A Phase 1, Open-Label, Fixed-Sequence Study to Evaluate the Effect of Vimseltinib on Organic Cation Transporter 2 (OCT2) Inhibition in Healthy Male Participants

The main purpose of this study is to evaluate the effect of multiple doses of vimseltinib on the pharmacokinetics (PK) of a clinical OCT2 substrate (metformin) in healthy male participants. This study will also assess the safety and tolerability when vimseltinib is co-administered with the clinical OCT2 substrate (metformin) in healthy male participants. This study will last approximately 25 days.

开始日期2025-11-01

申办/合作机构

Deciphera Pharmaceuticals, Inc.

NCT07158398

/ Not yet recruiting临床1期

A Phase 1, Open-Label, Fixed-Sequence Study to Evaluate the Effect of Vimseltinib on BCRP and OATP1B1 Inhibition in Healthy Male Participants

The main purpose of this study is to determine the effect of Vimseltinib dosing on breast cancer resistance protein (BCRP) and organic-anion-transporting polypeptide 1 B1 (OAT1PB1) activity by using rosuvastatin in healthy male participants. This study will also evaluate the safety and tolerability when vimseltinib is co-administered with rosuvastatin in healthy male participants. This study will last approximately 26 days.

开始日期2025-10-01

申办/合作机构

Deciphera Pharmaceuticals, Inc.

NCT06619561

/ Recruiting临床2期

A Phase 2, Open-label, Multicenter Study to Evaluate the Safety, Tolerability, PK, and Efficacy of Vimseltinib in Adults With Active Chronic GVHD After Failure of Prior Systemic Therapy

The purpose of this study is to determine if vimseltinib is safe, tolerable and works effectively to treat adults with active moderate to severe cGVHD. Participants will be treated with vimseltinib in 28-day treatment cycles for approximately 2 years.

开始日期2024-11-21

申办/合作机构

Deciphera Pharmaceuticals, Inc.

100 项与 Vimseltinib 相关的临床结果

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100 项与 Vimseltinib 相关的转化医学

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100 项与 Vimseltinib 相关的专利（医药）

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项与 Vimseltinib 相关的文献（医药）

2025-08-01·ESMO Open

A phase I study of the CSF1R inhibitor vimseltinib in combination with the PD-L1 inhibitor avelumab in patients with advanced sarcoma

Article

作者: Wong, P ; Antonescu, C R ; Biniakewitz, M ; Chan, J E ; D'Angelo, S P ; Gounder, M M ; Hwang, S ; Movva, S ; Qin, L-X ; Rosenbaum, E ; Avutu, V ; Desir, R ; Chi, P ; Keohan, M L ; Nacev, B A ; Tap, W D ; Seier, K ; Dickson, M A ; Jasnani, S ; Kelly, C M ; Bradic, M ; Erinjeri, J ; Duchemin, M

BACKGROUND:

Sarcomas are frequently infiltrated with immunosuppressive myeloid cells. Vimseltinib is an inhibitor of the colony-stimulating factor 1 receptor kinase and has been shown to decrease tumor-infiltrating myeloid cells in preclinical models. We hypothesized that vimseltinib combined with the Programmed death-ligand 1 (PD-L1) inhibitor avelumab would be safe, tolerable, and clinically effective in patients with advanced sarcoma.

METHODS:

This was a phase I study of vimseltinib plus avelumab in patients with unresectable or metastatic sarcoma. The study used a standard 3 + 3 dose-escalation design, followed by dose expansion in patients with select histological subtypes. Vimseltinib was administered daily by mouth in 28-day cycles; avelumab was administered intravenously every 2 weeks. The primary objectives of the dose-escalation and dose-expansion phases were to determine the recommended phase II dose and to estimate the best objective response rate by RECIST version 1.1.

RESULTS:

Thirteen patients were treated in the dose-escalation phase, and 19 patients were treated in the dose-expansion phase. The most common treatment-related adverse events were asymptomatic increases in serum levels of amylase, lipase, creatine phosphokinase, aspartate aminotransferase, and alanine aminotransferase. One of six patients treated at the highest dose level had a dose-limiting toxicity (grade 4 increase in aspartate aminotransferase). The highest dose level was determined to be the recommended phase II dose. There were no objective responses. The median progression-free survival of patients treated at the recommended phase II dose was 1.55 months (95% confidence interval 1.25-1.78 months). Flow cytometric analysis of peripheral blood mononuclear cells revealed a decrease in myeloid-derived suppressor cells and regulatory T cells after treatment. RNA sequencing of paired tumor samples revealed an increase in tumor-infiltrating T cells and a decrease in macrophages after treatment.

