P
L
L
Y
Y
D
G
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Deep sequencing assay | ||||||||||||
| Experiment for Drug Resistance |
MTT assay | ||||||||||||
| Mechanism Description | We report here on a novel mutation of ERalpha, in which an A to G substitution at position 1,613 resulted in substitution of aspartic acid at position 538 to glycine (D538G). The mutation was identified in liver metastases obtained from patients who developed endocrine resistance, but not in samples of primary tumors obtained prior to commencing endocrine treatment. Structural modeling indicates that D538G substitution creates a conformational change that disrupts the interaction between the receptor and either estrogen or tamoxifen, but mimics the conformation of the activated receptor. Studies in cell lines confirmed ligand-independent, constitutive activity of the mutated receptor. Taken together, these data indicate the mutation D538G as a novel mechanism conferring acquired endocrine resistance. | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: GTPase Hras (HRAS) | [8] | ||||||||||||
| Resistant Disease | HER2 positive breast cancer [ICD-11: 2C60.8] | ||||||||||||
| Resistant Drug | Lapatinib | ||||||||||||
| Molecule Alteration | Missense mutation | p.G12S |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.24 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.71 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
M
T
T
E
E
Y
Y
K
K
L
L
V
V
V
V
V
V
10
|
G
G
A
A
G
S
G
G
V
V
G
G
K
K
S
S
A
A
L
L
20
|
T
T
I
I
Q
Q
L
L
I
I
Q
Q
N
N
H
H
F
F
V
V
30
|
D
D
E
E
Y
Y
D
D
P
P
T
T
I
I
E
E
D
D
S
S
40
|
Y
Y
R
R
K
K
Q
Q
V
V
V
V
I
I
D
D
G
G
E
E
50
|
T
T
C
C
L
L
L
L
D
D
I
I
L
L
D
D
T
T
A
A
60
|
G
G
Q
Q
E
E
E
E
Y
Y
S
S
A
A
M
M
R
R
D
D
70
|
Q
Q
Y
Y
M
M
R
R
T
T
G
G
E
E
G
G
F
F
L
L
80
|
C
C
V
V
F
F
A
A
I
I
N
N
N
N
T
T
K
K
S
S
90
|
F
F
E
E
D
D
I
I
H
H
H
H
Y
Y
R
R
E
E
Q
Q
100
|
I
I
K
K
R
R
V
V
K
K
D
D
S
S
E
E
D
D
V
V
110
|
P
P
M
M
V
V
L
L
V
V
G
G
N
N
K
K
C
C
D
D
120
|
L
L
P
P
S
S
R
R
T
T
V
V
D
D
T
T
K
K
Q
Q
130
|
A
A
Q
Q
D
D
L
L
A
A
R
R
S
S
Y
Y
G
G
I
I
140
|
P
P
F
F
I
I
E
E
T
T
S
S
A
A
K
K
T
T
R
R
150
|
Q
Q
G
G
V
V
D
D
D
D
A
A
F
F
Y
Y
T
T
L
L
160
|
V
V
R
R
E
E
I
I
R
R
K
K
H
H
K
K
E
E
K
K
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vitro Model | Plasma | Blood | Homo sapiens (Human) | N.A. | |||||||||
| Experiment for Molecule Alteration |
Next-generation sequencing assay; Circulating-free DNA assay | ||||||||||||
| Experiment for Drug Resistance |
Positron emission tomography/Computed tomography assay | ||||||||||||
| Mechanism Description | Seven genes, including epidermal growth factor receptor (EGFR), G protein subunit alpha S (GNAS), HRas proto-oncogene (HRAS), mutL homolog 1 (MLH1), cadherin 1 (CDH1), neuroblastoma RAS viral oncogene homolog (NRAS), and NOTCH1, that only occurred mutations in the resistant group were associated with the resistance of targeted therapy. | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [1], [2] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Letrozole | ||||||||||||
| Molecule Alteration | Missense mutation | p.Y537S |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.50 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
M
-
D
-
P
-
M
-
I
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
-
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
-
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
-
K
K
N
N
V
V
V
V
P
P
L
L
Y
S
D
D
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Droplet digital polymerase chain reaction assay | ||||||||||||
| Experiment for Drug Resistance |
Chest x-ray assay; Computed tomography assay; Magnetic resonance imaging assay; Positron emission tomography assay | ||||||||||||
| Mechanism Description | We have developed a ddPCR-based method for the sensitive detection and quantification of 4 representative ESR1 mutations, Y537S, Y537N, Y537C, and D538G, in 325 breast cancer specimens, in which 270 primary breast cancer and 55 MBC specimens. | ||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [9] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Letrozole | ||||||||||||
| Molecule Alteration | Missense mutation | p.D538G |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.90 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
V
-
D
-
L
-
G
-
T
-
E
290
|
-
N
-
L
-
Y
-
F
-
Q
-
S
-
N
-
A
-
M
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
C
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
C
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
C
K
K
N
N
V
V
V
V
P
P
L
L
Y
Y
D
G
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| 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; dPCR assay | ||||||||||||
| Mechanism Description | Acquired mutations in the estrogen-receptor gene ESR1 can be a marker of resistance to aromatase inhibitors in metastatic breast cancer. | ||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [1] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Letrozole | ||||||||||||
| Molecule Alteration | Missense mutation | p.D538G |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.90 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
V
-
D
-
L
-
G
-
T
-
E
290
|
-
N
-
L
-
Y
-
F
-
Q
-
S
-
N
-
A
-
M
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
C
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
C
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
C
K
K
N
N
V
V
V
V
P
P
L
L
Y
Y
D
G
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| 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-genome sequencing assay | ||||||||||||
| Mechanism Description | Whole-exome and transcriptome analysis showed that six cases harbored mutations of ESR1 affecting its ligand-binding domain (LBD), all of whom had been treated with anti-estrogens and estrogen deprivation therapies. | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [2] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | MPA | ||||||||||||
| Molecule Alteration | Missense mutation | p.Y537S |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.50 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
M
-
D
-
P
-
M
-
I
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
-
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
-
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
-
K
K
N
N
V
V
V
V
P
P
L
L
Y
S
D
D
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Droplet digital polymerase chain reaction assay | ||||||||||||
| Experiment for Drug Resistance |
Chest x-ray assay; Computed tomography assay; Magnetic resonance imaging assay; Positron emission tomography assay | ||||||||||||
| Mechanism Description | We have developed a ddPCR-based method for the sensitive detection and quantification of 4 representative ESR1 mutations, Y537S, Y537N, Y537C, and D538G, in 325 breast cancer specimens, in which 270 primary breast cancer and 55 MBC specimens. | ||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [2] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | MPA | ||||||||||||
| Molecule Alteration | Missense mutation | p.D538G |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.90 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
V
-
D
-
L
-
G
-
T
-
E
290
|
-
N
-
L
-
Y
-
F
-
Q
-
S
-
N
-
A
-
M
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
C
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
C
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
C
K
K
N
N
V
V
V
V
P
P
L
L
Y
Y
D
G
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Droplet digital polymerase chain reaction assay | ||||||||||||
| Experiment for Drug Resistance |
Chest x-ray assay; Computed tomography assay; Magnetic resonance imaging assay; Positron emission tomography assay | ||||||||||||
| Mechanism Description | We have developed a ddPCR-based method for the sensitive detection and quantification of 4 representative ESR1 mutations, Y537S, Y537N, Y537C, and D538G, in 325 breast cancer specimens, in which 270 primary breast cancer and 55 MBC specimens. | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Receptor tyrosine-protein kinase erbB-2 (ERBB2) | [10] | ||||||||||||
| Sensitive Disease | HER2 negative breast cancer [ICD-11: 2C60.11] | ||||||||||||
| Sensitive Drug | Neratinib | ||||||||||||
| Molecule Alteration | Missense mutation | p.S310F (c.929C>T) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 3.09 Å | |||||||||||
| Mutant Type Structure | Method: Electron microscopy | Resolution: 3.09 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
T
M
Q
E
V
L
C
A
T
A
G
L
T
C
D
R
M
W
10
|
K
G
L
L
R
L
L
L
P
A
A
L
S
L
P
P
E
P
T
G
20
|
H
A
L
A
D
S
M
T
L
Q
R
V
H
C
L
T
Y
G
Q
T
30
|
G
D
C
M
Q
K
V
L
V
R
Q
L
G
P
N
A
L
S
E
P
40
|
L
E
T
T
Y
H
L
L
P
D
T
M
N
L
A
R
S
H
L
L
50
|
S
Y
F
Q
L
G
Q
C
D
Q
I
V
Q
V
E
Q
V
G
Q
N
60
|
G
L
Y
E
V
L
L
T
I
Y
A
L
H
P
N
T
Q
N
V
A
70
|
R
S
Q
L
V
S
P
F
L
L
Q
Q
R
D
L
I
R
Q
I
E
80
|
V
V
R
Q
G
G
T
Y
Q
V
L
L
F
I
E
A
D
H
N
N
90
|
Y
Q
A
V
L
R
A
Q
V
V
L
P
D
L
N
Q
G
R
D
L
100
|
P
R
L
I
N
V
N
R
T
G
T
T
P
Q
V
L
T
F
G
E
110
|
A
D
S
N
P
Y
G
A
G
L
L
A
R
V
E
L
L
D
Q
N
120
|
L
G
R
D
S
P
L
L
T
N
E
N
I
T
L
T
K
P
G
V
130
|
G
T
V
G
L
A
I
S
Q
P
R
G
N
G
P
L
Q
R
L
E
140
|
C
L
Y
Q
Q
L
D
R
T
S
I
L
L
T
W
E
K
I
D
L
150
|
I
K
F
G
H
G
K
V
N
L
N
I
Q
Q
L
R
A
N
L
P
160
|
T
Q
L
L
I
C
D
Y
T
Q
N
D
R
T
S
I
R
L
A
W
170
|
C
K
H
D
P
I
C
F
S
H
P
K
M
N
C
N
K
Q
G
L
180
|
S
A
R
L
C
T
W
L
G
I
E
D
S
T
S
N
E
R
D
S
190
|
C
R
Q
A
S
C
L
H
T
P
R
C
T
S
V
P
C
M
A
C
200
|
G
K
G
G
C
S
A
R
R
C
C
W
K
G
G
E
P
S
L
S
210
|
P
E
T
D
D
C
C
Q
C
S
H
L
E
T
Q
R
C
T
A
V
220
|
A
C
G
A
C
G
T
G
G
C
P
A
K
R
H
C
S
K
D
G
230
|
C
P
L
L
A
P
C
T
L
D
H
C
F
C
N
H
H
E
S
Q
240
|
G
C
I
A
C
A
E
G
L
C
H
T
C
G
P
P
A
K
L
H
250
|
V
S
T
D
Y
C
N
L
T
A
D
C
T
L
F
H
E
F
S
N
260
|
M
H
P
S
N
G
P
I
E
C
G
E
R
L
Y
H
T
C
F
P
270
|
G
A
A
L
S
V
C
T
V
Y
T
N
A
T
C
D
P
T
Y
F
280
|
N
E
Y
S
L
M
S
P
T
N
D
P
V
E
G
G
S
R
C
Y
290
|
T
T
L
F
V
G
C
A
P
S
L
C
H
V
N
T
Q
A
E
C
300
|
V
P
T
Y
A
N
E
Y
D
L
G
S
T
T
Q
D
R
V
C
G
310
|
E
F
K
C
C
T
S
L
K
V
P
C
C
P
A
L
R
H
V
N
320
|
C
Q
Y
E
G
V
L
T
G
A
M
E
E
D
H
G
L
T
R
Q
330
|
E
R
V
C
R
E
A
K
V
C
T
S
S
K
A
P
N
C
I
A
340
|
Q
R
E
V
F
C
A
Y
G
G
C
L
K
G
K
M
I
E
F
H
350
|
G
L
S
R
L
E
A
V
F
R
L
A
P
V
E
T
S
S
F
A
360
|
D
N
G
I
D
Q
P
E
A
F
S
A
N
G
T
C
A
K
P
K
370
|
L
