Pharmacological impact of FLT3 mutations on receptor activity and responsiveness to tyrosine kinase inhibitors

Marensi, Vanessa, Keeshan, Karen R and MacEwan, David J ORCID: 0000-0002-2879-0935 (2021) Pharmacological impact of FLT3 mutations on receptor activity and responsiveness to tyrosine kinase inhibitors. BIOCHEMICAL PHARMACOLOGY, 183. 114348-.

Text Pharmacological Impact of FLT3 Mutations clean.docx - Author Accepted Manuscript Download (227kB)

Abstract

Acute myelogenous leukaemia (AML) is an aggressive blood cancer characterized by the rapid proliferation of immature myeloid blast cells, resulting in a high mortality rate. The 5-year overall survival rate for AML patients is approximately 25%. Circa 35% of all patients carry a mutation in the FLT3 gene which have a poor prognosis. Targeting FLT3 receptor tyrosine kinase has become a treatment strategy in AML patients possessing FLT3 mutations. The most common mutations are internal tandem duplications (ITD) within exon 14 and a single nucleotide polymorphism (SNP) that leads to a point mutation in the D835 of the tyrosine kinase domain (TKD). Variations in the ITD sequence and the occurrence of other point mutations that lead to ligand-independent FLT3 receptor activation create difficulties in developing personalized therapeutic strategies to overcome observed mutation-driven drug resistance. Midostaurin and quizartinib are tyrosine kinase inhibitors (TKIs) with inhibitory efficacy against FLT3-ITD, but exhibit limited clinical impact. In this review, we focus on the structural aspects of the FLT3 receptor and correlate those mutations with receptor activation and the consequences for molecular and clinical responsiveness towards therapies targeting FLT3-ITD positive AML.

Item Type:	Article
Uncontrolled Keywords:	Leukemia, Receptor Tyrosine Kinase, TKI, AML, Mutation evolution
Depositing User:	Symplectic Admin
Date Deposited:	07 Dec 2020 10:55
Last Modified:	18 Jan 2023 23:19
DOI:	10.1016/j.bcp.2020.114348
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3109224