CONCLUSIONS:

Vimseltinib plus avelumab was generally safe and well tolerated. This combination had minimal clinical efficacy in our population of heavily pretreated patients with sarcoma.

2025-05-31·Intractable & Rare Diseases Research

Vimseltinib: A novel colony stimulating factor 1 receptor (CSF1R) inhibitor approved for treatment of tenosynovial giant cell tumors (TGCTs)

Letter

作者: Lu, Daoran ; Dou, Fangzhou ; Gao, Jianjun

A tenosynovial giant cell tumor (TGCT) is a rare benign neoplasm arising from the tendon sheaths, bursae, or synovial lining of joints and is characterized by locally aggressive growth and the potential for recurrent disease. Surgery is still the main form of treatment for a TGCT, but these neoplasms, and most notably the diffuse type, exhibit a high proclivity for recurrence, thus highlighting the unmet clinical need for novel therapeutic modalities. At the same time, a subgroup of patients deemed ineligible for surgery are confronted with limited therapeutic alternatives, further underscoring the urgent need for innovative treatment paradigms. On February 14, 2025, the US Food and Drug Administration approved a new colony-stimulating factor 1 receptor (CSF1R) inhibitor, vimseltinib, for the treatment of symptomatic TGCTs in adult patients for whom surgical resection would likely result in severe functional limitations or serious complications. As the second-in-class CSF1R inhibitor approved for TGCTs, vimseltinib exhibits enhanced selectivity for CSF1R over pexidartinib, the first-in-class agent, suggesting potential translational benefits in safety profiles. The clinical utility of vimseltinib is anticipated to be further elucidated by real-world evidence and expanded clinical evaluations.

2025-04-03·Expert Review of Anticancer Therapy

An evaluation of vimseltinib for treatment of tenosynovial giant cell tumors

Review

作者: Rutkowski, Piotr ; Kisielewska, Katarzyna

INTRODUCTION:

Tenosynovial giant cell tumor (TGCT) is a rare soft tissue neoplasm with aggressive local growth. The disease is driven by excessive CSF1 expression in tumor cells, leading to increased recruitment of monocytes and macrophages, cytokine production, and tumor development. Targeted therapy against CSF1R is an effective treatment approach for unresectable, symptomatic TGCT. Vimseltinib, a novel, small-molecule tyrosine kinase inhibitor of CSF1R, has shown clinical efficacy in patients with TGCT.

AREAS COVERED:

This paper outlines the pathogenesis and therapeutic options for TGCT, along with a detailed profile of vimseltinib, including its mechanism of action, pharmacokinetics, efficacy and safety data from clinical studies. The efficacy and tolerability of vimseltinib are indirectly compared with previously known CSF1R inhibitors.

EXPERT OPINION:

In the MOTION study, the use of vimseltinib in patients with advanced TGCT resulted in a high objective response rate, substantial benefit in reducing clinical symptoms (such as pain and stiffness), and a favorable safety profile. Vimseltinib represents a promising new therapeutic option for patients with unresectable TGCT and is currently awaiting regulatory review by the FDA and EMA.

