Discovery of Selective Estrogen Receptor Covalent Antagonists for the Treatment of ER alphaWTand ER alphaMUTBreast Cancer.
Puyang, X., Furman, C., Zheng, G.Z., Wu, Z.J., Banka, D., Aithal, K., Agoulnik, S., Bolduc, D.M., Buonamici, S., Caleb, B., Das, S., Eckley, S., Fekkes, P., Hao, M.H., Hart, A., Houtman, R., Irwin, S., Joshi, J.J., Karr, C., Kim, A., Kumar, N., Kumar, P., Kuznetsov, G., Lai, W.G., Larsen, N., Mackenzie, C., Martin, L.A., Melchers, D., Moriarty, A., Nguyen, T.V., Norris, J., O'Shea, M., Pancholi, S., Prajapati, S., Rajagopalan, S., Reynolds, D.J., Rimkunas, V., Rioux, N., Ribas, R., Siu, A., Sivakumar, S., Subramanian, V., Thomas, M., Vaillancourt, F.H., Wang, J., Wardell, S., Wick, M.J., Yao, S., Yu, L., Warmuth, M., Smith, P.G., Zhu, P., Korpal, M.(2018) Cancer Discov 8: 1176-1193
- PubMed: 29991605 
- DOI: https://doi.org/10.1158/2159-8290.CD-17-1229
- Primary Citation of Related Structures:  
6CHW, 6CHZ - PubMed Abstract: 
Mutations in estrogen receptor alpha (ER¦Á) that confer resistance to existing classes of endocrine therapies are detected in up to 30% of patients who have relapsed during endocrine treatments. Because a significant proportion of therapy-resistant breast cancer metastases continue to be dependent on ER¦Á signaling, there remains a critical need to develop the next generation of ER¦Á antagonists that can overcome aberrant ER¦Á activity. Through our drug-discovery efforts, we identified H3B-5942, which covalently inactivates both wild-type and mutant ER¦Á by targeting Cys530 and enforcing a unique antagonist conformation. H3B-5942 belongs to a class of ER¦Á antagonists referred to as selective estrogen receptor covalent antagonists (SERCA). In vitro comparisons of H3B-5942 with standard-of-care (SoC) and experimental agents confirmed increased antagonist activity across a panel of ER¦Á WT and ER¦Á MUT cell lines. In vivo , H3B-5942 demonstrated significant single-agent antitumor activity in xenograft models representing ER¦Á WT and ER¦Á Y537S breast cancer that was superior to fulvestrant. Lastly, H3B-5942 potency can be further improved in combination with CDK4/6 or mTOR inhibitors in both ER¦Á WT and ER¦Á MUT cell lines and/or tumor models. In summary, H3B-5942 belongs to a class of orally available ER¦Á covalent antagonists with an improved profile over SoCs. Significance: Nearly 30% of endocrine therapy-resistant breast cancer metastases harbor constitutively activating mutations in ER¦Á. SERCA H3B-5942 engages C530 of both ER¦Á WT and ER¦Á MUT , promotes a unique antagonist conformation, and demonstrates improved in vitro and in vivo activity over SoC agents. Importantly, single-agent efficacy can be further enhanced by combining with CDK4/6 or mTOR inhibitors. Cancer Discov; 8(9); 1176-93. ?2018 AACR. This article is highlighted in the In This Issue feature, p. 1047 .
Organizational Affiliation: 
H3 Biomedicine, Inc., Cambridge, Massachusetts.