The efficacy of tucatinib-based therapeutic approaches for HER2-positive breast cancer

Overexpression of human epidermal growth factor receptor 2 (HER2) occurs in approximately 15–20% of breast cancer cases. HER2 is a member of the epidermal growth factor receptor (EGFR) family with tyrosinase kinase activity, and its overexpression is linked to poor prognosis and shorter progression-free survival (PFS) and overall survival (OS). Among various treatment options, HER2-targeting monoclonal antibodies and tyrosine kinase inhibitors (TKIs) have mostly been applied in recent decades to treat HER2-positive (HER2^(+)) breast cancer patients. Although positive clinical outcomes were documented in both advanced disease and neoadjuvant settings, the development of resistance mechanisms to such approaches has been one of the major challenges with the continuous usage of these drugs. In addition, patients who experience disease progression after treatment with multiple HER2-targeted therapies often have limited treatment options. The Food and Drug Administration (FDA) has recently approved a new TKI (i.e., tucatinib) for use in combination with immunotherapy and/or chemotherapeutic agents for the treatment of advanced-stage/metastatic HER2^(+) breast cancer. This review highlights recent updates on the efficacy of tucatinib-based therapeutic approaches in experimental models as well as in the clinical settings of HER2^(+) breast cancer.

Tyrosine kinase inhibitors and human epidermal growth factor receptor-2 positive breast cancer

The body of evidence investigating human epidermal growth factor receptor-2(HER2)directed therapy in patients with breast cancer(BC)has been growing within the last decade.Recently,the use of tyrosine kinase inhibitors(TKIs)has been of particular interest in the treatment of human malignancies.This literature commentary is intended to highlight the most recent findings associated with the widely-studied TKI agents and their clinical significance in improving the outcomes of HER2 positive BC.

妥卡替尼的合成

以2-氨基-4-氯吡啶为起始原料,经过缩合、取代、环合、乌尔曼反应和水合肼还原硝基5步反应得到中间体4-([1,2,4]三唑并[1,5-a]吡啶-7-氧基)-3-甲基苯胺(Ⅷ)。2-氨基-5-硝基苯腈先与N,N-二甲基甲酰胺二甲基缩醛(DMF-DMA)缩合,再与4-([1,2,4]三唑并[1,5-a]吡啶-7-氧基)-3-甲基苯胺环合得到N-[3-甲基-4-([1,2,4]三唑并[1,5-a]吡啶-7-氧基)苯基]-6-硝基-4-喹唑啉胺(ⅩⅦ),再经硝基还原得到N^(4)-[3-甲基-4-([1,2,4]三唑并[1,5-a]吡啶-7-氧基)苯基]-4,6-喹唑啉二胺(ⅩⅧ)。同时,采用二硫化碳和2-氨基-2-甲基-1-丙醇为原料,经两步反应制备4,5-二氢-4,4-二甲基-2-(甲硫基)唑三氟甲磺酸盐,收率68.6%。最后,N^(4)-[3-甲基-4-([1,2,4]三唑并[1,5-a]吡啶-7-氧基)苯基]-4,6-喹唑啉二胺和4,5-二氢-4,4-二甲基-2-(甲硫基)唑三氟甲磺酸盐以三乙胺为碱进行缩合反应得到妥卡替尼,收率62.8%,HPLC纯度99.08%。采用~1HNMR、CNMR和HRMS对产物结构进行了表征。

妥卡替尼的合成新工艺

开发妥卡替尼的新工艺路线并对其进行改进,重点合成其三个关建中间体。4-([1,2,4]三唑并[1,5-a]吡啶-7-氧基)-3-甲基苯胺(6)经5步反应制得,产率32.8%,纯度99.1%;N4-(4-([1,2,4]三唑并[1,5-a]吡啶-7-氧基)-3-甲基苯基)喹唑啉-4,6-二胺(15)经3步反应制得,产率67.0%,纯度99.5%;4,4-二甲基-2-(甲硫基)-4,5-二氢恶唑三氟甲磺酸盐(17)经2步反应制得,产率为67.2%;得出结论:妥卡替尼经9步反应制得,总收率16.7%,纯度>99.5%(HPLC),目标产物及中间体结构经1H-NMR、13 C-NMR和LC-MS确证。

妥卡替尼的合成研究进展

妥卡替尼(1)是一种可口服的人类表皮生长因子受体酪氨酸激酶(HER2)抑制剂,临床上主要用于治疗HER2阳性乳腺癌。文章分别对1及其重要中间体4‑([1,2,4]三唑并[1,5‑a]吡啶‑7‑氧基)‑3‑甲基苯胺(2)的合成方法进行了总结、概括,并对各路线进行了简要评述,为该药物的合成工艺研究提供有益参考。