项与 Vimseltinib 相关的新闻（医药）

2025-08-07

·精准药物

【综述】丁克、王震等：激酶药物研发30年——进展与挑战

1 引言激酶是一类能够将三磷酸腺苷(adenosine triphosphate, ATP)末端的磷酸基团转移至特定蛋白质或脂质等底物的酶[1]. 激酶介导的磷酸化修饰会导致底物构象变化, 从而影响底物的亚细胞定位、催化活性以及与其他分子的结合能力, 在调控细胞生长、增殖、分化、迁移和凋亡等过程中发挥着关键作用[2]. 激酶包含一个高度保守的ATP结合域, 由一个铰链多肽连接的β-折叠结构域和α-螺旋结构域组成, 是激酶发挥催化活性的中心(图1). 自1956年被Edmond H. Fischer和Edwin G. Krebs发现以来[3,4], 激酶研究迅速发展. 激酶已成为真核生物中第四大基因家族(占比2%), 仅次于C2H2锌指蛋白(3%)、G蛋白偶联受体(G protein-coupled receptors, GPCRs, 2.8%)和主要组织相容性复合体(major histocompatibility complex, MHC)蛋白家族(2.8%)[5]. 人类基因组中约有518种激酶, 包括478种蛋白激酶和40种脂质激酶等, 其功能异常已被证实与癌症、代谢性疾病、神经退行性疾病、免疫性疾病及感染性疾病等多种人类疾病密切相关[6]. 然而, 由于细胞内高浓度ATP的存在、对激酶活性调控机制的认知不足, 以及ATP结合口袋的高度保守性, 靶向ATP结合位点的激酶药物研发最初被视为不可逾越的挑战[7]. 尽管早在1995年, 首个激酶抑制剂法舒地尔(Fasudil)在日本获批上市用于治疗脑血管痉挛, 以及随后在1999年, 西罗莫司(Sirolimus)成为首个在美国获批上市的激酶抑制剂, 但这两种药物的作用靶点(Rho相关激酶(Rho-associated kinase, ROCK)和哺乳动物雷帕霉素靶蛋白(mammalian target of rapamycin, mTOR))均是后期深入的机制研究发现的[8]. 直到2001年, 伊马替尼(Imatinib)获批上市, 成为首个通过靶向特定蛋白激酶(BCR-ABL)开发并获批用于疾病治疗的药物, 其显著的临床疗效成为肿瘤分子靶向治疗领域研究热潮的催化[8]. 到2025年5月31日止, 美国食品药品监督管理局(U.S. Food and Drug Administration, FDA)批准了14种激酶大分子药物和96种激酶小分子药物(图2)[2,8~10]. 其中, 激酶小分子抑制剂最多, 本文采用Roskoski提出的激酶抑制剂分类标准[11], 具体如下. I型抑制剂: 结合于活性激酶的ATP结合口袋; I1/2型与II型抑制剂: 均结合于非活性激酶的ATP结合口袋, 其区别在于非活性构象中DFG基序的取向——I1/2型为“DFG-in”构象, II型为“DFG-out”构象; III型与IV型抑制剂: 指变构抑制剂(非ATP竞争性), 其中III型结合位点毗邻ATP结合位点, IV型则远离该位点; 共价抑制剂: 通过不可逆结合发挥作用, 在此分类体系中单独归类. 本文将归纳总结FDA上市药物的作用靶标、作用模式以及适应证, 并分析探讨了目前激酶药物的研发现状和未来机遇.. 2 FDA批准的激酶药物2.1 FDA批准的小分子激酶药物 1999年, 辉瑞公司的西罗莫司(Sirolimus)获批上市(图3), 用于预防肾移植患者的器官排斥反应. 该药物是一种含有大环内酯结构的天然产物, 是一类变构激酶抑制剂, 通过诱导亲环蛋白FK506结合蛋白12 (FK506-binding protein 12, FKBP12)和mTOR激酶形成复合物, 抑制mTOR的激酶活性及其信号通路从而发挥免疫抑制活性[12,13]. 2001年, 诺华公司的伊马替尼(Imatinib)获批上市, 用于治疗费城染色体阳性的慢性髓性白血病. 该药物是II型ATP竞争性的一代BCR-ABL激酶抑制剂, 通过稳定BCR-ABL的非活性构象抑制其激酶活性发挥从而抑制肿瘤细胞增殖. 