I
Q
F
P
G
E
S
Q
L
L
A
Q
F
V
L
F
P
E
E
380
|
T
S
L
F
E
D
E
G
I
D
T
P
G
A
Y
S
L
N
Y
T
390
|
I
A
S
P
A
L
W
Q
P
P
D
E
S
Q
L
L
P
Q
D
V
400
|
L
F
S
E
V
T
F
L
Q
E
N
E
L
I
Q
T
V
G
I
Y
410
|
R
L
G
Y
R
I
I
S
L
A
H
W
N
P
G
D
A
S
Y
L
420
|
S
P
L
D
T
L
L
S
Q
V
G
F
L
Q
G
N
I
L
S
Q
430
|
W
V
L
I
G
R
L
G
R
R
S
I
L
L
R
H
E
N
L
G
440
|
G
A
S
Y
G
S
L
L
A
T
L
L
I
Q
H
G
H
L
N
G
450
|
T
I
H
S
L
W
C
L
F
G
V
L
H
R
T
S
V
L
P
R
460
|
W
E
D
L
Q
G
L
S
F
G
R
L
N
A
P
L
H
I
Q
H
470
|
A
H
L
N
L
T
H
H
T
L
A
C
N
F
R
V
P
H
E
T
480
|
D
V
E
P
C
W
V
D
G
Q
E
L
G
F
L
R
A
N
C
P
490
|
H
H
Q
Q
L
A
C
L
A
L
R
H
G
T
H
A
C
N
W
R
500
|
G
P
P
E
G
D
P
E
T
C
Q
V
C
G
V
E
N
G
C
L
510
|
S
A
Q
C
F
H
L
Q
R
L
G
C
Q
A
E
R
C
G
V
H
520
|
E
C
E
W
C
G
R
P
V
G
L
P
Q
T
G
Q
L
C
P
V
530
|
R
N
E
C
Y
S
V
Q
N
F
A
L
R
R
H
G
C
Q
L
E
540
|
P
C
C
V
H
E
P
E
E
C
C
R
Q
V
P
L
Q
Q
N
G
550
|
G
L
S
P
V
R
T
E
C
Y
F
V
G
N
P
A
E
R
A
H
560
|
D
C
Q
L
C
P
V
C
A
H
-
P
-
E
-
C
-
Q
-
P
570
|
-
Q
-
N
-
G
-
S
-
V
-
T
-
C
-
F
-
G
-
P
580
|
-
E
-
A
-
D
-
Q
-
C
-
V
-
A
-
C
-
A
-
H
590
|
-
Y
-
K
-
D
-
P
-
P
-
F
-
C
-
V
-
A
-
R
600
|
-
C
-
P
-
S
-
G
-
V
-
K
-
P
-
D
-
L
-
S
610
|
-
Y
-
M
-
P
-
I
-
W
-
K
-
F
-
P
-
D
-
E
620
|
-
E
-
G
-
A
-
C
-
Q
-
P
-
C
-
P
-
I
-
N
630
|
-
C
-
T
-
H
-
S
-
C
-
V
-
D
-
L
-
D
-
D
640
|
-
K
-
G
-
C
-
P
-
A
-
E
-
Q
-
R
-
A
-
S
650
|
-
P
-
L
-
T
-
S
-
I
-
I
-
S
-
A
-
V
-
V
660
|
-
G
-
I
-
L
-
L
-
V
-
V
-
V
-
L
-
G
-
V
670
|
-
V
-
F
-
G
-
I
-
L
-
I
-
K
-
R
-
R
-
Q
680
|
-
Q
-
K
-
I
-
R
-
K
-
Y
-
T
-
M
-
R
-
R
690
|
-
L
-
L
-
Q
-
E
-
T
-
E
-
L
-
V
-
E
-
P
700
|
-
L
-
T
-
P
-
S
-
G
-
A
-
M
-
P
-
N
-
Q
710
|
-
A
-
Q
-
M
-
R
-
I
-
L
-
K
-
E
-
T
-
E
720
|
-
L
-
R
-
K
-
V
-
K
-
V
-
L
-
G
-
S
-
G
730
|
-
A
-
F
-
G
-
T
-
V
-
Y
-
K
-
G
-
I
-
W
740
|
-
I
-
P
-
D
-
G
-
E
-
N
-
V
-
K
-
I
-
P
750
|
-
V
-
A
-
I
-
K
-
V
-
L
-
R
-
E
-
N
-
T
760
|
-
S
-
P
-
K
-
A
-
N
-
K
-
E
-
I
-
L
-
D
770
|
-
E
-
A
-
Y
-
V
-
M
-
A
-
G
-
V
-
D
-
S
780
|
-
P
-
Y
-
V
-
S
-
R
-
L
-
L
-
G
-
I
-
C
790
|
-
L
-
T
-
S
-
T
-
V
-
Q
-
L
-
V
-
T
-
Q
800
|
-
L
-
M
-
P
-
Y
-
G
-
C
-
L
-
L
-
D
-
H
810
|
-
V
-
R
-
E
-
N
-
R
-
G
-
R
-
L
-
G
-
S
820
|
-
Q
-
D
-
L
-
L
-
N
-
W
-
C
-
M
-
Q
-
I
830
|
-
A
-
K
-
G
-
M
-
S
-
Y
-
L
-
E
-
D
-
V
840
|
-
R
-
L
-
V
-
H
-
R
-
D
-
L
-
A
-
A
-
R
850
|
-
N
-
V
-
L
-
V
-
K
-
S
-
P
-
N
-
H
-
V
860
|
-
K
-
I
-
T
-
D
-
F
-
G
-
L
-
A
-
R
-
L
870
|
-
L
-
D
-
I
-
D
-
E
-
T
-
E
-
Y
-
H
-
A
880
|
-
D
-
G
-
G
-
K
-
V
-
P
-
I
-
K
-
W
-
M
890
|
-
A
-
L
-
E
-
S
-
I
-
L
-
R
-
R
-
R
-
F
900
|
-
T
-
H
-
Q
-
S
-
D
-
V
-
W
-
S
-
Y
-
G
910
|
-
V
-
T
-
V
-
W
-
E
-
L
-
M
-
T
-
F
-
G
920
|
-
A
-
K
-
P
-
Y
-
D
-
G
-
I
-
P
-
A
-
R
930
|
-
E
-
I
-
P
-
D
-
L
-
L
-
E
-
K
-
G
-
E
940
|
-
R
-
L
-
P
-
Q
-
P
-
P
-
I
-
C
-
T
-
I
950
|
-
D
-
V
-
Y
-
M
-
I
-
M
-
V
-
K
-
C
-
W
960
|
-
M
-
I
-
D
-
S
-
E
-
C
-
R
-
P
-
R
-
F
970
|
-
R
-
E
-
L
-
V
-
S
-
E
-
F
-
S
-
R
-
M
980
|
-
A
-
R
-
D
-
P
-
Q
-
R
-
F
-
V
-
V
-
I
990
|
-
Q
-
N
-
E
-
D
-
L
-
G
-
P
-
A
-
S
-
P
1000
|
-
L
-
D
-
S
-
T
-
F
-
Y
-
R
-
S
-
L
-
L
1010
|
-
E
-
D
-
D
-
D
-
M
-
G
-
D
-
L
-
V
-
D
1020
|
-
A
-
E
-
E
-
Y
-
L
-
V
-
P
-
Q
-
Q
-
G
1030
|
-
G
-
G
-
S
-
L
-
E
-
V
-
L
-
F
-
Q
-
G
1040
|
-
P
-
S
-
S
-
P
-
S
-
G
-
S
-
S
-
M
-
K
1050
|
-
I
-
E
-
E
-
G
-
K
-
L
-
V
-
I
-
W
-
I
1060
|
-
N
-
G
-
D
-
K
-
G
-
Y
-
N
-
G
-
L
-
A
1070
|
-
E
-
V
-
G
-
K
-
K
-
F
-
E
-
K
-
D
-
T
1080
|
-
G
-
I
-
K
-
V
-
T
-
V
-
E
-
H
-
P
-
D
1090
|
-
K
-
L
-
E
-
E
-
K
-
F
-
P
-
Q
-
V
-
A
1100
|
-
A
-
T
-
G
-
D
-
G
-
P
-
D
-
I
-
I
-
F
1110
|
-
W
-
A
-
H
-
D
-
R
-
F
-
G
-
G
-
Y
-
A
1120
|
-
Q
-
S
-
G
-
L
-
L
-
A
-
E
-
I
-
T
-
P
1130
|
-
D
-
K
-
A
-
F
-
Q
-
D
-
K
-
L
-
Y
-
P
1140
|
-
F
-
T
-
W
-
D
-
A
-
V
-
R
-
Y
-
N
-
G
1150
|
-
K
-
L
-
I
-
A
-
Y
-
P
-
I
-
A
-
V
-
E
1160
|
-
A
-
L
-
S
-
L
-
I
-
Y
-
N
-
K
-
D
-
L
1170
|
-
L
-
P
-
N
-
P
-
P
-
K
-
T
-
W
-
E
-
E
1180
|
-
I
-
P
-
A
-
L
-
D
-
K
-
E
-
L
-
K
-
A
1190
|
-
K
-
G
-
K
-
S
-
A
-
L
-
M
-
F
-
N
-
L
1200
|
-
Q
-
E
-
P
-
Y
-
F
-
T
-
W
-
P
-
L
-
I
1210
|
-
A
-
A
-
D
-
G
-
G
-
Y
-
A
-
F
-
K
-
Y
1220
|
-
E
-
N
-
G
-
K
-
Y
-
D
-
I
-
K
-
D
-
V
1230
|
-
G
-
V
-
D
-
N
-
A
-
G
-
A
-
K
-
A
-
G
1240
|
-
L
-
T
-
F
-
L
-
V
-
D
-
L
-
I
-
K
-
N
1250
|
-
K
-
H
-
M
-
N
-
A
-
D
-
T
-
D
-
Y
-
S
1260
|
-
I
-
A
-
E
-
A
-
A
-
F
-
N
-
K
-
G
-
E
1270
|
-
T
-
A
-
M
-
T
-
I
-
N
-
G
-
P
-
W
-
A
1280
|
-
W
-
S
-
N
-
I
-
D
-
T
-
S
-
K
-
V
-
N
1290
|
-
Y
-
G
-
V
-
T
-
V
-
L
-
P
-
T
-
F
-
K
1300
|
-
G
-
Q
-
P
-
S
-
K
-
P
-
F
-
V
-
G
-
V
1310
|
-
L
-
S
-
A
-
G
-
I
-
N
-
A
-
A
-
S
-
P
1320
|
-
N
-
K
-
E
-
L
-
A
-
K
-
E
-
F
-
L
-
E
1330
|
-
N
-
Y
-
L
-
L
-
T
-
D
-
E
-
G
-
L
-
E
1340
|
-
A
-
V
-
N
-
K
-
D
-
K
-
P
-
L
-
G
-
A
1350
|
-
V
-
A
-
L
-
K
-
S
-
Y
-
E
-
E
-
E
-
L
1360
|
-
A
-
K
-
D
-
P
-
R
-
I
-
A
-
A
-
T
-
M
1370
|
-
E
-
N
-
A
-
Q
-
K
-
G
-
E
-
I
-
M
-
P
1380
|
-
N
-
I
-
P
-
Q
-
M
-
S
-
A
-
F
-
W
-
Y
1390
|
-
A
-
V
-
R
-
T
-
A
-
V
-
I
-
N
-
A
-
A
1400
|
-
S
-
G
-
R
-
Q
-
T
-
V
-
D
-
E
-
A
-
L
1410
|
-
K
-
D
-
A
-
Q
-
T
-
N
-
S
-
S
-
S
-
S
1420
|
-
G
-
P
-
S
-
S
-
P
-
S
-
A
-
W
-
S
-
H
1430
|
-
P
-
Q
-
F
-
E
-
K
-
G
-
G
-
G
-
S
-
G
1440
|
-
G
-
G
-
S
-
G
-
G
-
S
-
S
-
A
-
W
-
S
1450
|
-
H
-
P
-
Q
-
F
-
E
-
K
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [11] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Palbociclib | ||||||||||||
| Molecule Alteration | Missense mutation | p.Y537S |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.50 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
M
-
D
-
P
-
M
-
I
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
-
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
-
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
-
K
K
N
N
V
V
V
V
P
P
L
L
Y
S
D
D
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vitro Model | Breast cancer tissue | N.A. | |||||||||||
| Experiment for Molecule Alteration |
Digital PCR assay | ||||||||||||
| Mechanism Description | We show that clonal evolution occurs frequently during treatment, reflecting substantial sub-clonal complexity in breast cancer that has progressed after prior endocrine therapy. RB1 mutations emerged only in the palbociclib plus fulvestrant arm and in a minority of patients (6/127, 4.7%, p=0.041). New driver mutations emerged in PIK3CA (p=0.00069) and ESR1 after treatment in both arms, in particular ESR1 Y537S (p=0.0037). Evolution of driver gene mutations was uncommon in patients progressing early on palbociclib plus fulvestrant but common in patients progressing later on treatment. These findings inform future treatment strategies to address resistance to palbociclib plus fulvestrant. | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: GTPase Hras (HRAS) | [8] | ||||||||||||
| Resistant Disease | HER2 positive breast cancer [ICD-11: 2C60.8] | ||||||||||||
| Resistant Drug | Pertuzumab | ||||||||||||
| Molecule Alteration | Missense mutation | p.G12S |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.24 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.71 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
M
T
T
E
E
Y
Y
K
K
L
L
V
V
V
V
V
V
10
|
G
G
A
A
G
S
G
G
V
V
G
G
K
K
S
S
A
A
L
L
20
|
T
T
I
I
Q
Q
L
L
I
I
Q
Q
N
N
H
H
F
F
V
V
30
|
D
D
E
E
Y
Y
D
D
P
P
T
T
I
I
E
E
D
D
S
S
40
|
Y
Y
R
R
K
K
Q
Q
V
V
V
V
I
I
D
D
G
G
E
E
50
|
T
T
C
C
L
L
L
L
D
D
I
I
L
L
D
D
T
T
A
A
60
|
G
G
Q
Q
E
E
E
E
Y
Y
S
S
A
A
M
M
R
R
D
D
70
|
Q
Q
Y
Y
M
M
R
R
T
T
G
G
E
E
G
G
F
F
L
L
80
|
C
C
V
V
F
F
A
A
I
I
N
N
N
N
T
T
K
K
S
S
90
|
F
F
E
E
D
D
I
I
H
H
H
H
Y
Y
R
R
E
E
Q
Q
100
|
I
I
K
K
R
R
V
V
K
K
D
D
S
S
E
E
D
D
V
V
110
|
P
P
M
M
V
V
L
L
V
V
G
G
N
N
K
K
C
C
D
D
120
|
L
L
P
P
S
S
R
R
T
T
V
V
D
D
T
T
K
K
Q
Q
130
|
A
A
Q
Q
D
D
L
L
A
A
R
R
S
S
Y
Y
G
G
I
I
140
|
P
P
F
F
I
I
E
E
T
T
S
S
A
A
K
K
T
T
R
R
150
|
Q
Q
G
G
V
V
D
D
D
D
A
A
F
F
Y
Y
T
T
L
L
160
|
V
V
R
R
E
E
I
I
R
R
K
K
H
H
K
K
E
E
K
K
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vitro Model | Plasma | Blood | Homo sapiens (Human) | N.A. | |||||||||
| Experiment for Molecule Alteration |
Next-generation sequencing assay; Circulating-free DNA assay | ||||||||||||
| Experiment for Drug Resistance |
Positron emission tomography/Computed tomography assay | ||||||||||||
| Mechanism Description | Seven genes, including epidermal growth factor receptor (EGFR), G protein subunit alpha S (GNAS), HRas proto-oncogene (HRAS), mutL homolog 1 (MLH1), cadherin 1 (CDH1), neuroblastoma RAS viral oncogene homolog (NRAS), and NOTCH1, that only occurred mutations in the resistant group were associated with the resistance of targeted therapy. | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [1], [6], [12] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Tamoxifen | ||||||||||||
| Molecule Alteration | Missense mutation | p.Y537S |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.50 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
M
-
D
-
P
-
M
-
I
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
-
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
-
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
-
K
K
N
N
V
V
V
V
P
P
L
L
Y
S
D
D
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| Cell Pathway Regulation | PI3K signaling pathway | Activation | hsa04151 | ||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Whole-exome sequencing assay; SNP Array profiling assay | ||||||||||||
| Experiment for Drug Resistance |
Tumor biopsy assay | ||||||||||||
| Mechanism Description | Mutations in ESR1 were detected in 4% of cancers and clustered in the ligand-binding domain. These included p.Tyr537(Cys/Asn/Ser) mutations (three patients) that have been shown to cause constitutive activation and resistance to tamoxifen therapy in breast cancer. | ||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [6] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Tamoxifen | ||||||||||||
| Molecule Alteration | Missense mutation | p.D538G |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.90 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
V
-
D
-
L
-
G
-
T
-
E
290
|
-
N
-
L
-
Y
-
F
-
Q
-
S
-
N
-
A
-
M
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
C
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
C
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
C
K
K
N
N
V
V
V
V
P
P
L
L
Y
Y
D
G
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Next-generation sequencing assay | ||||||||||||
