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9QEK

Structure of Human ROS1 Kinase Domain Harboring the G2032R Solvent-front Mutation in Complex with Zidesamtinib (NVL-520)

This is a non-PDB format compatible entry.
Summary for 9QEK
Entry DOI10.2210/pdb9qek/pdb
DescriptorProto-oncogene tyrosine-protein kinase ROS, 1,2-ETHANEDIOL, Zidesamtinib, ... (4 entities in total)
Functional Keywordsros1, g2032r, solvent-front mutation, zidesamtinib, nvl-520, transferase
Biological sourceHomo sapiens (human)
Total number of polymer chains1
Total formula weight35022.37
Authors
Tangpeerachaikul, A.,Mente, S.,Magrino, J.,Gu, F.,Horan, J.C.,Pelish, H.E. (deposition date: 2025-03-10, release date: 2025-04-30, Last modification date: 2025-05-14)
Primary citationTangpeerachaikul, A.,Mente, S.,Magrino, J.,Gu, F.,Horan, J.C.,Pelish, H.E.
Zidesamtinib Selective Targeting of Diverse ROS1 Drug-Resistant Mutations.
Mol.Cancer Ther., 2025
Cited by
PubMed Abstract: Zidesamtinib (NVL-520) is a ROS1-selective macrocyclic tyrosine kinase inhibitor designed with the aim to address clinical challenges for patients with non-small cell lung or other cancers that are ROS1 fusion-positive. These challenges include emergent ROS1 resistance mutations and brain metastases that can lead to disease progression, and central nervous system adverse events attributed to off-target TRK inhibition that can be treatment limiting. We evaluated zidesamtinib in accelerated mutagenesis screens and a brain tumor model, comparing it to other approved or investigational ROS1 inhibitors. At clinically relevant concentrations, zidesamtinib robustly inhibited >1,500 pooled ROS1 mutants with virtually no resistance emerging (≤1%), outperforming comparators crizotinib, entrectinib, and repotrectinib. Zidesamtinib also induced more durable responses than repotrectinib and taletrectinib in an aggressive intracranial ROS1 G2032R xenograft model. A 2.2 Å co-crystal structure with ROS1 G2032R, the most frequently identified ROS1 resistance mutation, reveals that zidesamtinib uniquely accommodates the mutated residue while potentially clashing with TRK, consistent with its selective ROS1-targeting design and supported by computational modeling. Taken together, these data support zidesamtinib's potential as a novel best-in-class ROS1 inhibitor.
PubMed: 40299789
DOI: 10.1158/1535-7163.MCT-25-0025
PDB entries with the same primary citation
Experimental method
X-RAY DIFFRACTION (2.205 Å)
Structure validation

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