Mutated epidermal growth factor receptor (EGFR) is a major driver of non-small cell lung cancer (NSCLC). The EGFR^T790M secondary mutation has become a leading cause of clinically-acquired resistance to gefitinib and erlotinib. Herein, we present a structure-based design approach to increase the potency and selectivity of the previously reported reversible EGFR inhibitor 7, at the kinase and cellular levels. Three-step structure-activity relationship exploration led to promising compounds 19e and 19h with unique chemical structure and binding mode from the other third-generation tyrosine kinase inhibitors. In a human NSCLC xenograft model, 19e and 19h exhibited dose-dependent tumor growth suppression without toxicity. These selective inhibitors are promising drug candidates for EGFR^T790M-driven NSCLC.

突变的表皮生长因子受体（EGFR）是非小细胞肺癌（NSCLC）的主要驱动力。EGFR ^T790M继发突变已成为临床上获得的对吉非替尼和厄洛替尼耐药性的主要原因。在本文中，我们提出了一种基于结构的设计方法，以在激酶和细胞水平上提高先前报道的可逆性EGFR抑制剂7的效力和选择性。三步结构-活性关系的探索产生了有希望的化合物19e和19h，具有与其他第三代酪氨酸激酶抑制剂不同的独特化学结构和结合方式。在人类NSCLC异种移植模型中，19e和19h表现出剂量依赖性的肿瘤生长抑制作用而无毒性。这些选择性抑制剂是EGFR ^T790M驱动的NSCLC的有希望的候选药物。