| Mechanism Description | In our analysis of frequently mutated oncogenes and tumor suppressors, ESR1 mutations stood out as a common and plausible event that could contribute to resistance. We found that the mutations in both Tyr537 and Asp538 strongly promoted ER signaling in absence of ligand. This was observed biochemically as increased phosphorylation on S118, increased association with AIB1, and diminished sensitivity to HSP90 inhibitors. Functionally, the mutations in vitro promoted the expression of classical ER target genes in the absence of hormone. | ||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [1], [3], [12] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Tamoxifen | ||||||||||||
| Molecule Alteration | Missense mutation | p.D538G |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.90 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
V
-
D
-
L
-
G
-
T
-
E
290
|
-
N
-
L
-
Y
-
F
-
Q
-
S
-
N
-
A
-
M
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
C
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
C
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
C
K
K
N
N
V
V
V
V
P
P
L
L
Y
Y
D
G
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Circulating cell-free DNA assay; Liquid biopsy assay; Droplet digital PCR assay; Next generation assay | ||||||||||||
| Experiment for Drug Resistance |
Progression-free survival assay; Overall survival assay | ||||||||||||
| Mechanism Description | Recent studies have also highlighted the utility of ex vivo culturing of CTCs as a method of individualized drug susceptibility testing. Using this method, the authors found that CTCs have various mutations (including the p.D538G and p.Y537S ESR1 mutations), and showed that low-dose administration of the HSP90 inhibitor STA9090 alone or in combination with raloxifene and fulvestrant has growth-inhibitory effects. | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [13] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | Trametinib | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | MCF10A cells | Breast | Homo sapiens (Human) | CVCL_0598 | |||||||||
| Ba/F3 cells | Colon | Homo sapiens (Human) | CVCL_0161 | ||||||||||
| In Vivo Model | Female nude mouse xenograft model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
Immunoblotting analysis | ||||||||||||
| Mechanism Description | The missense mutation p.H1047R (c.3140A>G) in gene PIK3CA cause the sensitivity of Trametinib by unusual activation of pro-survival pathway | ||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [13] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | Trametinib | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047L (c.3140A>T) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.77 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.96 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
A
A
H
L
H
H
G
G
1050
|
G
G
-
W
T
T
T
T
K
K
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | MCF10A cells | Breast | Homo sapiens (Human) | CVCL_0598 | |||||||||
| Ba/F3 cells | Colon | Homo sapiens (Human) | CVCL_0161 | ||||||||||
| In Vivo Model | Female nude mouse xenograft model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
Immunoblotting analysis | ||||||||||||
| Mechanism Description | The missense mutation p.H1047L (c.3140A>T) in gene PIK3CA cause the sensitivity of Trametinib by unusual activation of pro-survival pathway | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: GTPase Hras (HRAS) | [8] | ||||||||||||
| Resistant Disease | HER2 positive breast cancer [ICD-11: 2C60.8] | ||||||||||||
| Resistant Drug | Trastuzumab | ||||||||||||
| Molecule Alteration | Missense mutation | p.G12S |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.24 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.71 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
M
T
T
E
E
Y
Y
K
K
L
L
V
V
V
V
V
V
10
|
G
G
A
A
G
S
G
G
V
V
G
G
K
K
S
S
A
A
L
L
20
|
T
T
I
I
Q
Q
L
L
I
I
Q
Q
N
N
H
H
F
F
V
V
30
|
D
D
E
E
Y
Y
D
D
P
P
T
T
I
I
E
E
D
D
S
S
40
|
Y
Y
R
R
K
K
Q
Q
V
V
V
V
I
I
D
D
G
G
E
E
50
|
T
T
C
C
L
L
L
L
D
D
I
I
L
L
D
D
T
T
A
A
60
|
G
G
Q
Q
E
E
E
E
Y
Y
S
S
A
A
M
M
R
R
D
D
70
|
Q
Q
Y
Y
M
M
R
R
T
T
G
G
E
E
G
G
F
F
L
L
80
|
C
C
V
V
F
F
A
A
I
I
N
N
N
N
T
T
K
K
S
S
90
|
F
F
E
E
D
D
I
I
H
H
H
H
Y
Y
R
R
E
E
Q
Q
100
|
I
I
K
K
R
R
V
V
K
K
D
D
S
S
E
E
D
D
V
V
110
|
P
P
M
M
V
V
L
L
V
V
G
G
N
N
K
K
C
C
D
D
120
|
L
L
P
P
S
S
R
R
T
T
V
V
D
D
T
T
K
K
Q
Q
130
|
A
A
Q
Q
D
D
L
L
A
A
R
R
S
S
Y
Y
G
G
I
I
140
|
P
P
F
F
I
I
E
E
T
T
S
S
A
A
K
K
T
T
R
R
150
|
Q
Q
G
G
V
V
D
D
D
D
A
A
F
F
Y
Y
T
T
L
L
160
|
V
V
R
R
E
E
I
I
R
R
K
K
H
H
K
K
E
E
K
K
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vitro Model | Plasma | Blood | Homo sapiens (Human) | N.A. | |||||||||
| Experiment for Molecule Alteration |
Next-generation sequencing assay; Circulating-free DNA assay | ||||||||||||
| Experiment for Drug Resistance |
Positron emission tomography/Computed tomography assay | ||||||||||||
| Mechanism Description | Seven genes, including epidermal growth factor receptor (EGFR), G protein subunit alpha S (GNAS), HRas proto-oncogene (HRAS), mutL homolog 1 (MLH1), cadherin 1 (CDH1), neuroblastoma RAS viral oncogene homolog (NRAS), and NOTCH1, that only occurred mutations in the resistant group were associated with the resistance of targeted therapy. | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: GTPase Hras (HRAS) | [8] | ||||||||||||
| Resistant Disease | HER2 positive breast cancer [ICD-11: 2C60.8] | ||||||||||||
| Resistant Drug | Trastuzumab emtansine | ||||||||||||
| Molecule Alteration | Missense mutation | p.G12S |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.24 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.71 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
M
T
T
E
E
Y
Y
K
K
L
L
V
V
V
V
V
V
10
|
G
G
A
A
G
S
G
G
V
V
G
G
K
K
S
S
A
A
L
L
20
|
T
T
I
I
Q
Q
L
L
I
I
Q
Q
N
N
H
H
F
F
V
V
30
|
D
D
E
E
Y
Y
D
D
P
P
T
T
I
I
E
E
D
D
S
S
40
|
Y
Y
R
R
K
K
Q
Q
V
V
V
V
I
I
D
D
G
G
E
E
50
|
T
T
C
C
L
L
L
L
D
D
I
I
L
L
D
D
T
T
A
A
60
|
G
G
Q
Q
E
E
E
E
Y
Y
S
S
A
A
M
M
R
R
D
D
70
|
Q
Q
Y
Y
M
M
R
R
T
T
G
G
E
E
G
G
F
F
L
L
80
|
C
C
V
V
F
F
A
A
I
I
N
N
N
N
T
T
K
K
S
S
90
|
F
F
E
E
D
D
I
I
H
H
H
H
Y
Y
R
R
E
E
Q
Q
100
|
I
I
K
K
R
R
V
V
K
K
D
D
S
S
E
E
D
D
V
V
110
|
P
P
M
M
V
V
L
L
V
V
G
G
N
N
K
K
C
C
D
D
120
|
L
L
P
P
S
S
R
R
T
T
V
V
D
D
T
T
K
K
Q
Q
130
|
A
A
Q
Q
D
D
L
L
A
A
R
R
S
S
Y
Y
G
G
I
I
140
|
P
P
F
F
I
I
E
E
T
T
S
S
A
A
K
K
T
T
R
R
150
|
Q
Q
G
G
V
V
D
D
D
D
A
A
F
F
Y
Y
T
T
L
L
160
|
V
V
R
R
E
E
I
I
R
R
K
K
H
H
K
K
E
E
K
K
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vitro Model | Plasma | Blood | Homo sapiens (Human) | N.A. | |||||||||
| Experiment for Molecule Alteration |
Next-generation sequencing assay; Circulating-free DNA assay | ||||||||||||
| Experiment for Drug Resistance |
Positron emission tomography/Computed tomography assay | ||||||||||||
| Mechanism Description | Seven genes, including epidermal growth factor receptor (EGFR), G protein subunit alpha S (GNAS), HRas proto-oncogene (HRAS), mutL homolog 1 (MLH1), cadherin 1 (CDH1), neuroblastoma RAS viral oncogene homolog (NRAS), and NOTCH1, that only occurred mutations in the resistant group were associated with the resistance of targeted therapy. | ||||||||||||
Clinical Trial Drug(s)
9 drug(s) in total
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [14] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | Buparlisib | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vitro Model | T47D cells | Breast | Homo sapiens (Human) | CVCL_0553 | |||||||||
| BT474 cells | Breast | Homo sapiens (Human) | CVCL_0179 | ||||||||||
| MDA-MB-361 cells | Breast | Homo sapiens (Human) | CVCL_0620 | ||||||||||
| In Vivo Model | Athymic mouse PDX model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
qRT-PCR; Western blot analysis | ||||||||||||
| Experiment for Drug Resistance |
Promega assay | ||||||||||||
| Mechanism Description | Brain metastases evade phosphatidylinositide 3-kinase (PI3K) inhibition despite drug accumulation in the brain lesions. In comparison to extracranial disease, increased HER3 expression and phosphorylation in brain lesions. HER3 blockade overcame the resistance of HER2-amplified and/or PIK3CA-mutant breast cancer brain metastases to PI3K inhibitors, resulting in marked tumor growth delay and improvement in mouse survival. | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: RAC-alpha serine/threonine-protein kinase (AKT1) | [15] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | Capivasertib | ||||||||||||
| Molecule Alteration | Missense mutation | p.E17K (c.49G>A) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.65 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.94 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
0
|
-
S
M
M
S
S
D
D
V
V
A
A
I
I
V
V
K
K
E
E
10
|
G
G
W
W
L
L
H
H
K
K
R
R
G
G
E
K
Y
Y
I
I
20
|
K
K
T
T
W
W
R
R
P
P
R
R
Y
Y
F
F
L
L
L
L
30
|
K
K
N
N
D
D
G
G
T
T
F
F
I
I
G
G
Y
Y
K
K
40
|
E
E
R
R
P
P
Q
Q
D
D
V
V
D
D
Q
Q
R
R
E
E
50
|
A
A
P
P
L
L
N
N
N
N
F
F
S
S
V
V
A
A
Q
Q
60
|
C
C
Q
Q
L
L
M
M
K
K
T
T
E
E
R
R
P
P
R
R
70
|
P
P
N
N
T
T
F
F
I
I
I
I
R
R
C
C
L
L
Q
Q
80
|
W
W
T
T
T
T
V
V
I
I
E
E
R
R
T
T
F
F
H
H
90
|
V
V
E
E
T
T
P
P
E
E
E
E
R
R
E
E
E
E
W
W
100
|
T
T
T
T
A
A
I
I
Q
Q
T
T
V
V
A
A
D
D
G
G
110
|
L
L
K
K
K
K
Q
Q
E
E
E
E
E
E
E
E
M
M
D
D
120
|
F
F
R
R
-
S
-
G
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| Mechanism Description | The missense mutation p.E17K (c.49G>A) in gene AKT1 cause the sensitivity of Capivasertib by aberration of the drug's therapeutic target | ||||||||||||
| Key Molecule: RAC-alpha serine/threonine-protein kinase (AKT1) | [16] | ||||||||||||
| Sensitive Disease | HER2 negative breast cancer [ICD-11: 2C60.11] | ||||||||||||
| Sensitive Drug | Capivasertib | ||||||||||||
| Molecule Alteration | Missense mutation | p.E17K (c.49G>A) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.65 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.94 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
0
|
-
S
M
M
S
S
D
D
V
V
A
A
I
I
V
V
K
K
E
E
10
|
G
G
W
W
L
L
H
H
K
K
R
R
G
G
E
K
Y
Y
I
I
20
|
K
K
T
T
W
W
R
R
P
P
R
R
Y
Y
F
F
L
L
L
L
30
|
K
K
N
N
D
D
G
G
T
T
F
F
I
I
G
G
Y
