title: Tackling Crizotinib Resistance: The Pathway from Drug Discovery to the Pediatric Clinic.
abstract: Neuroblastoma is a childhood malignancy that has not yet benefitted from the rapid progress in the development of small-molecule therapeutics for cancer. An opportunity to take advantage of pharmaceutical innovation in this area arose when the identification of ALK fusion proteins in non-small cell lung cancer (NSCLC) occurred in parallel to the discovery of point mutations of ALK in neuroblastomas. ALK is now known to be a marker of poor outcome in neuroblastoma, and therefore, urgent development of specific ALK inhibitors to treat this devastating disease is a necessity. However, the translation of small molecules from adult directly into pediatric practice has thus far been challenging, due to mutation-specific structural variances in the ALK kinase domain. We discuss how the most recent structural and biological characterizations of ALK are directing preclinical and clinical studies of ALK inhibitors for both NSCLC and neuroblastoma.
authors.affiliation: Paediatric Solid Tumour Biology and Therapeutics Team, Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Tucker
authors.affiliation: Paediatric Solid Tumour Biology and Therapeutics Team, Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom.
authors.forename: Laura S
authors.initials: LS
authors.lastname: Danielson
authors.affiliation: Cancer Research UK Cancer Therapeutics Unit, Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom.
authors.forename: Paolo
authors.initials: P
authors.lastname: Innocenti
authors.affiliation: Paediatric Solid Tumour Biology and Therapeutics Team, Division of Cancer Therapeutics, The Institute of Cancer Research, London, United Kingdom. Louis.Chesler@icr.ac.uk.
authors.forename: Louis
authors.initials: L
authors.lastname: Chesler
mesh_terms: D000328:Adult; D000077548:Anaplastic Lymphoma Kinase; D000818:Animals; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000235:genetics; D002648:Child; D000077547:Crizotinib; D055808:Drug Discovery / Q000379:methods; D019008:Drug Resistance, Neoplasm / Q000187:drug effects; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000235:genetics; D009447:Neuroblastoma / Q000188:drug therapy / Q000235:genetics; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011720:Pyrazoles / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*; D020794:Receptor Protein-Tyrosine Kinases / Q000502:physiology
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011720:Pyrazoles; D011725:Pyridines; D000077547:Crizotinib; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases