Rapid emergence of tumor resistance via RAS pathway reactivation has been reported from clinical studies of covalent KRAS^G12C inhibitors. Thus, inhibitors with broad potential for combination treatment and distinct binding modes to overcome resistance mutations may prove beneficial. JDQ443 is an investigational covalent KRAS^G12C inhibitor derived from structure-based drug design followed by extensive optimization of two dissimilar prototypes. JDQ443 is a stable atropisomer containing a unique 5-methylpyrazole core and a spiro-azetidine linker designed to position the electrophilic acrylamide for optimal engagement with KRAS^G12C C12. A substituted indazole at pyrazole position 3 results in novel interactions with the binding pocket that do not involve residue H95. JDQ443 showed PK/PD activity in vivo and dose-dependent antitumor activity in mouse xenograft models. JDQ443 is now in clinical development, with encouraging early phase data reported from an ongoing Phase Ib/II clinical trial (NCT04699188).

中文翻译：

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JDQ443，一种结构新颖、基于吡唑的 KRASG12C 共价抑制剂，用于治疗实体瘤

共价 KRAS ^G12C抑制剂的临床研究报告称，通过 RAS 通路重新激活，肿瘤耐药性迅速出现。因此，具有广泛联合治疗潜力和克服耐药突变的独特结合模式的抑制剂可能是有益的。JDQ443 是一种在研共价 KRAS ^G12C抑制剂，源自基于结构的药物设计，然后对两种不同的原型进行了广泛优化。JDQ443 是一种稳定的阻转异构体，含有独特的 5-甲基吡唑核心和螺氮杂环丁烷连接体，旨在定位亲电子丙烯酰胺，以实现与 KRAS G12C ^C12的最佳接合。吡唑位 3 处的取代吲唑导致与不涉及残基 H95 的结合袋发生新的相互作用。JDQ443 在小鼠异种移植模型中显示出体内 PK/PD 活性和剂量依赖性抗肿瘤活性。JDQ443目前正处于临床开发阶段，正在进行的 Ib/II 期临床试验 (NCT04699188) 报告了令人鼓舞的早期阶段数据。