该药物也因对KIT激酶的良好抑制活性于2002年获批用于治疗胃肠道间质瘤[12,14,15]. 2003年, 阿斯利康公司的吉非替尼(Gefitinib)获批上市, 用于治疗携带表皮生长因子受体(epidermal growth factor receptor, EGFR) 19号外显子缺失(EGFRDel19)或21号外显子替换突变(EGFRL858R)等激活性突变的非小细胞肺癌. 该药物是I型ATP竞争性的一代EGFR激酶抑制剂, 通过结合活性构象的EGFR抑制其激酶活性发挥从而抑制肿瘤细胞增殖[12,16]. 2004年, 罗氏公司的厄洛替尼(Erlotinib)获批上市, 用于治疗携带EGFRDel19或EGFRL858R等激活性突变的非小细胞肺癌. 该药物属于一代EGFR激酶抑制剂, 既可作为I型ATP竞争性激酶抑制剂结合活性构象的EGFR, 也能以I1/2型结合非活性构象的EGFR来抑制EGFR的激酶活性[12,17,18]. 2005年, 拜耳公司的索拉非尼(Sorafenib)获批上市, 用于治疗肾细胞癌. 该药物是II型ATP竞争性的BRAF激酶抑制剂, 能同时抑制野生型BRAF及其突变体V600E和RAF1等. 该药物还分别于2007年和2013年获批用于治疗肝细胞癌和甲状腺癌[12,19]. 2006年, FDA批准了2款激酶药物, 包括百时美施贵宝公司的达沙替尼(Dasatinib)和辉瑞公司的舒尼替尼(Sunitinib)[12]. 达沙替尼是I型ATP竞争性的二代BCR-ABL激酶抑制剂, 用于治疗对伊马替尼产生耐药的慢性髓性白血病, 对除T315I外的BCR-ABL突变体有良好的抑制效果[20]. 舒尼替尼是I1/2型ATP竞争性的周期蛋白依赖激酶2 (cyclin-dependent kinase 2, CDK2)激酶抑制剂, 同时对KIT、血管内皮细胞生长因子受体2 (vascular endothelial growth factor receptor 2, VEGFR2)和FMS样酪氨酸激酶3 (Fms-like tyrosine kinase, FLT3)等激酶具有良好的抑制活性, 用于治疗对伊马替尼耐药的胃肠道间质瘤和肾细胞癌[14,21]. 2007年, FDA批准了3款激酶药物, 包括葛兰素史克公司的拉帕替尼(Lapatinib)、诺华公司的尼洛替尼(Nilotinib)和辉瑞公司的替西罗莫司(Temsirolimus)[12]. 拉帕替尼是I1/2型ATP竞争性的EGFR和人表皮生长因子受体2 (human epidermal growth factor receptor 2, HER2)等激酶抑制剂, 用于治疗HER2阳性的乳腺癌[14,22]. 尼洛替尼是II型ATP竞争性的二代BCR-ABL激酶抑制剂, 用于治疗对伊马替尼产生耐药的慢性髓性白血病, 对除T315I外的BCR-ABL突变体有良好的抑制效果[23,24]. 替西罗莫司是一种大环内酯类药物, 是西罗莫司的酯类似物, 同样靶向mTOR激酶, 用于静脉注射治疗肾细胞癌[25]. 2009年, FDA批准了2款激酶药物, 包括诺华公司的依维莫司(Everolimus)和葛兰素史克公司的帕唑帕尼(Pazopanib)[12]. 依维莫司是一种大环内酯类药物, 是西罗莫司的类似物, 同样靶向mTOR激酶, 用于预防移植器官排斥反应以及治疗舒尼替尼或索拉非尼耐药的肾细胞癌[26]. 帕唑帕尼是II型ATP竞争性的泛VEGFR激酶抑制剂, 用于治疗肾细胞癌. 该药物于2012年被获批用于治疗软组织肉瘤[27]. 2011年, FDA批准了4款激酶药物, 包括辉瑞公司的克唑替尼(Crizotinib)、Incyte公司的鲁索利替尼(Ruxolitinib)、阿斯利康公司的凡德他尼(Vandetanib)和罗氏公司的维莫非尼(Vemurafenib)[12]. 克唑替尼是I1/2型ATP竞争性的间变性淋巴瘤激酶(anaplastic lymphoma kinase, ALK)、ROS1和间质表皮转化因子(mesenchymal to epithelial transition factor, MET)等激酶抑制剂, 用于治疗ALK阳性或ROS1阳性的非小细胞肺癌[25,28]. 