Y
K
K
40
|
E
E
R
R
P
P
Q
Q
D
D
V
V
D
D
Q
Q
R
R
E
E
50
|
A
A
P
P
L
L
N
N
N
N
F
F
S
S
V
V
A
A
Q
Q
60
|
C
C
Q
Q
L
L
M
M
K
K
T
T
E
E
R
R
P
P
R
R
70
|
P
P
N
N
T
T
F
F
I
I
I
I
R
R
C
C
L
L
Q
Q
80
|
W
W
T
T
T
T
V
V
I
I
E
E
R
R
T
T
F
F
H
H
90
|
V
V
E
E
T
T
P
P
E
E
E
E
R
R
E
E
E
E
W
W
100
|
T
T
T
T
A
A
I
I
Q
Q
T
T
V
V
A
A
D
D
G
G
110
|
L
L
K
K
K
K
Q
Q
E
E
E
E
E
E
E
E
M
M
D
D
120
|
F
F
R
R
-
S
-
G
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vitro Model | Breast | N.A. | |||||||||||
| Mechanism Description | The missense mutation p.E17K (c.49G>A) in gene AKT1 cause the sensitivity of Capivasertib by aberration of the drug's therapeutic target | ||||||||||||
| Key Molecule: RAC-alpha serine/threonine-protein kinase (AKT1) | [16] | ||||||||||||
| Sensitive Disease | HER2 negative breast cancer [ICD-11: 2C60.11] | ||||||||||||
| Sensitive Drug | Capivasertib | ||||||||||||
| Molecule Alteration | Missense mutation | p.E17K (c.49G>A) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.65 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.94 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
0
|
-
S
M
M
S
S
D
D
V
V
A
A
I
I
V
V
K
K
E
E
10
|
G
G
W
W
L
L
H
H
K
K
R
R
G
G
E
K
Y
Y
I
I
20
|
K
K
T
T
W
W
R
R
P
P
R
R
Y
Y
F
F
L
L
L
L
30
|
K
K
N
N
D
D
G
G
T
T
F
F
I
I
G
G
Y
Y
K
K
40
|
E
E
R
R
P
P
Q
Q
D
D
V
V
D
D
Q
Q
R
R
E
E
50
|
A
A
P
P
L
L
N
N
N
N
F
F
S
S
V
V
A
A
Q
Q
60
|
C
C
Q
Q
L
L
M
M
K
K
T
T
E
E
R
R
P
P
R
R
70
|
P
P
N
N
T
T
F
F
I
I
I
I
R
R
C
C
L
L
Q
Q
80
|
W
W
T
T
T
T
V
V
I
I
E
E
R
R
T
T
F
F
H
H
90
|
V
V
E
E
T
T
P
P
E
E
E
E
R
R
E
E
E
E
W
W
100
|
T
T
T
T
A
A
I
I
Q
Q
T
T
V
V
A
A
D
D
G
G
110
|
L
L
K
K
K
K
Q
Q
E
E
E
E
E
E
E
E
M
M
D
D
120
|
F
F
R
R
-
S
-
G
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vitro Model | Breast | N.A. | |||||||||||
| Mechanism Description | The missense mutation p.E17K (c.49G>A) in gene AKT1 cause the sensitivity of Capivasertib by aberration of the drug's therapeutic target | ||||||||||||
| Key Molecule: RAC-alpha serine/threonine-protein kinase (AKT1) | [17] | ||||||||||||
| Sensitive Disease | ER positive breast cancer [ICD-11: 2C60.6] | ||||||||||||
| Sensitive Drug | Capivasertib | ||||||||||||
| Molecule Alteration | Missense mutation | p.E17K (c.49G>A) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.65 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.94 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
0
|
-
S
M
M
S
S
D
D
V
V
A
A
I
I
V
V
K
K
E
E
10
|
G
G
W
W
L
L
H
H
K
K
R
R
G
G
E
K
Y
Y
I
I
20
|
K
K
T
T
W
W
R
R
P
P
R
R
Y
Y
F
F
L
L
L
L
30
|
K
K
N
N
D
D
G
G
T
T
F
F
I
I
G
G
Y
Y
K
K
40
|
E
E
R
R
P
P
Q
Q
D
D
V
V
D
D
Q
Q
R
R
E
E
50
|
A
A
P
P
L
L
N
N
N
N
F
F
S
S
V
V
A
A
Q
Q
60
|
C
C
Q
Q
L
L
M
M
K
K
T
T
E
E
R
R
P
P
R
R
70
|
P
P
N
N
T
T
F
F
I
I
I
I
R
R
C
C
L
L
Q
Q
80
|
W
W
T
T
T
T
V
V
I
I
E
E
R
R
T
T
F
F
H
H
90
|
V
V
E
E
T
T
P
P
E
E
E
E
R
R
E
E
E
E
W
W
100
|
T
T
T
T
A
A
I
I
Q
Q
T
T
V
V
A
A
D
D
G
G
110
|
L
L
K
K
K
K
Q
Q
E
E
E
E
E
E
E
E
M
M
D
D
120
|
F
F
R
R
-
S
-
G
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vitro Model | Breast | N.A. | |||||||||||
| Mechanism Description | The missense mutation p.E17K (c.49G>A) in gene AKT1 cause the sensitivity of Capivasertib by aberration of the drug's therapeutic target | ||||||||||||
| Key Molecule: RAC-alpha serine/threonine-protein kinase (AKT1) | [17] | ||||||||||||
| Sensitive Disease | ER negative breast cancer [ICD-11: 2C60.7] | ||||||||||||
| Sensitive Drug | Capivasertib | ||||||||||||
| Molecule Alteration | Missense mutation | p.E17K (c.49G>A) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.65 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.94 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
0
|
-
S
M
M
S
S
D
D
V
V
A
A
I
I
V
V
K
K
E
E
10
|
G
G
W
W
L
L
H
H
K
K
R
R
G
G
E
K
Y
Y
I
I
20
|
K
K
T
T
W
W
R
R
P
P
R
R
Y
Y
F
F
L
L
L
L
30
|
K
K
N
N
D
D
G
G
T
T
F
F
I
I
G
G
Y
Y
K
K
40
|
E
E
R
R
P
P
Q
Q
D
D
V
V
D
D
Q
Q
R
R
E
E
50
|
A
A
P
P
L
L
N
N
N
N
F
F
S
S
V
V
A
A
Q
Q
60
|
C
C
Q
Q
L
L
M
M
K
K
T
T
E
E
R
R
P
P
R
R
70
|
P
P
N
N
T
T
F
F
I
I
I
I
R
R
C
C
L
L
Q
Q
80
|
W
W
T
T
T
T
V
V
I
I
E
E
R
R
T
T
F
F
H
H
90
|
V
V
E
E
T
T
P
P
E
E
E
E
R
R
E
E
E
E
W
W
100
|
T
T
T
T
A
A
I
I
Q
Q
T
T
V
V
A
A
D
D
G
G
110
|
L
L
K
K
K
K
Q
Q
E
E
E
E
E
E
E
E
M
M
D
D
120
|
F
F
R
R
-
S
-
G
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vitro Model | Breast | N.A. | |||||||||||
| Mechanism Description | The missense mutation p.E17K (c.49G>A) in gene AKT1 cause the sensitivity of Capivasertib by aberration of the drug's therapeutic target | ||||||||||||
| Key Molecule: RAC-alpha serine/threonine-protein kinase (AKT1) | [18] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | Capivasertib | ||||||||||||
| Molecule Alteration | Missense mutation | p.E17K (c.49G>A) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.65 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.94 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
0
|
-
S
M
M
S
S
D
D
V
V
A
A
I
I
V
V
K
K
E
E
10
|
G
G
W
W
L
L
H
H
K
K
R
R
G
G
E
K
Y
Y
I
I
20
|
K
K
T
T
W
W
R
R
P
P
R
R
Y
Y
F
F
L
L
L
L
30
|
K
K
N
N
D
D
G
G
T
T
F
F
I
I
G
G
Y
Y
K
K
40
|
E
E
R
R
P
P
Q
Q
D
D
V
V
D
D
Q
Q
R
R
E
E
50
|
A
A
P
P
L
L
N
N
N
N
F
F
S
S
V
V
A
A
Q
Q
60
|
C
C
Q
Q
L
L
M
M
K
K
T
T
E
E
R
R
P
P
R
R
70
|
P
P
N
N
T
T
F
F
I
I
I
I
R
R
C
C
L
L
Q
Q
80
|
W
W
T
T
T
T
V
V
I
I
E
E
R
R
T
T
F
F
H
H
90
|
V
V
E
E
T
T
P
P
E
E
E
E
R
R
E
E
E
E
W
W
100
|
T
T
T
T
A
A
I
I
Q
Q
T
T
V
V
A
A
D
D
G
G
110
|
L
L
K
K
K
K
Q
Q
E
E
E
E
E
E
E
E
M
M
D
D
120
|
F
F
R
R
-
S
-
G
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vitro Model | MCF10A cells | Breast | Homo sapiens (Human) | CVCL_0598 | |||||||||
| In Vivo Model | Male nude mouse (nu/nu:Alpk) xenograft model | Mus musculus | |||||||||||
| Mechanism Description | The missense mutation p.E17K (c.49G>A) in gene AKT1 cause the sensitivity of Capivasertib by aberration of the drug's therapeutic target | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Cellular tumor antigen p53 (TP53) | [19] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | Ganetespib | ||||||||||||
| Molecule Alteration | Missense mutation | p.R175H (c.524G>A) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 2.37 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.38 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
H
H
M
M
170
|
T
T
E
E
V
V
V
V
R
R
R
H
C
C
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | SkBR3 cells | Breast | Homo sapiens (Human) | CVCL_0033 | |||||||||
| H1975 cells | Lung | Homo sapiens (Human) | CVCL_1511 | ||||||||||
| T47D cells | Breast | Homo sapiens (Human) | CVCL_0553 | ||||||||||
| ES2 cells | Ovary | Homo sapiens (Human) | CVCL_AX39 | ||||||||||
| DU145 cells | Prostate | Homo sapiens (Human) | CVCL_0105 | ||||||||||
| MDA-MB-231 cells | Breast | Homo sapiens (Human) | CVCL_0062 | ||||||||||
| MDA-46 cells | N.A. | Homo sapiens (Human) | N.A. | ||||||||||
| HOC7 cells | Ascites | Homo sapiens (Human) | CVCL_5455 | ||||||||||
| EFO21 cells | Ascites | Homo sapiens (Human) | CVCL_0029 | ||||||||||
| COV434 cells | N.A. | Homo sapiens (Human) | CVCL_2010 | ||||||||||
| COLO704 cells | Ascites | Homo sapiens (Human) | CVCL_1994 | ||||||||||
| HOC7 cells | Ascites | Homo sapiens (Human) | CVCL_5455 | ||||||||||
| In Vivo Model | Athymic (nu/nu) male xenograft mouse model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
Western blot analysis; Quantitative PCR analysis | ||||||||||||
| Experiment for Drug Resistance |
CellTiter-blue cell viability assay | ||||||||||||
| Key Molecule: Cellular tumor antigen p53 (TP53) | [19] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | Ganetespib | ||||||||||||
| Molecule Alteration | Missense mutation | p.R280K (c.839G>A) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 2.05 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.00 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
S
-
S
-
S
-
V
V
P
P
S
S
100
|
Q
Q
K
K
T
T
Y
Y
Q
Q
G
G
S
S
Y
Y
G
G
F
F
110
|
R
R
L
L
G
G
F
F
L
L
H
H
S
S
G
G
T
T
A
A
120
|
K
K
S
S
V
V
T
T
C
C
T
T
Y
Y
S
S
P
P
A
A
130
|
L
L
N
N
K
K
M
M
F
F
C
C
Q
Q
L
L
A
A
K
K
140
|
T
T
C
C
P
P
V
V
Q
Q
L
L
W
W
V
V
D
D
S
S
150
|
T
T
P
P
P
P
P
P
G
G
T
T
R
R
V
V
R
R
A
A
160
|
M
M
A
A
I
I
Y
Y
K
K
Q
Q
S
S
Q
Q
H
H
M
M
170
|
T
T
E
E
V
V
V
V
R
R
R
R
C
C
P
P
H
H
H
H
180
|
E
E
R
R
C
C
S
S
D
D
S
S
D
D
G
G
L
L
A
A
190
|
P
P
P
P
Q
Q
H
H
L
L
I
I
R
R
V
V
E
E
G
G
200
|
N
N
L
L
R
R
V
V
E
E
Y
Y
L
L
D
D
D
D
R
R
210
|
N
N
T
T
F
F
R
R
H
H
S
S
V
V
V
V
V
V
P
P
220
|
Y
Y
E
E
P
P
P
P
E
E
V
V
G
G
S
S
D
D
C
C
230
|
T
T
T
T
I
I
H
H
Y
Y
N
N
Y
Y
M
M
C
C
N
N
240
|
S
S
S
S
C
C
M
M
G
G
G
G
M
M
N
N
R
R
R
R
250
|
P
P
I
I
L
L
T
T
I
I
I
I
T
T
L
L
E
E
D
D
260
|
S
S
S
S
G
G
N
N
L
L
L
L
G
G
R
R
N
N
S
S
270
|
F
F
E
E
V
V
R
R
V
V
C
C
A
A
C
C
P
P
G
G
280
|
R
K
D
D
R
R
R
R
T
T
E
E
E
E
E
E
N
N
L
L
290
|
R
-
K
-
K
-
G
-
E
-
P
-
H
-
H
-
E
-
L
-
300
|
P
-
P
-
G
-
S
-
T
-
K
-
R
-
A
-
L
-
P
-
310
|
N
-
N
-
T
-
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | SkBR3 cells | Breast | Homo sapiens (Human) | CVCL_0033 | |||||||||
| H1975 cells | Lung | Homo sapiens (Human) | CVCL_1511 | ||||||||||
| T47D cells | Breast | Homo sapiens (Human) | CVCL_0553 | ||||||||||
| ES2 cells | Ovary | Homo sapiens (Human) | CVCL_AX39 | ||||||||||
| DU145 cells | Prostate | Homo sapiens (Human) | CVCL_0105 | ||||||||||
| MDA-MB-231 cells | Breast | Homo sapiens (Human) | CVCL_0062 | ||||||||||
| MDA-46 cells | N.A. | Homo sapiens (Human) | N.A. | ||||||||||
| HOC7 cells | Ascites | Homo sapiens (Human) | CVCL_5455 | ||||||||||
| EFO21 cells | Ascites | Homo sapiens (Human) | CVCL_0029 | ||||||||||
| COV434 cells | N.A. | Homo sapiens (Human) | CVCL_2010 | ||||||||||
| COLO704 cells | Ascites | Homo sapiens (Human) | CVCL_1994 | ||||||||||
| HOC7 cells | Ascites | Homo sapiens (Human) | CVCL_5455 | ||||||||||
| In Vivo Model | Athymic (nu/nu) male xenograft mouse model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
Western blot analysis; Quantitative PCR analysis | ||||||||||||
| Experiment for Drug Resistance |
CellTiter-blue cell viability assay | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: RAC-alpha serine/threonine-protein kinase (AKT1) | [20] | ||||||||||||
| Sensitive Disease | HER2 negative breast cancer [ICD-11: 2C60.11] | ||||||||||||
