Anaplastic Lymphoma Kinase (ALK): Structure, Oncogenic Activation, and Pharmacological Inhibition
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Pharmacological Research 68 (2013) 68–94 Contents lists available at SciVerse ScienceDirect Pharmacological Research jo urnal homepage: www.elsevier.com/locate/yphrs Invited review Anaplastic lymphoma kinase (ALK): Structure, oncogenic activation, and pharmacological inhibition ∗ Robert Roskoski Jr. Blue Ridge Institute for Medical Research, 3754 Brevard Road, Suite 116, Box 19, Horse Shoe, NC 28742, USA a r t i c l e i n f o a b s t r a c t Article history: Anaplastic lymphoma kinase was first described in 1994 as the NPM-ALK fusion protein that is expressed Received 14 November 2012 in the majority of anaplastic large-cell lymphomas. ALK is a receptor protein-tyrosine kinase that was Accepted 18 November 2012 more fully characterized in 1997. Physiological ALK participates in embryonic nervous system develop- ment, but its expression decreases after birth. ALK is a member of the insulin receptor superfamily and Keywords: is most closely related to leukocyte tyrosine kinase (Ltk), which is a receptor protein-tyrosine kinase. Crizotinib Twenty different ALK-fusion proteins have been described that result from various chromosomal rear- Drug discovery rangements, and they have been implicated in the pathogenesis of several diseases including anaplastic Non-small cell lung cancer large-cell lymphoma, diffuse large B-cell lymphoma, and inflammatory myofibroblastic tumors. The Protein kinase inhibitor EML4-ALK fusion protein and four other ALK-fusion proteins play a fundamental role in the development Targeted cancer therapy Acquired drug resistance in about 5% of non-small cell lung cancers. The formation of dimers by the amino-terminal portion of the ALK fusion proteins results in the activation of the ALK protein kinase domain that plays a key role in the tumorigenic process. Downstream signaling from ALK fusion proteins involves the Ras/Raf/MEK/ERK1/2 cell proliferation module and the JAK/STAT cell survival pathway. Furthermore, nearly two dozen ALK activating mutations participate in the pathogenesis of childhood neuroblastomas along with ALK over- expression. The occurrence of oncogenic ALK, particularly in non-small cell lung cancer, has generated considerable interest and effort in developing ALK inhibitors. Currently, crizotinib has been approved by the US Food and Drug Administration for the treatment of ALK-positive non-small cell lung cancer along with an approved fluorescence in situ hybridization kit used for the diagnosis of the disease. The emergence of crizotinib drug resistance with a median occurrence at approximately 10 months after the initiation of therapy has stimulated the development of second-generation drugs for the treatment of non-small cell lung cancer and other disorders. About 28% of the cases of crizotinib resistance are related to nearly a dozen different mutations of ALK in the EML4-ALK fusion protein; the other cases of resis- tance are related to the upregulation of alternative signaling pathways or to undefined mechanisms. It is remarkable that the EML4-ALK fusion protein was discovered in 2007 and crizotinib was approved for the treatment of ALK-positive non-small cell lung cancer in 2011, which is a remarkably short timeframe in the overall scheme of drug discovery. © 2012 Elsevier Ltd. All rights reserved. Contents 1. Introduction . 69 2. An overview of anaplastic lymphoma kinase (ALK) . 70 3. Structure of the ALK protein kinase domain. 71 3.1. Catalytic residues in the amino- and carboxyterminal lobes of the ALK protein kinase domain . 71 3.2. ALK hydrophobic spines . 73 Abbreviations: AL, activation loop; ALCL, anaplastic large-cell lymphoma; C-spine, catalytic spine; CRC, colorectal cancer; D, distribution coefficient; DLBCL, diffuse large B-cell lymphoma; EGFR, epidermal growth factor receptor; HGF/SF, hepatocyte growth factor/scatter factor; IMT, inflammatory myofibroblastic tumor; IRS1, insulin receptor substrate 1; JAK, Janus activated kinase; LE, ligand efficiency; LipE, lipophilic efficiency; MW, molecular weight; NSCLC, non-small cell lung cancer; P, partition coefficient; PDGFR, platelet-derived growth factor receptor; PI3K, phosphatidylinositol 3-kinase; PKA, protein kinase A; PKC, protein kinase C; PLC, phospholipase C; pY, phosphotyrosine; R-spine, regulatory spine; VEGFR, vascular endothelial growth factor receptor. ∗ Tel.: +1 828 891 5637; fax: +1 828 890 8130. E-mail address: [email protected] 1043-6618/$ – see front matter © 2012 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.phrs.2012.11.007 R. Roskoski Jr. / Pharmacological Research 68 (2013) 68–94 69 3.3. Structure of quiescent ALK protein kinase . 73 3.4. Steady-state enzyme kinetic parameters of quiescent and active ALK . 74 4. ALK phosphorylation, activation, and downstream signaling . 74 4.1. ALK phosphorylation and activation . 74 4.2. ALK signaling . 74 5. ALK in disease: fusion proteins, mutants, and overexpression. 75 5.1. Anaplastic large-cell lymphoma . 75 5.2. Non-small cell lung cancer . 76 5.3. Diffuse large B-cell lymphoma . 76 5.4. Inflammatory myofibroblastic tumors . 77 5.5. Neuroblastoma . 78 5.6. Anaplastic thyroid cancer . 78 5.7. Rhabdomyosarcoma . 78 6. Oncogenic activation of ALK . 79 6.1. ALK activation following chromosomal translocations or inversions with the formation of ALK fusion proteins . 79 6.2. ALK activation by missense mutations in neuroblastomas and in anaplastic thyroid carcinomas . 79 7. ALK inhibitors ... 81 7.1. Crizotinib: a combined ALK and c-Met inhibitor . 81 7.1.1. ALK and c-Met as drug targets . 81 7.1.2. Development of crizotinib . 81 7.1.3. Inhibition of tumor growth and drug-induced toxicity . 82 7.1.4. Acquired crizotinib resistance . 83 7.2. CH5424842 . ..