鲁索利替尼是I型ATP竞争性的JAK1和JAK2等激酶抑制剂, 是首个获批用于治疗骨髓纤维化的药物[29,30]. 凡德他尼是I型ATP竞争性的RET、VEGFR和EGFR等激酶抑制剂, 用于治疗甲状腺癌[31,32]. 维莫非尼是I1/2型ATP竞争性的BRAF激酶抑制剂(对BRAFV600E活性更优), 用于治疗携带BRAFV600E突变的黑色素瘤, 是首个针对致癌性BRAF的抑制剂[14,33]. 2012年, FDA批准了6款激酶药物, 包括辉瑞公司的阿昔替尼(Axitinib)、博舒替尼(Bosutinib)、托法替尼(Tofacitinib)、Exelixis公司的卡博替尼(Cabozantinib)、武田公司的普纳替尼(Ponatinib)和拜耳公司的瑞戈非尼(Regorafenib)[12]. 阿昔替尼是II型ATP竞争性的VEGFR激酶抑制剂, 用于治疗肾细胞癌[14,34]. 博舒替尼是I型ATP竞争性的二代BCR-ABL激酶抑制剂, 用于治疗费城染色体阳性的慢性髓性白血病[23,35]. 托法替尼是I型ATP竞争性的泛JAK激酶抑制剂, 用于治疗类风湿关节炎、银屑病关节炎和溃疡性结肠炎[36,37]. 卡博替尼是MET、VEGFR2和RET等激酶抑制剂, 用于治疗甲状腺髓样癌和索拉非尼耐药的肾细胞癌和肝细胞癌[38]. 普纳替尼是II型ATP竞争性的第三代BCR-ABL抑制剂, 用于治疗携带BCR-ABLT315I突变的慢性髓性白血病[39]. 瑞戈非尼是II型ATP竞争性的VEGFR、血小板衍生生长因子受体(platelet-derived growth factor receptor, PDGFR)、成纤维细胞生长因子受体(fibroblast growth factor receptor, FGFR)、BRAF、TIE2、RAF1、KIT和RET等激酶抑制剂, 用于治疗结直肠癌、胃肠道间质瘤和肾细胞癌[40]. 2013年, FDA批准了4款激酶药物, 包括勃林格殷格翰公司的阿法替尼(Afatinib)、葛兰素史克公司的达拉非尼(Dabrafenib)、曲美替尼(Trametinib)和强生公司的伊布替尼(Ibrutinib)[12] (图4). 阿法替尼是二代EGFR激酶抑制剂, 也是首个与ATP结合口袋的Cys797形成共价键的共价EGFR抑制剂, 用于治疗携带EGFRDel19或EGFRL858R等激活性突变的非小细胞肺癌[41]. 达拉非尼是I1/2型ATP竞争性的BRAF激酶抑制剂, 用于治疗携带BRAFV600E的黑色素瘤[42,43]. 曲美替尼是III型MEK1/2变构激酶抑制剂, 用于治疗携带BRAFV600E或BRAFV600K的黑色素瘤[44,45]. 伊布替尼是共价布鲁顿酪氨酸激酶(Bruton’s tyrosine kinase, BTK)激酶抑制剂, 用于治疗套细胞淋巴瘤、慢性淋巴细胞白血病、华氏巨球蛋白血症、慢性移植物抗宿主病和边缘区淋巴瘤[46,47].. 2014年, FDA批准了3款激酶药物, 包括诺华公司的色瑞替尼(Ceritinib)、吉利德公司的艾代拉利司(Idelalisib)和勃林格殷格翰公司的尼达尼布(Nintedanib)[12]. 色瑞替尼是I1/2型ATP竞争性的二代ALK抑制剂, 用于治疗ALK阳性的非小细胞肺癌, 对克唑替尼耐药患者有效[25,48]. 艾代拉利司是I型ATP竞争性的磷脂酰肌醇3-激酶δ (phosphoinositide 3-kinase δ, PI3Kδ)抑制剂, 也是首个上市的PI3K选择性抑制剂, 联合利妥昔单抗治疗慢性淋巴细胞白血病以及治疗B细胞非霍奇金淋巴瘤和小淋巴细胞性淋巴瘤[49,50]. 尼达尼布是II型ATP竞争性的泛VEGFR激酶抑制剂, 用于治疗特发性肺纤维化[14,51]. 2015年, FDA批准了5款激酶药物, 包括罗氏公司的阿来替尼(Alectinib)、考比替尼(Cobimetinib)、卫材公司的仑伐替尼(Lenvatinib)、阿斯利康公司的奥希替尼(Osimertinib)和辉瑞公司的哌柏西利(Palbociclib)[12]. 