| Sensitive Drug | Ipatasertib | ||||||||||||
| Molecule Alteration | Missense mutation | p.E17K (c.49G>A) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.65 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.94 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
0
|
-
S
M
M
S
S
D
D
V
V
A
A
I
I
V
V
K
K
E
E
10
|
G
G
W
W
L
L
H
H
K
K
R
R
G
G
E
K
Y
Y
I
I
20
|
K
K
T
T
W
W
R
R
P
P
R
R
Y
Y
F
F
L
L
L
L
30
|
K
K
N
N
D
D
G
G
T
T
F
F
I
I
G
G
Y
Y
K
K
40
|
E
E
R
R
P
P
Q
Q
D
D
V
V
D
D
Q
Q
R
R
E
E
50
|
A
A
P
P
L
L
N
N
N
N
F
F
S
S
V
V
A
A
Q
Q
60
|
C
C
Q
Q
L
L
M
M
K
K
T
T
E
E
R
R
P
P
R
R
70
|
P
P
N
N
T
T
F
F
I
I
I
I
R
R
C
C
L
L
Q
Q
80
|
W
W
T
T
T
T
V
V
I
I
E
E
R
R
T
T
F
F
H
H
90
|
V
V
E
E
T
T
P
P
E
E
E
E
R
R
E
E
E
E
W
W
100
|
T
T
T
T
A
A
I
I
Q
Q
T
T
V
V
A
A
D
D
G
G
110
|
L
L
K
K
K
K
Q
Q
E
E
E
E
E
E
E
E
M
M
D
D
120
|
F
F
R
R
-
S
-
G
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| Cell Pathway Regulation | AKT signaling pathway | Inhibition | hsa04151 | ||||||||||
| In Vivo Model | SCID beige mouse PDX model | Mus musculus | |||||||||||
| Experiment for Drug Resistance |
CellTitre-Glo assay; Wallac multilabel reader assay | ||||||||||||
| Mechanism Description | Ipatasertib (GDC-0068) is a novel selective ATP-competitive small-molecule inhibitor of AKT that preferentially targets active phosphorylated AKT (pAKT) and is potent in cell lines with evidence of AKT activation. | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [21] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | Taselisib | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| Cell Pathway Regulation | PI3K signaling pathway | Inhibition | hsa04151 | ||||||||||
| In Vitro Model | KPL-4 cells | Breast | Homo sapiens (Human) | CVCL_5310 | |||||||||
| In Vivo Model | SCID beige mouse PDX model | Mus musculus | |||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [22] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | Miransertib | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | DU-145 cells | Prostate | Homo sapiens (Human) | CVCL_0105 | |||||||||
| LNCaP cells | Prostate | Homo sapiens (Human) | CVCL_0395 | ||||||||||
| MDA-MB-231 cells | Breast | Homo sapiens (Human) | CVCL_0062 | ||||||||||
| Hela cells | Cervix uteri | Homo sapiens (Human) | CVCL_0030 | ||||||||||
| T47D cells | Breast | Homo sapiens (Human) | CVCL_0553 | ||||||||||
| NCI-H460 cells | Lung | Homo sapiens (Human) | CVCL_0459 | ||||||||||
| MDA-MB-453 cells | Breast | Homo sapiens (Human) | CVCL_0418 | ||||||||||
| MDA-MB-468 cells | Breast | Homo sapiens (Human) | CVCL_0419 | ||||||||||
| HCC70 cells | Breast | Homo sapiens (Human) | CVCL_1270 | ||||||||||
| A2058 cells | Skin | Homo sapiens (Human) | CVCL_1059 | ||||||||||
| Caco2 cells | Colon | Homo sapiens (Human) | CVCL_0025 | ||||||||||
| MCF-7 cells | Breast | Homo sapiens (Human) | CVCL_0031 | ||||||||||
| ZR75-1 cells | Breast | Homo sapiens (Human) | CVCL_0588 | ||||||||||
| NCI-60 cells | N.A. | Homo sapiens (Human) | N.A. | ||||||||||
| KU-19 cells | Blood | Bos taurus (Bovine) | CVCL_VN09 | ||||||||||
| EVSA-T cells | Ascites | Homo sapiens (Human) | CVCL_1207 | ||||||||||
| CAL-120 cells | Pleural effusion | Homo sapiens (Human) | CVCL_1104 | ||||||||||
| BT-549 cells | Breast | Homo sapiens (Human) | CVCL_1092 | ||||||||||
| BT-474 cells | Breast | Homo sapiens (Human) | CVCL_0179 | ||||||||||
| BT-20 cells | Mammary gland | Homo sapiens (Human) | CVCL_0178 | ||||||||||
| B16F10 cells | Skin | Mus musculus (Mouse) | CVCL_0159 | ||||||||||
| In Vivo Model | Female NMRI (nu/nu) mouse xenograft model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
Western blot analysis | ||||||||||||
| Mechanism Description | The missense mutation p.H1047R (c.3140A>G) in gene PIK3CA cause the sensitivity of Miransertib by aberration of the drug's therapeutic target | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [23] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | CH-5132799 | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | KPL-4 cells | Breast | Homo sapiens (Human) | CVCL_5310 | |||||||||
| IGROV1 cells | Ovary | Homo sapiens (Human) | CVCL_1304 | ||||||||||
| GXF97 cells | N.A. | N.A. | N.A. | ||||||||||
| In Vivo Model | Female BALB-nu/nu mouse xenograft model | Mus musculus | |||||||||||
| Experiment for Drug Resistance |
CCK-8 assay | ||||||||||||
| Mechanism Description | The missense mutation p.H1047R (c.3140A>G) in gene PIK3CA cause the sensitivity of CH-5132799 by aberration of the drug's therapeutic target | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: RAC-alpha serine/threonine-protein kinase (AKT1) | [24] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | BAY1125976 | ||||||||||||
| Molecule Alteration | Missense mutation | p.E17K (c.49G>A) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.65 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.94 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
0
|
-
S
M
M
S
S
D
D
V
V
A
A
I
I
V
V
K
K
E
E
10
|
G
G
W
W
L
L
H
H
K
K
R
R
G
G
E
K
Y
Y
I
I
20
|
K
K
T
T
W
W
R
R
P
P
R
R
Y
Y
F
F
L
L
L
L
30
|
K
K
N
N
D
D
G
G
T
T
F
F
I
I
G
G
Y
Y
K
K
40
|
E
E
R
R
P
P
Q
Q
D
D
V
V
D
D
Q
Q
R
R
E
E
50
|
A
A
P
P
L
L
N
N
N
N
F
F
S
S
V
V
A
A
Q
Q
60
|
C
C
Q
Q
L
L
M
M
K
K
T
T
E
E
R
R
P
P
R
R
70
|
P
P
N
N
T
T
F
F
I
I
I
I
R
R
C
C
L
L
Q
Q
80
|
W
W
T
T
T
T
V
V
I
I
E
E
R
R
T
T
F
F
H
H
90
|
V
V
E
E
T
T
P
P
E
E
E
E
R
R
E
E
E
E
W
W
100
|
T
T
T
T
A
A
I
I
Q
Q
T
T
V
V
A
A
D
D
G
G
110
|
L
L
K
K
K
K
Q
Q
E
E
E
E
E
E
E
E
M
M
D
D
120
|
F
F
R
R
-
S
-
G
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | LNCaP cells | Prostate | Homo sapiens (Human) | CVCL_0395 | |||||||||
| MDA-MB-231 cells | Breast | Homo sapiens (Human) | CVCL_0062 | ||||||||||
| Hela cells | Cervix uteri | Homo sapiens (Human) | CVCL_0030 | ||||||||||
| NCI-H460 cells | Lung | Homo sapiens (Human) | CVCL_0459 | ||||||||||
| MDA-MB-453 cells | Breast | Homo sapiens (Human) | CVCL_0418 | ||||||||||
| MDA-MB-468 cells | Breast | Homo sapiens (Human) | CVCL_0419 | ||||||||||
| HCC70 cells | Breast | Homo sapiens (Human) | CVCL_1270 | ||||||||||
| A2058 cells | Skin | Homo sapiens (Human) | CVCL_1059 | ||||||||||
| Caco2 cells | Colon | Homo sapiens (Human) | CVCL_0025 | ||||||||||
| MCF-7 cells | Breast | Homo sapiens (Human) | CVCL_0031 | ||||||||||
| ZR75-1 cells | Breast | Homo sapiens (Human) | CVCL_0588 | ||||||||||
| DU-145 cells | Prostate | Homo sapiens (Human) | CVCL_0105 | ||||||||||
| NCI-60 cells | N.A. | Homo sapiens (Human) | N.A. | ||||||||||
| EVSA-T cells | Ascites | Homo sapiens (Human) | CVCL_1207 | ||||||||||
| KU-19 cells | Blood | Bos taurus (Bovine) | CVCL_VN09 | ||||||||||
| T47D cells | Pleural effusion | Homo sapiens (Human) | CVCL_0553 | ||||||||||
| CAL-120 cells | Pleural effusion | Homo sapiens (Human) | CVCL_1104 | ||||||||||
| BT-549 cells | Breast | Homo sapiens (Human) | CVCL_1092 | ||||||||||
| BT-474 cells | Breast | Homo sapiens (Human) | CVCL_0179 | ||||||||||
| BT-20 cells | Mammary gland | Homo sapiens (Human) | CVCL_0178 | ||||||||||
| B16F10 cells | Skin | Mus musculus (Mouse) | CVCL_0159 | ||||||||||
| In Vivo Model | Female NMRI (nu/nu) mouse xenograft model | Mus musculus | |||||||||||
| Mechanism Description | The missense mutation p.E17K (c.49G>A) in gene AKT1 cause the sensitivity of BAY1125976 by unusual activation of pro-survival pathway | ||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [24] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | BAY1125976 | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | LNCaP cells | Prostate | Homo sapiens (Human) | CVCL_0395 | |||||||||
| MDA-MB-231 cells | Breast | Homo sapiens (Human) | CVCL_0062 | ||||||||||
| Hela cells | Cervix uteri | Homo sapiens (Human) | CVCL_0030 | ||||||||||
| NCI-H460 cells | Lung | Homo sapiens (Human) | CVCL_0459 | ||||||||||
| MDA-MB-453 cells | Breast | Homo sapiens (Human) | CVCL_0418 | ||||||||||
| MDA-MB-468 cells | Breast | Homo sapiens (Human) | CVCL_0419 | ||||||||||
| HCC70 cells | Breast | Homo sapiens (Human) | CVCL_1270 | ||||||||||
| A2058 cells | Skin | Homo sapiens (Human) | CVCL_1059 | ||||||||||
| Caco2 cells | Colon | Homo sapiens (Human) | CVCL_0025 | ||||||||||
| MCF-7 cells | Breast | Homo sapiens (Human) | CVCL_0031 | ||||||||||
| ZR75-1 cells | Breast | Homo sapiens (Human) | CVCL_0588 | ||||||||||
| DU-145 cells | Prostate | Homo sapiens (Human) | CVCL_0105 | ||||||||||
| NCI-60 cells | N.A. | Homo sapiens (Human) | N.A. | ||||||||||
| EVSA-T cells | Ascites | Homo sapiens (Human) | CVCL_1207 | ||||||||||
| KU-19 cells | Blood | Bos taurus (Bovine) | CVCL_VN09 | ||||||||||
| T47D cells | Pleural effusion | Homo sapiens (Human) | CVCL_0553 | ||||||||||
| CAL-120 cells | Pleural effusion | Homo sapiens (Human) | CVCL_1104 | ||||||||||
| BT-549 cells | Breast | Homo sapiens (Human) | CVCL_1092 | ||||||||||
| BT-474 cells | Breast | Homo sapiens (Human) | CVCL_0179 | ||||||||||
| BT-20 cells | Mammary gland | Homo sapiens (Human) | CVCL_0178 | ||||||||||
| B16F10 cells | Skin | Mus musculus (Mouse) | CVCL_0159 | ||||||||||
| In Vivo Model | Female NMRI (nu/nu) mouse xenograft model | Mus musculus | |||||||||||
| Mechanism Description | The missense mutation p.H1047R (c.3140A>G) in gene PIK3CA cause the sensitivity of BAY1125976 by unusual activation of pro-survival pathway | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [25] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | M2698 | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| Cell Pathway Regulation | PI3K signaling pathway | Inhibition | hsa04151 | ||||||||||
| In Vitro Model | U251 cells | Brain | Homo sapiens (Human) | CVCL_0021 | |||||||||
| MDA-MB-453 cells | Breast | Homo sapiens (Human) | CVCL_0418 | ||||||||||
| MDA-MB-468 cells | Breast | Homo sapiens (Human) | CVCL_0419 | ||||||||||
| JIMT-1 cells | Breast | Homo sapiens (Human) | CVCL_2077 | ||||||||||
| HCC1419 cells | Breast | Homo sapiens (Human) | CVCL_1251 | ||||||||||
| In Vivo Model | Nude mouse PDX model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
Western blot analysis | ||||||||||||
| Experiment for Drug Resistance |
SRB staining assay | ||||||||||||
| Mechanism Description | M2698 blocked p70S6K to provide potent PAM pathway inhibition while simultaneously targeting Akt to overcome the compensatory feedback loop. | ||||||||||||
Preclinical Drug(s)
9 drug(s) in total
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: RAC-alpha serine/threonine-protein kinase (AKT1) | [26] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | Allosteric AKT inhibitors | ||||||||||||
| Molecule Alteration | Missense mutation | p.E17K (c.49G>A) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.65 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.94 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
0
|
-
S
M
M
S
S
D
D
V
V
A
A
I
I
V
V
K
K
E
E
10
|
G
G
W
W
L
L
H
H
K
K
R
R
G
G
E
K
Y
Y
I
I
20
|
K
K
T
T
W
W
R
R
P
P
R
R
Y
Y
F
F
L
L
L
L
30
|
K
K
N
N
D
D
G
G
T
T
F
F
I
I
G
G
Y
Y
K
K
40
|
E
E
R
R
P
P
Q
Q
D
D
V
V
D
D
Q
Q
R
R
E
E
50
|
A
A
P
P
L
L
N
N
N
N
F
F
S
S
V
V
A
A
Q
Q
60
|
C
C
Q
Q
L
L
M
M
K
K
T
T
E
E
R
R
P
P
R
R
70
|
P
P
N
N
T
T
F
F
I
I
I
I
R
R
C
C
L
L
Q
Q
80
|
W
W
T
T
T
T
V
V
I
I
E
E
R
R
T
T
F
F
H
H
90
|
V
V
E
E
T
T
P
P
E
E
E
E
R
R
E
E
E
E
W
W
100
|
T
T
T
T
A
A
I
I
Q
Q
T
T
V
V
A
A
D
D
G
G
110
|
L
L
K
K
K
K
Q
Q
E
E
E
E
E
E
E
E
M
M
D
D
120
|
F
F
R
R
-
S
-
G
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | Hela cells | Cervix uteri | Homo sapiens (Human) | CVCL_0030 | |||||||||
| HEK293 cells | Kidney | Homo sapiens (Human) | CVCL_0045 | ||||||||||
| In Vivo Model | Female NOD/SCID mouse xenograft model | Mus musculus | |||||||||||
| Mechanism Description | The missense mutation p.E17K (c.49G>A) in gene AKT1 cause the sensitivity of allosteric AKT inhibitors by aberration of the drug's therapeutic target | ||||||||||||
| Key Molecule: RAC-alpha serine/threonine-protein kinase (AKT1) | [26] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | Allosteric AKT inhibitors | ||||||||||||
| Molecule Alteration | Missense mutation | p.E17K (c.49G>A) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.65 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.94 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
0
|
-
S
M
M
S
S
D
D
V
V
A
A
I
I
V
V
K
K
E
E
10
|
G
G
W
W
L
L
H
H
K
K
R
R
G
G
E
K
Y
Y
I
I
20
|
K
K
T
T
W
W
R
R
P
P
R
R
Y
Y
F
F
L
L
L
L
30
|
K
K
N
N
D
D
G
G
T
T
F
F
I
I
G
G
Y
Y
K
K
40
|
E
E
R
R
P
P
Q
Q
D
D
V
V
D
D
Q
Q
R
R
E
E
50
|
A
A
P
P
L
L
N
N
N
N
F
F
S
S
V
V
A
A
Q
Q
60
|
C
C
Q
Q
L
L
M
M
K
K
T
T
E
E
R
R
P
P
R
R
70
|
P
P
N
N
T
T
F
F
I
I
I
I
R
R
C
C
L
L
Q
Q
80
|
W
W
T
T
T
T
V
V
I
I
E
E
R
R
T
T
F
F
H
H
90
|
V
V
E
E
T
T
P
P
E
E
E
E
R
R
E
E
E
E
W
W
100
|
T
T
T
T
A
A
I
I
Q
Q
T
T
V
V
A
A
D
D
G
G
110
|
L
L
K
K
K
K
Q
Q
E
E
E
E
E
E
E
E
M
M
D
D
120
|
F
F
R
R
-
S
-
G
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | Hela cells | Cervix uteri | Homo sapiens (Human) | CVCL_0030 | |||||||||
| HEK293T cells | Kidney | Homo sapiens (Human) | CVCL_0063 | ||||||||||
| In Vivo Model | Female NOD/SCID mouse xenograft model | Mus musculus | |||||||||||
| Experiment for Drug Resistance |
MTT assay | ||||||||||||
| Mechanism Description | Deactivation of Akt by a small molecule inhibitor ,SC66, targeting pleckstrin homology domain and facilitating Akt ubiquitination. A cancer-relevant Akt1 (e17k) mutant is unstable, making it intrinsically sensitive to functional inhibition by SC66 in cellular contexts in which the PI3K inhibition has little inhibitory effect. | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [22] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | ARQ 751 | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | DU-145 cells | Prostate | Homo sapiens (Human) | CVCL_0105 | |||||||||
| LNCaP cells | Prostate | Homo sapiens (Human) | CVCL_0395 | ||||||||||
| MDA-MB-231 cells | Breast | Homo sapiens (Human) | CVCL_0062 | ||||||||||
| Hela cells | Cervix uteri | Homo sapiens (Human) | CVCL_0030 | ||||||||||
| T47D cells | Breast | Homo sapiens (Human) | CVCL_0553 | ||||||||||
| NCI-H460 cells | Lung | Homo sapiens (Human) | CVCL_0459 | ||||||||||
| MDA-MB-453 cells | Breast | Homo sapiens (Human) | CVCL_0418 | ||||||||||
| MDA-MB-468 cells | Breast | Homo sapiens (Human) | CVCL_0419 | ||||||||||
| HCC70 cells | Breast | Homo sapiens (Human) | CVCL_1270 | ||||||||||
| A2058 cells | Skin | Homo sapiens (Human) | CVCL_1059 | ||||||||||
| Caco2 cells | Colon | Homo sapiens (Human) | CVCL_0025 | ||||||||||
| MCF-7 cells | Breast | Homo sapiens (Human) | CVCL_0031 | ||||||||||
| ZR75-1 cells | Breast | Homo sapiens (Human) | CVCL_0588 | ||||||||||
| NCI-60 cells | N.A. | Homo sapiens (Human) | N.A. | ||||||||||
| KU-19 cells | Blood | Bos taurus (Bovine) | CVCL_VN09 | ||||||||||
| EVSA-T cells | Ascites | Homo sapiens (Human) | CVCL_1207 | ||||||||||
| CAL-120 cells | Pleural effusion | Homo sapiens (Human) | CVCL_1104 | ||||||||||
| BT-549 cells | Breast | Homo sapiens (Human) | CVCL_1092 | ||||||||||
| BT-474 cells | Breast | Homo sapiens (Human) | CVCL_0179 | ||||||||||
| BT-20 cells | Mammary gland | Homo sapiens (Human) | CVCL_0178 | ||||||||||
| B16F10 cells | Skin | Mus musculus (Mouse) | CVCL_0159 | ||||||||||
| In Vivo Model | Female NMRI (nu/nu) mouse xenograft model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
Western blot analysis | ||||||||||||
| Mechanism Description | The missense mutation p.H1047R (c.3140A>G) in gene PIK3CA cause the sensitivity of ARQ 751 by aberration of the drug's therapeutic target | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [15] | ||||||||||||
| Sensitive Disease | HER2 positive breast cancer [ICD-11: 2C60.8] | ||||||||||||
| Sensitive Drug | AZD5363/Trastuzumab | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| Experiment for Molecule Alteration |
Western blot analysis | ||||||||||||
| Experiment for Drug Resistance |
MTS assay | ||||||||||||
| Mechanism Description | The missense mutation p.H1047R (c.3140A>G) in gene PIK3CA cause the sensitivity of AZD5363 + Trastuzumab by unusual activation of pro-survival pathway | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [27] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | CYH33 | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| Cell Pathway Regulation | PI3K signaling pathway | Inhibition | hsa04151 | ||||||||||
| In Vitro Model | MCF-7 cells | Breast | Homo sapiens (Human) | CVCL_0031 | |||||||||
| T47D cells | Breast | Homo sapiens (Human) | CVCL_0553 | ||||||||||
| AU565 cells | Breast | Homo sapiens (Human) | CVCL_1074 | ||||||||||
| In Vivo Model | MMTV-Cre mouse PDX model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
Western blot analysis; Immunohistochemistry analysis | ||||||||||||
| Experiment for Drug Resistance |
Sulforhodamine B assay; FACS assay | ||||||||||||
| Mechanism Description | Sensitivity to CYH33 has been further revealed to be associated with induction of G1 phase arrest and simultaneous inhibition of Akt and ERK. Sensitivity of patient-derived xenograft to CYH33 was also positively correlated with decrease in phosphorylated ERK. Taken together, CYH33 is a promising PI3Kalpha inhibitor for breast cancer treatment and decrease in ERK phosphorylation may indicate its efficacy, which provides useful clues for rational design of the ongoing clinical trials. | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [28] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | DHM25 | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | MCF-7 cells | Breast | Homo sapiens (Human) | CVCL_0031 | |||||||||
| MDA-MB-231 cells | Breast | Homo sapiens (Human) | CVCL_0062 | ||||||||||
| BT474 cells | Breast | Homo sapiens (Human) | CVCL_0179 | ||||||||||
| ZR75-1 cells | Breast | Homo sapiens (Human) | CVCL_0588 | ||||||||||
| MDA-MB-453 cells | Breast | Homo sapiens (Human) | CVCL_0418 | ||||||||||
| MDA-MB-468 cells | Breast | Homo sapiens (Human) | CVCL_0419 | ||||||||||
| BT549 cells | Breast | Homo sapiens (Human) | CVCL_1092 | ||||||||||
| T47-D cells | Pleural effusion | Homo sapiens (Human) | CVCL_0553 | ||||||||||
| In Vivo Model | NOD/SCID/gamac null mouse xenograft model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
Western blot analysis | ||||||||||||
| Experiment for Drug Resistance |
MTT assay | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [6] | ||||||||||||
| Resistant Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Resistant Drug | Hormone therapy | ||||||||||||
| Molecule Alteration | Missense mutation | p.Y537S (c.1610A>C) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.50 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
M
-
D
-
P
-
M
-
I
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
-
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
-
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
-
K
K
N
N
V
V
V
V
P
P
L
L
Y
S
D
D
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vitro Model | MDA-MB-231cells | Breast | Homo sapiens (Human) | CVCL_0062 | |||||||||
| ZR75-1 cells | Breast | Homo sapiens (Human) | CVCL_0588 | ||||||||||
| MDA-MB-361 cells | Breast | Homo sapiens (Human) | CVCL_0620 | ||||||||||
| MDA-MB-231cells | Breast | Homo sapiens (Human) | CVCL_0062 | ||||||||||
| SkBR3 MCF7 cells | Breast | Homo sapiens (Human) | N.A. | ||||||||||
| MCF Tet-On cells | Pleural effusion | Homo sapiens (Human) | CVCL_V332 | ||||||||||
| Ishikawa cells | Endometrium | Homo sapiens (Human) | CVCL_2529 | ||||||||||
| MCF Tet-On cells | Pleural effusion | Homo sapiens (Human) | CVCL_V332 | ||||||||||
| In Vivo Model | Nu/Nu athymic BALB/c female mouse model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
IMPACT assay; Western blot analysis; Luciferase assays; Microarrays assay | ||||||||||||
| Experiment for Drug Resistance |
MSKCC assay | ||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [6] | ||||||||||||
| Resistant Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Resistant Drug | Hormone therapy | ||||||||||||
| Molecule Alteration | Missense mutation | p.D538G (c.1613A>G) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.90 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
V
-
D
-
L
-
G
-
T
-
E
290
|
-
N
-
L
-
Y
-
F
-
Q
-
S
-
N
-
A
-
M
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
C
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
C
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