阿来替尼是I1/2型ATP竞争性的ALK和RET等激酶抑制剂, 也是二代ALK抑制剂, 用于治疗对克唑替尼耐药的ALK阳性的非小细胞肺癌[52]. 考比替尼是III型的MEK1/2变构激酶抑制剂, 该药联合维莫非尼用于治疗携带BRAFV600E或BRAFV600K的黑色素瘤[53]. 仑伐替尼是I1/2型ATP竞争性的VEGFR、RET、PDGFR和KIT等激酶抑制剂, 用于治疗甲状腺癌、肝细胞癌和肾细胞癌[54]. 奥希替尼是三代共价EGFR抑制剂, 用于治疗携带EGFRT790M突变的非小细胞肺癌[55]. 哌柏西利是I型ATP竞争性CDK4和CDK6等激酶抑制剂, 与来曲唑联用治疗激素受体阳性和HER2阴性乳腺癌[56]. 2017年, FDA批准了8款激酶药物, 包括礼来公司的阿贝西利(Abemaciclib)、阿斯利康公司的阿卡替尼(Acalabrutinib)、武田公司的布加替尼(Brigatinib)、拜耳公司的可泮利塞(Copanlisib)、诺华公司的米哚妥林(Midostaurin)、瑞波西利(Ribociclib)、辉瑞公司的来那替尼(Neratinib)和Aerie公司的奈舒地尔(Netarsudil)[12]. 阿贝西利是I型ATP竞争性的 CDK4和CDK6等激酶抑制剂, 联合芳香化酶抑制剂或氟维司群治疗激素受体阳性和HER2阴性的乳腺癌[56]. 阿卡替尼是共价BTK激酶抑制剂, 用于治疗套细胞淋巴瘤、慢性淋巴细胞白血病和小淋巴细胞性淋巴瘤[57]. 布加替尼是I型ATP竞争性的ALK激酶抑制剂, 用于治疗对克唑替尼耐药的ALK阳性的非小细胞肺癌[58]. 可泮利塞是I型ATP竞争性的泛PI3K激酶抑制剂, 用于治疗滤泡性淋巴瘤[59]. 米哚妥林是I型ATP竞争性的蛋白激酶C (protein kinase C, PKC)、FLT3和KIT等激酶抑制剂, 用于治疗FLT3突变的急性髓细胞性白血病、侵袭性系统性肥大细胞增多症、系统性肥大细胞增多症. 伴相关血液系统肿瘤和肥大细胞白血病[60]. 瑞波西利是I1/2型ATP竞争性的CDK4和CDK6等激酶抑制剂, 联合芳香化酶抑制剂治疗激素受体阳性和HER2阴性的乳腺癌[11]. 来那替尼是共价HER2和EGFR等激酶抑制剂, 用于治疗HER2阳性的乳腺癌[16]. 奈舒地尔是ATP竞争性的ROCK激酶抑制剂, 作为滴眼液用于治疗开角型青光眼或高眼压症[61]. 2018年, FDA批准了9款激酶药物, 包括礼来公司的巴瑞替尼(Baricitinib)、辉瑞公司的比美替尼(Binimetinib)、达可替尼(Dacomitinib)、康奈非尼(Encorafenib)、洛拉替尼(Lorlatinib)、Secura公司的度维利塞(Duvelisib)、Rigel公司的福坦替尼(Fostamatinib)、安斯泰来公司的吉瑞替尼(Gilteritinib)和拜耳公司的拉罗替尼(Larotrectinib)[12] (图5). 巴瑞替尼是I型ATP竞争性的Janus激酶1 (Janus kinase 1, JAK1)和JAK2等激酶抑制剂, 用于治疗类风湿性关节炎[30]. 比美替尼是III型的MEK1/2变构激酶抑制剂, 联合康奈非尼治疗携带BRAFV600E或BRAFV600K的黑色素瘤或非小细胞肺癌[25]. 达可替尼是二代共价EGFR激酶抑制剂, 用于治疗携带EGFRDel19或EGFRL858R等激活性突变的非小细胞肺癌[62]. 康奈非尼是BRAFV600E/K激酶抑制剂, 联合比美替尼治疗携带BRAFV600E或BRAFV600K的黑色素瘤或非小细胞肺癌, 以及联合西妥昔单抗治疗携带BRAFV600E的结直肠癌[42]. 洛拉替尼是I型大环类ALK和ROS1等激酶抑制剂, 用于治疗ALK阳性的非小细胞肺癌[63]. 度维利塞是I型ATP竞争性的PI3Kδ和PI3Kγ等激酶抑制剂, 用于治疗慢性淋巴细胞白血病、小淋巴细胞性淋巴瘤和滤泡性淋巴瘤[64]. 福坦替尼是I型ATP竞争性的脾酪氨酸激酶(spleen tyrosine kinase, Syk)抑制剂的口服前药, 用于治疗慢性免疫性血小板减少症[65]. 吉瑞替尼是II型ATP竞争性的FLT3和AXL等激酶抑制剂, 用于治疗携带FLT3致癌突变的急性髓系白血病[66]. 拉罗替尼是原肌球蛋白受体激酶A/B/C (tropomyosin receptor kinase A/B/C, TRKA/B/C)等激酶抑制剂, 是首个获得美国FDA“组织不确定”突破性疗法认定的小分子药物, 用于治疗神经营养性酪氨酸受体激酶(neurotrophic tyrosine receptor kinase, NTRK)基因融合的实体瘤[25]. 2019年, FDA批准了7款激酶药物, 包括诺华公司的阿培利司(Alpelisib)、罗氏公司的恩曲替尼(Entrectinib)、强生公司的厄达替尼(Erdafitinib)、赛诺菲公司的菲卓替尼(Fedratinib)、第一三共公司的培西达替尼(Pexidartinib)、艾伯维公司的乌帕替尼(Upadacitinib)和百济神州公司的泽布替尼(Zanubrutinib)[12]. 阿培利司是I型ATP竞争性的PI3Kα激酶抑制剂, 联合氟维司群治疗激素受体阳性、HER2阴性和携带PIK3CA突变的乳腺癌[67]. 恩曲替尼是I1/2型ATP竞争性的TRKA/B/C、ROS1和ALK等激酶抑制剂, 用于治疗携带NTRK基因融合的实体瘤和ROS1阳性的非小细胞肺癌[68]. 厄达替尼是I1/2型ATP竞争性的泛FGFR激酶抑制剂, 用于治疗携带FGFR基因改变的尿路上皮癌[69]. 菲卓替尼是I型ATP竞争性的JAK2激酶抑制剂, 用于治疗骨髓纤维化[30]. 培西达替尼是II型ATP竞争性的集落刺激因子1受体(colony stimulating factor 1 receptor, CSF1R)激酶抑制剂, 用于治疗腱鞘巨细胞瘤[70]. 乌帕替尼是I型ATP竞争性的JAK1抑制剂, 用于治疗类风湿关节炎、银屑病和特应性皮炎[71]. 泽布替尼是共价BTK激酶抑制剂, 选择性优于伊布替尼, 用于治疗套细胞淋巴瘤[72]. 2020年, FDA批准了8款激酶药物, 包括Blueprint Medicines公司的阿伐替尼(Avapritinib)、普拉替尼(Pralsetinib)、诺华公司的卡马替尼(Capmatinib)、Incyte公司的佩米替尼(Pemigatinib)、Deciphera公司的瑞派替尼(Ripretinib)、礼来公司的塞普替尼(Selpercatinib)、阿斯利康公司的司美替尼(Selumetinib)和辉瑞公司的妥卡替尼(Tucatinib)[12]. 阿伐替尼是I型ATP竞争性的KIT和PDGFRA等激酶抑制剂, 用于治疗携带PDGFRA外显子18突变的胃肠道间质瘤[73]. 普拉替尼是I型ATP竞争性的RET激酶抑制剂, 治疗RET融合的非小细胞肺癌、RET突变的甲状腺髓样癌或RET融合的甲状腺癌[74]. 卡马替尼是ATP竞争性的MET激酶抑制剂, 用于治疗携带MET基因14号外显子跳跃突变的非小细胞肺癌[75]. 佩米替尼是ATP竞争性的泛FGFR激酶抑制剂, 用于治疗FGFR2融合或其他重排的胆管癌[76]. 瑞派替尼是II型ATP竞争性的KIT和PDGFR等激酶抑制剂, 用于治疗胃肠道间质瘤[77]. 塞普替尼是I型ATP竞争性的RET激酶抑制剂, 用于治疗RET融合的非小细胞肺癌、RET突变的甲状腺髓样癌或RET融合的甲状腺癌[74]. 司美替尼是III型的MEK1变构激酶抑制剂, 用于治疗神经纤维瘤[78]. 妥卡替尼是ATP竞争性的HER2激酶抑制剂, 联合曲妥珠单抗和卡培他滨治疗HER2阳性乳腺癌[79]. 2021年, FDA批准了8款激酶药物, 包括默克公司的特泊替尼(Tepotinib)、TG Therapeutics公司的厄布利塞(Umbralisib)、G1 Therapeutics公司的曲拉西利(Trilaciclib)、诺华公司的英菲格拉替尼(Infigratinib)、赛诺菲公司的贝舒地尔(Belumosudil)武田公司的莫博替尼(Mobocertinib)、Aveo公司的替沃扎尼(Tivozanib)和诺华公司的阿西米尼(Asciminib)[12] (图6). 