C
K
K
N
N
V
V
V
V
P
P
L
L
Y
Y
D
G
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vitro Model | MDA-MB-231cells | Breast | Homo sapiens (Human) | CVCL_0062 | |||||||||
| ZR75-1 cells | Breast | Homo sapiens (Human) | CVCL_0588 | ||||||||||
| MDA-MB-361 cells | Breast | Homo sapiens (Human) | CVCL_0620 | ||||||||||
| MDA-MB-231cells | Breast | Homo sapiens (Human) | CVCL_0062 | ||||||||||
| SkBR3 MCF7 cells | Breast | Homo sapiens (Human) | N.A. | ||||||||||
| MCF Tet-On cells | Pleural effusion | Homo sapiens (Human) | CVCL_V332 | ||||||||||
| Ishikawa cells | Endometrium | Homo sapiens (Human) | CVCL_2529 | ||||||||||
| MCF Tet-On cells | Pleural effusion | Homo sapiens (Human) | CVCL_V332 | ||||||||||
| In Vivo Model | Nu/Nu athymic BALB/c female mouse model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
IMPACT assay; Western blot analysis; Luciferase assays; Microarrays assay | ||||||||||||
| Experiment for Drug Resistance |
MSKCC assay | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [13] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | MK2206 | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | MCF10A cells | Breast | Homo sapiens (Human) | CVCL_0598 | |||||||||
| Ba/F3 cells | Colon | Homo sapiens (Human) | CVCL_0161 | ||||||||||
| In Vivo Model | Female nude mouse xenograft model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
Immunoblotting analysis | ||||||||||||
| Mechanism Description | The missense mutation p.H1047R (c.3140A>G) in gene PIK3CA cause the sensitivity of MK2206 by unusual activation of pro-survival pathway | ||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [13] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | MK2206 | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047L (c.3140A>T) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.77 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.96 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
A
A
H
L
H
H
G
G
1050
|
G
G
-
W
T
T
T
T
K
K
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | MCF10A cells | Breast | Homo sapiens (Human) | CVCL_0598 | |||||||||
| Ba/F3 cells | Colon | Homo sapiens (Human) | CVCL_0161 | ||||||||||
| In Vivo Model | Female nude mouse xenograft model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
Immunoblotting analysis | ||||||||||||
| Mechanism Description | The missense mutation p.H1047L (c.3140A>T) in gene PIK3CA cause the sensitivity of MK2206 by unusual activation of pro-survival pathway | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Cellular tumor antigen p53 (TP53) | [29] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | NSC319726 | ||||||||||||
| Molecule Alteration | Missense mutation | p.R175H (c.524G>A) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 2.37 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.38 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
H
H
M
M
170
|
T
T
E
E
V
V
V
V
R
R
R
H
C
C
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | (MEF) (10)3 cells | N.A. | Mus musculus (Mouse) | N.A. | |||||||||
| Experiment for Molecule Alteration |
Western blot analysis | ||||||||||||
| Experiment for Drug Resistance |
MTS assay | ||||||||||||
| Mechanism Description | The missense mutation p.R175H (c.524G>A) in gene TP53 cause the sensitivity of NSC319726 by aberration of the drug's therapeutic target | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Cellular tumor antigen p53 (TP53) | [30] | ||||||||||||
| Sensitive Disease | ER negative breast cancer [ICD-11: 2C60.7] | ||||||||||||
| Sensitive Drug | YW3-56 | ||||||||||||
| Molecule Alteration | Missense mutation | p.R280K (c.839G>A) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 2.05 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.00 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
S
-
S
-
S
-
V
V
P
P
S
S
100
|
Q
Q
K
K
T
T
Y
Y
Q
Q
G
G
S
S
Y
Y
G
G
F
F
110
|
R
R
L
L
G
G
F
F
L
L
H
H
S
S
G
G
T
T
A
A
120
|
K
K
S
S
V
V
T
T
C
C
T
T
Y
Y
S
S
P
P
A
A
130
|
L
L
N
N
K
K
M
M
F
F
C
C
Q
Q
L
L
A
A
K
K
140
|
T
T
C
C
P
P
V
V
Q
Q
L
L
W
W
V
V
D
D
S
S
150
|
T
T
P
P
P
P
P
P
G
G
T
T
R
R
V
V
R
R
A
A
160
|
M
M
A
A
I
I
Y
Y
K
K
Q
Q
S
S
Q
Q
H
H
M
M
170
|
T
T
E
E
V
V
V
V
R
R
R
R
C
C
P
P
H
H
H
H
180
|
E
E
R
R
C
C
S
S
D
D
S
S
D
D
G
G
L
L
A
A
190
|
P
P
P
P
Q
Q
H
H
L
L
I
I
R
R
V
V
E
E
G
G
200
|
N
N
L
L
R
R
V
V
E
E
Y
Y
L
L
D
D
D
D
R
R
210
|
N
N
T
T
F
F
R
R
H
H
S
S
V
V
V
V
V
V
P
P
220
|
Y
Y
E
E
P
P
P
P
E
E
V
V
G
G
S
S
D
D
C
C
230
|
T
T
T
T
I
I
H
H
Y
Y
N
N
Y
Y
M
M
C
C
N
N
240
|
S
S
S
S
C
C
M
M
G
G
G
G
M
M
N
N
R
R
R
R
250
|
P
P
I
I
L
L
T
T
I
I
I
I
T
T
L
L
E
E
D
D
260
|
S
S
S
S
G
G
N
N
L
L
L
L
G
G
R
R
N
N
S
S
270
|
F
F
E
E
V
V
R
R
V
V
C
C
A
A
C
C
P
P
G
G
280
|
R
K
D
D
R
R
R
R
T
T
E
E
E
E
E
E
N
N
L
L
290
|
R
-
K
-
K
-
G
-
E
-
P
-
H
-
H
-
E
-
L
-
300
|
P
-
P
-
G
-
S
-
T
-
K
-
R
-
A
-
L
-
P
-
310
|
N
-
N
-
T
-
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | MDA-MB-231 cells | Breast | Homo sapiens (Human) | CVCL_0062 | |||||||||
| 1833TR cells | N.A. | N.A. | N.A. | ||||||||||
| In Vivo Model | Female xenograft nude mouse model | Mus musculus | |||||||||||
| Experiment for Molecule Alteration |
Western blot analysis | ||||||||||||
Investigative Drug(s)
6 drug(s) in total
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [31] | ||||||||||||
| Sensitive Disease | HER2 negative breast cancer [ICD-11: 2C60.11] | ||||||||||||
| Sensitive Drug | Alpelisib/Fulvestrant | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [31] | ||||||||||||
| Sensitive Disease | HER2 negative breast cancer [ICD-11: 2C60.11] | ||||||||||||
| Sensitive Drug | Alpelisib/Fulvestrant | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047L (c.3140A>T) |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.77 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.96 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
A
A
H
L
H
H
G
G
1050
|
G
G
-
W
T
T
T
T
K
K
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [3] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Anastrazola/Goserelin | ||||||||||||
| Molecule Alteration | Missense mutation | p.D538G |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.90 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
V
-
D
-
L
-
G
-
T
-
E
290
|
-
N
-
L
-
Y
-
F
-
Q
-
S
-
N
-
A
-
M
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
C
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
C
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
C
K
K
N
N
V
V
V
V
P
P
L
L
Y
Y
D
G
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Deep sequencing assay | ||||||||||||
| Experiment for Drug Resistance |
MTT assay | ||||||||||||
| Mechanism Description | We report here on a novel mutation of ERalpha, in which an A to G substitution at position 1,613 resulted in substitution of aspartic acid at position 538 to glycine (D538G). The mutation was identified in liver metastases obtained from patients who developed endocrine resistance, but not in samples of primary tumors obtained prior to commencing endocrine treatment. Structural modeling indicates that D538G substitution creates a conformational change that disrupts the interaction between the receptor and either estrogen or tamoxifen, but mimics the conformation of the activated receptor. Studies in cell lines confirmed ligand-independent, constitutive activity of the mutated receptor. Taken together, these data indicate the mutation D538G as a novel mechanism conferring acquired endocrine resistance. | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [32] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | Buparlisib/Paclitaxel | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [7] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Exemestane/Everolimus | ||||||||||||
| Molecule Alteration | Missense mutation | p.Y537S |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.50 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
M
-
D
-
P
-
M
-
I
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
-
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
-
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
-
K
K
N
N
V
V
V
V
P
P
L
L
Y
S
D
D
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Next-generation sequencing assay | ||||||||||||
| Experiment for Drug Resistance |
Overall survival assay | ||||||||||||
| Mechanism Description | All 28 patients were found to harbor ESR1 mutations affecting ligand-binding domain with the most common mutations affecting Y537 (17/28, 60.7%) and D538 (9/28, 32.1%). ESR1 mutation was found in 12.1% of a large cohort of advanced breast cancer patients. Exemestane in combination with everolimus might be a reasonable option. Prospective studies are warranted to validate these findings. | ||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [7] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Exemestane/Everolimus | ||||||||||||
| Molecule Alteration | Missense mutation | p.D538G |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.90 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
V
-
D
-
L
-
G
-
T
-
E
290
|
-
N
-
L
-
Y
-
F
-
Q
-
S
-
N
-
A
-
M
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
C
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
C
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
C
K
K
N
N
V
V
V
V
P
P
L
L
Y
Y
D
G
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Next-generation sequencing assay | ||||||||||||
| Experiment for Drug Resistance |
Overall survival assay | ||||||||||||
| Mechanism Description | All 28 patients were found to harbor ESR1 mutations affecting ligand-binding domain with the most common mutations affecting Y537 (17/28, 60.7%) and D538 (9/28, 32.1%). ESR1 mutation was found in 12.1% of a large cohort of advanced breast cancer patients. Exemestane in combination with everolimus might be a reasonable option. Prospective studies are warranted to validate these findings. | ||||||||||||
| Drug Sensitivity Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: PI3-kinase alpha (PIK3CA) | [33] | ||||||||||||
| Sensitive Disease | Breast adenocarcinoma [ICD-11: 2C60.1] | ||||||||||||
| Sensitive Drug | PKI-587 | ||||||||||||
| Molecule Alteration | Missense mutation | p.H1047R (c.3140A>G) |
|||||||||||
| Wild Type Structure | Method: Electron microscopy | Resolution: 2.41 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 2.61 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
M
-
S
-
Y
-
Y
-
H
-
H
-
H
-
-20
|
H
-
H
-
H
-
D
-
Y
-
D
-
I
-
P
-
T
-
T
-
-10
|
E
-
N
-
L
-
Y
-
F
-
Q
-
G
G
A
A
M
M
G
G
0
|
S
S
M
M
P
P
P
P
R
R
P
P
S
S
S
S
G
G
E
E
10
|
L
L
W
W
G
G
I
I
H
H
L
L
M
M
P
P
P
P
R
R
20
|
I
I
L
L
V
V
E
E
C
C
L
L
L
L
P
P
N
N
G
G
30
|
M
M
I
I
V
V
T
T
L
L
E
E
C
C
L
L
R
R
E
E
40
|
A
A
T
T
L
L
I
I
T
T
I
I
K
K
H
H
E
E
L
L
50
|
F
F
K
K
E
E
A
A
R
R
K
K
Y
Y
P
P
L
L
H
H
60
|
Q
Q
L
L
L
L
Q
Q
D
D
E
E
S
S
S
S
Y
Y
I
I
70
|
F
F
V
V
S
S
V
V
T
T
Q
Q
E
E
A
A
E
E
R
R
80
|
E
E
E
E
F
F
F
F
D
D
E
E
T
T
R
R
R
R
L
L
90
|
C
C
D
D
L
L
R
R
L
L
F
F
Q
Q
P
P
F
F
L
L
100
|
K
K
V
V
I
I
E
E
P
P
V
V
G
G
N
N
R
R
E
E
110
|
E
E
K
K
I
I
L
L
N
N
R
R
E
E
I
I
G
G
F
F
120
|
A
A
I
I
G
G
M
M
P
P
V
V
C
C
E
E
F
F
D
D
130
|
M
M
V
V
K
K
D
D
P
P
E
E
V
V
Q
Q
D
D
F
F
140
|
R
R
R
R
N
N
I
I
L
L
N
N
V
V
C
C
K
K
E
E
150
|
A
A
V
V
D
D
L
L
R
R
D
D
L
L
N
N
S
S
P
P
160
|
H
H
S
S
R
R
A
A
M
M
Y
Y
V
V
Y
Y
P
P
P
P
170
|
N
N
V
V
E
E
S
S
S
S
P
P
E
E
L
L
P
P
K
K
180
|
H
H
I
I
Y
Y
N
N
K
K
L
L
D
D
K
K
G
G
Q
Q
190
|
I
I
I
I
V
V
V
V
I
I
W
W
V
V
I
I
V
V
S
S
200
|
P
P
N
N
N
N
D
D
K
K
Q
Q
K
K
Y
Y
T
T
L
L
210
|
K
K
I
I
N
N
H
H
D
D
C
C
V
V
P
P
E
E
Q
Q
220
|
V
V
I
I
A
A
E
E
A
A
I
I
R
R
K
K
K
K
T
T
230
|
R
R
S
S
M
M
L
L
L
L
S
S
S
S
E
E
Q
Q
L
L
240
|
K
K
L
L
C
C
V
V
L
L
E
E
Y
Y
Q
Q
G
G
K
K
250
|
Y
Y
I
I
L
L
K
K
V
V
C
C
G
G
C
C
D
D
E
E
260
|
Y
Y
F
F
L
L
E
E
K
K
Y
Y
P
P
L
L
S
S
Q
Q
270
|
Y
Y
K
K
Y
Y
I
I
R
R
S
S
C
C
I
I
M
M
L
L
280
|
G
G
R
R
M
M
P
P
N
N
L
L
M
M
L
L
M
M
A
A
290
|
K
K
E
E
S
S
L
L
Y
Y
S
S
Q
Q
L
L
P
P
M
M
300
|
D
D
C
C
F
F
T
T
M
M
P
P
S
S
Y
Y
S
S
R
R
310
|
R
R
I
I
S
S
T
T
A
A
T
T
P
P
Y
Y
M
M
N
N
320
|
G
G
E
E
T
T
S
S
T
T
K
K
S
S
L
L
W
W
V
V
330
|
I
I
N
N
S
S
A
A
L
L
R
R
I
I
K
K
I
I
L
L
340
|
C
C
A
A
T
T
Y
Y
V
V
N
N
V
V
N
N
I
I
R
R
350
|
D
D
I
I
D
D
K
K
I
I
Y
Y
V
V
R
R
T
T
G
G
360
|
I
I
Y
Y
H
H
G
G
G
G
E
E
P
P
L
L
C
C
D
D
370
|
N
N
V
V
N
N
T
T
Q
Q
R
R
V
V
P
P
C
C
S
S
380
|
N
N
P
P
R
R
W
W
N
N
E
E
W
W
L
L
N
N
Y
Y
390
|
D
D
I
I
Y
Y
I
I
P
P
D
D
L
L
P
P
R
R
A
A
400
|
A
A
R
R
L
L
C
C
L
L
S
S
I
I
C
C
S
S
V
V
410
|
K
K
G
G
R
R
K
K
G
G
A
A
K
K
E
E
E
E
H
H
420
|
C
C
P
P
L
L
A
A
W
W
G
G
N
N
I
I
N
N
L
L
430
|
F
F
D
D
Y
Y
T
T
D
D
T
T
L
L
V
V
S
S
G
G
440
|
K
K
M
M
A
A
L
L
N
N
L
L
W
W
P
P
V
V
P
P
450
|
H
H
G
G
L
L
E
E
D
D
L
L
L
L
N
N
P
P
I
I
460
|
G
G
V
V
T
T
G
G
S
S
N
N
P
P
N
N
K
K
E
E
470
|
T
T
P
P
C
C
L
L
E
E
L
L
E
E
F
F
D
D
W
W
480
|
F
F
S
S
S
S
V
V
V
V
K
K
F
F
P
P
D
D
M
M
490
|
S
S
V
V
I
I
E
E
E
E
H
H
A
A
N
N
W
W
S
S
500
|
V
V
S
S
R
R
E
E
A
A
G
G
F
F
S
S
Y
Y
S
S
510
|
H
H
A
A
G
G
L
L
S
S
N
N
R
R
L
L
A
A
R
R
520
|
D
D
N
N
E
E
L
L
R
R
E
E
N
N
D
D
K
K
E
E
530
|
Q
Q
L
L
K
K
A
A
I
I
S
S
T
T
R
R
D
D
P
P
540
|
L
L
S
S
E
E
I
I
T
T
E
E
Q
Q
E
E
K
K
D
D
550
|
F
F
L
L
W
W
S
S
H
H
R
R
H
H
Y
Y
C
C
V
V
560
|
T
T
I
I
P
P
E
E
I
I
L
L
P
P
K
K
L
L
L
L
570
|
L
L
S
S
V
V
K
K
W
W
N
N
S
S
R
R
D
D
E
E
580
|
V
V
A
A
Q
Q
M
M
Y
Y
C
C
L
L
V
V
K
K
D
D
590
|
W
W
P
P
P
P
I
I
K
K
P
P
E
E
Q
Q
A
A
M
M
600
|
E
E
L
L
L
L
D
D
C
C
N
N
Y
Y
P
P
D
D
P
P
610
|
M
M
V
V
R
R
G
G
F
F
A
A
V
V
R
R
C
C
L
L
620
|
E
E
K
K
Y
Y
L
L
T
T
D
D
D
D
K
K
L
L
S
S
630
|
Q
Q
Y
Y
L
L
I
I
Q
Q
L
L
V
V
Q
Q
V
V
L
L
640
|
K
K
Y
Y
E
E
Q
Q
Y
Y
L
L
D
D
N
N
L
L
L
L
650
|
V
V
R
R
F
F
L
L
L
L
K
K
K
K
A
A
L
L
T
T
660
|
N
N
Q
Q
R
R
I
I
G
G
H
H
F
F
F
F
F
F
W
W
670
|
H
H
L
L
K
K
S
S
E
E
M
M
H
H
N
N
K
K
T
T
680
|
V
V
S
S
Q
Q
R
R
F
F
G
G
L
L
L
L
L
L
E
E
690
|
S
S
Y
Y
C
C
R
R
A
A
C
C
G
G
M
M
Y
Y
L
L
700
|
K
K
H
H
L
L
N
N
R
R
Q
Q
V
V
E
E
A
A
M
M
710
|
E
E
K
K
L
L
I
I
N
N
L
L
T
T
D
D
I
I
L
L
720
|
K
K
Q
Q
E
E
K
K
K
K
D
D
E
E
T
T
Q
Q
K
K
730
|
V
V
Q
Q
M
M
K
K
F
F
L
L
V
V
E
E
Q
Q
M
M
740
|
R
R
R
R
P
P
D
D
F
F
M
M
D
D
A
A
L
L
Q
Q
750
|
G
G
F
F
L
L
S
S
P
P
L
L
N
N
P
P
A
A
H
H
760
|
Q
Q
L
L
G
G
N
N
L
L
R
R
L
L
E
E
E
E
C
C
770
|
R
R
I
I
M
M
S
S
S
S
A
A
K
K
R
R
P
P
L
L
780
|
W
W
L
L
N
N
W
W
E
E
N
N
P
P
D
D
I
I
M
M
790
|
S
S
E
E
L
L
L
L
F
F
Q
Q
N
N
N
N
E
E
I
I
800
|
I
I
F
F
K
K
N
N
G
G
D
D
D
D
L
L
R
R
Q
Q
810
|
D
D
M
M
L
L
T
T
L
L
Q
Q
I
I
I
I
R
R
I
I
820
|
M
M
E
E
N
N
I
I
W
W
Q
Q
N
N
Q
Q
G
G
L
L
830
|
D
D
L
L
R
R
M
M
L
L
P
P
Y
Y
G
G
C
C
L
L
840
|
S
S
I
I
G
G
D
D
C
C
V
V
G
G
L
L
I
I
E
E
850
|
V
V
V
V
R
R
N
N
S
S
H
H
T
T
I
I
M
M
Q
Q
860
|
I
I
Q
Q
C
C
K
K
G
G
G
G
L
L
K
K
G
G
A
A
870
|
L
L
Q
Q
F
F
N
N
S
S
H
H
T
T
L
L
H
H
Q
Q
880
|
W
W
L
L
K
K
D
D
K
K
N
N
K
K
G
G
E
E
I
I
890
|
Y
Y
D
D
A
A
A
A
I
I
D
D
L
L
F
F
T
T
R
R
900
|
S
S
C
C
A
A
G
G
Y
Y
C
C
V
V
A
A
T
T
F
F
910
|
I
I
L
L
G
G
I
I
G
G
D
D
R
R
H
H
N
N
S
S
920
|
N
N
I
I
M
M
V
V
K
K
D
D
D
D
G
G
Q
Q
L
L
930
|
F
F
H
H
I
I
D
D
F
F
G
G
H
H
F
F
L
L
D
D
940
|
H
H
K
K
K
K
K
K
K
K
F
F
G
G
Y
Y
K
K
R
R
950
|
E
E
R
R
V
V
P
P
F
F
V
V
L
L
T
T
Q
Q
D
D
960
|
F
F
L
L
I
I
V
V
I
I
S
S
K
K
G
G
A
A
Q
Q
970
|
E
E
C
C
T
T
K
K
T
T
R
R
E
E
F
F
E
E
R
R
980
|
F
F
Q
Q
E
E
M
M
C
C
Y
Y
K
K
A
A
Y
Y
L
L
990
|
A
A
I
I
R
R
Q
Q
H
H
A
A
N
N
L
L
F
F
I
I
1000
|
N
N
L
L
F
F
S
S
M
M
M
M
L
L
G
G
S
S
G
G
1010
|
M
M
P
P
E
E
L
L
Q
Q
S
S
F
F
D
D
D
D
I
I
1020
|
A
A
Y
Y
I
I
R
R
K
K
T
T
L
L
A
A
L
L
D
D
1030
|
K
K
T
T
E
E
Q
Q
E
E
A
A
L
L
E
E
Y
Y
F
F
1040
|
M
M
K
K
Q
Q
M
M
N
N
D
D
A
A
H
R
H
H
G
G
1050
|
G
G
W
W
T
T
T
T
K
K
M
M
D
D
W
W
I
I
F
F
1060
|
H
H
T
T
I
I
K
K
Q
Q
H
H
A
A
L
L
N
N
|
|||||||||||||
| Experimental Note | Revealed Based on the Cell Line Data | ||||||||||||
| In Vitro Model | HT29 Cells | Colon | Homo sapiens (Human) | CVCL_A8EZ | |||||||||
| DLD1 cells | Colon | Homo sapiens (Human) | CVCL_0248 | ||||||||||
| H1975 cells | Lung | Homo sapiens (Human) | CVCL_1511 | ||||||||||
| PC3 cells | Prostate | Homo sapiens (Human) | CVCL_0035 | ||||||||||
| HCT116 cells | Colon | Homo sapiens (Human) | CVCL_0291 | ||||||||||
| MDA-MB-231 cells | Breast | Homo sapiens (Human) | CVCL_0062 | ||||||||||
| A549 cells | Lung | Homo sapiens (Human) | CVCL_0023 | ||||||||||
| H460 cells | Lung | Homo sapiens (Human) | CVCL_0459 | ||||||||||
| T47D cells | Breast | Homo sapiens (Human) | CVCL_0553 | ||||||||||
| BT474 cells | Breast | Homo sapiens (Human) | CVCL_0179 | ||||||||||
| U87 cells | Brain | Homo sapiens (Human) | CVCL_0022 | ||||||||||
| H1299 cells | Lung | Homo sapiens (Human) | CVCL_0060 | ||||||||||
| MDA-MB-468 cells | Breast | Homo sapiens (Human) | CVCL_0419 | ||||||||||
| H157 cells | Lung | Homo sapiens (Human) | CVCL_2458 | ||||||||||
| H2170 cells | Lung | Homo sapiens (Human) | CVCL_1535 | ||||||||||
| MDA-MB-361 cells | Breast | Homo sapiens (Human) | CVCL_0620 | ||||||||||
| H1650 cells | Pleural effusion | Homo sapiens (Human) | CVCL_4V01 | ||||||||||
| MCF-7 cells | Breast | Homo sapiens (Human) | CVCL_0031 | ||||||||||
| MIA PaCa-2 cells | Pancreas | Homo sapiens (Human) | CVCL_0428 | ||||||||||
| HTB44 cells | Kidney | Homo sapiens (Human) | N.A. | ||||||||||
| H1666 cells | Pleural effusion | Homo sapiens (Human) | CVCL_1485 | ||||||||||
| 786-0 cells | Kidney | Homo sapiens (Human) | CVCL_1051 | ||||||||||
| In Vivo Model | Female nude mouse xenograft model | Mus musculus | |||||||||||
| Experiment for Drug Resistance |
IC50 assay | ||||||||||||
| Drug Resistance Data Categorized by Their Corresponding Mechanisms | |||||||||||||
|
|
|||||||||||||
| Key Molecule: Estrogen receptor alpha (ESR1) | [3] | ||||||||||||
| Resistant Disease | Breast cancer [ICD-11: 2C60.3] | ||||||||||||
| Resistant Drug | Tamoxifen/Goserelin | ||||||||||||
| Molecule Alteration | Missense mutation | p.D538G |
|||||||||||
| Wild Type Structure | Method: X-ray diffraction | Resolution: 1.60 Å | |||||||||||
| Mutant Type Structure | Method: X-ray diffraction | Resolution: 1.90 Å | |||||||||||
| Download The Information of Sequence | Download The Structure File | ||||||||||||
-
-
V
-
D
-
L
-
G
-
T
-
E
290
|
-
N
-
L
-
Y
-
F
-
Q
-
S
-
N
-
A
-
M
-
K
300
|
-
R
-
S
-
K
-
K
-
N
-
S
-
L
-
A
-
L
S
S
310
|
L
L
T
T
A
A
D
D
Q
Q
M
M
V
V
S
S
A
A
L
L
320
|
L
L
D
D
A
A
E
E
P
P
P
P
I
I
L
L
Y
Y
S
S
330
|
E
E
Y
Y
D
D
P
P
T
T
R
R
P
P
F
F
S
S
E
E
340
|
A
A
S
S
M
M
M
M
G
G
L
L
L
L
T
T
N
N
L
L
350
|
A
A
D
D
R
R
E
E
L
L
V
V
H
H
M
M
I
I
N
N
360
|
W
W
A
A
K
K
R
R
V
V
P
P
G
G
F
F
V
V
D
D
370
|
L
L
T
T
L
L
H
H
D
D
Q
Q
V
V
H
H
L
L
L
L
380
|
E
E
C
C
A
A
W
W
L
L
E
E
I
I
L
L
M
M
I
I
390
|
G
G
L
L
V
V
W
W
R
R
S
S
M
M
E
E
H
H
P
P
400
|
G
G
K
K
L
L
L
L
F
F
A
A
P
P
N
N
L
L
L
L
410
|
L
L
D
D
R
R
N
N
Q
Q
G
G
K
K
C
C
V
V
E
E
420
|
G
G
M
M
V
V
E
E
I
I
F
F
D
D
M
M
L
L
L
L
430
|
A
A
T
T
S
S
S
S
R
R
F
F
R
R
M
M
M
M
N
N
440
|
L
L
Q
Q
G
G
E
E
E
E
F
F
V
V
C
C
L
L
K
K
450
|
S
S
I
I
I
I
L
L
L
L
N
N
S
S
G
G
V
V
Y
Y
460
|
T
T
F
F
L
L
S
S
S
S
T
T
L
L
K
K
S
S
L
L
470
|
E
E
E
E
K
K
D
D
H
H
I
I
H
H
R
R
V
V
L
L
480
|
D
D
K
K
I
I
T
T
D
D
T
T
L
L
I
I
H
H
L
L
490
|
M
M
A
A
K
K
A
A
G
G
L
L
T
T
L
L
Q
Q
Q
Q
500
|
Q
Q
H
H
Q
Q
R
R
L
L
A
A
Q
Q
L
L
L
L
L
L
510
|
I
I
L
L
S
S
H
H
I
I
R
R
H
H
M
M
S
S
N
N
520
|
K
K
G
G
M
M
E
E
H
H
L
L
Y
Y
S
S
M
M
K
K
530
|
C
C
K
K
N
N
V
V
V
V
P
P
L
L
Y
Y
D
G
L
L
540
|
L
L
L
L
E
E
M
M
L
L
D
D
A
A
H
H
R
R
L
L
550
|
H
H
A
A
P
P
T
T
S
S
|
|||||||||||||
| Experimental Note | Identified from the Human Clinical Data | ||||||||||||
| In Vivo Model | A retrospective survey in conducting clinical studies | Homo sapiens | |||||||||||
| Experiment for Molecule Alteration |
Deep sequencing assay | ||||||||||||
| Experiment for Drug Resistance |
MTT assay | ||||||||||||
| Mechanism Description | We report here on a novel mutation of ERalpha, in which an A to G substitution at position 1,613 resulted in substitution of aspartic acid at position 538 to glycine (D538G). The mutation was identified in liver metastases obtained from patients who developed endocrine resistance, but not in samples of primary tumors obtained prior to commencing endocrine treatment. Structural modeling indicates that D538G substitution creates a conformational change that disrupts the interaction between the receptor and either estrogen or tamoxifen, but mimics the conformation of the activated receptor. Studies in cell lines confirmed ligand-independent, constitutive activity of the mutated receptor. Taken together, these data indicate the mutation D538G as a novel mechanism conferring acquired endocrine resistance. | ||||||||||||
References
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