特泊替尼是I型ATP竞争性的MET激酶抑制剂, 用于治疗携带MET外显子14跳跃突变的非小细胞肺癌[80]. 厄布利塞是PI3Kδ和酪蛋白激酶1ε (casein kinase 1ε, CK1ε)双靶抑制剂, 用于治疗边缘区淋巴瘤或滤泡性淋巴瘤[81]. 曲拉西利是静脉给药的CDK4/6激酶抑制剂, 是首款骨髓保护疗法, 用于减少广泛期小细胞肺癌患者接受大剂量化疗所导致骨髓抑制频率[82]. 英菲格拉替尼是ATP竞争性的泛FGFR激酶抑制剂, 用于治疗携带FGFR2融合或其他重排的胆管癌[83]. 贝舒地尔是ROCK2激酶抑制剂, 用于治疗慢性移植物抗宿主病[84]. 莫博替尼是EGFR外显子20激活突变体抑制剂, 是首个用于治疗携带EGFR外显子20激活突变的非小细胞肺癌[85]. 替沃扎尼是II型ATP竞争性的泛VEGFR激酶抑制剂, 用于治疗肾细胞癌[34]. 阿西米尼是IV型的BCR-ABL变构激酶抑制剂, 通过结合BCR-ABL融合蛋白特有的肉豆蔻酰口袋来发挥作用, 用于携带BCR-ABLT315I的慢性髓性白血病[86]. 2022年, FDA批准了5款激酶药物, 包括辉瑞公司的阿布昔替尼(Abrocitinib)、百时美施贵宝公司的氘可来昔替尼(Deucravacitinib)、Tiaho公司的福巴替尼(Futibatinib)、Sobi公司的帕克替尼(Pacritinib)和Agios公司的米他匹伐(Mitapivat)[12]. 阿布昔替尼是I型ATP竞争性的JAK1激酶抑制剂, 是首个用于治疗特应性皮炎的激酶抑制剂[87]. 氘可来昔替尼是IV型的TYK2变构激酶抑制剂, 通过结合TYK2的假激酶口袋发挥作用, 用于治疗银屑病, 是首个结构中包含氘原子的激酶抑制剂[88]. 福巴替尼是共价泛FGFR激酶抑制剂, 用于治疗FGFR2融合的肝内胆管癌[89]. 帕克替尼是I型ATP竞争性的选择性JAK2激酶抑制剂, 用于治疗骨髓纤维化[90]. 米他匹伐是丙酮酸激酶(pyruvate kinase, PK)变构激活剂, 用于治疗溶血性贫血[91]. 2023年, FDA批准了8款激酶药物, 包括阿斯利康公司的卡匹色替(Capivasertib)、和记黄埔的呋喹替尼(Fruquintinib)、葛兰素史克公司的莫洛替尼(Momelotinib)、礼来公司的吡托布鲁替尼(Pirtobrutinib)、第一三共公司的奎扎替尼(Quizartinib)、百时美施贵宝公司的瑞普替尼(Repotrectinib)、辉瑞公司的利特昔替尼(Ritlecitinib)和Pharming公司的莱尼奥利西布(Leniolisib)[12]. 卡匹色替是I型ATP竞争性的AKT激酶抑制剂, 用于治疗激素受体阳性和HER2阴性的乳腺癌[92]. 呋喹替尼是ATP竞争性的VFGFR2激酶抑制剂, 用于治疗结直肠癌[93]. 莫洛替尼是I型ATP竞争性的JAK1/2激酶抑制剂, 用于治疗骨髓纤维化[90]. 吡托布鲁替尼是I1/2型ATP竞争性的BTK激酶抑制剂, 用于治疗套细胞淋巴瘤、慢性淋巴细胞白血病和小淋巴细胞淋巴瘤[94]. 奎扎替尼是II型ATP竞争性的FLT3激酶抑制剂, 用于治疗FLT3内部串联重复的急性髓性白血病[95]. 瑞普替尼是I型ATP竞争性的ROS1和TRK双靶激酶抑制剂, 用于治疗ROS1阳性的非小细胞肺癌[96]. 利特昔替尼是I型ATP竞争性的JAK3激酶抑制剂, 用于治疗斑秃[97]. 莱尼奥利西布是ATP竞争性的选择性PI3Kδ激酶抑制剂, 用于治疗PI3Kδ过度活化综合征[98]. 2024年, FDA批准了5款激酶药物, 包括Sun公司的氘代芦可替尼(Deuruxolitinib)、贝达药业的恩沙替尼(Ensartinib)、强生公司的拉泽替尼(Lazertinib)、Day One公司的托沃拉非尼(Tovorafenib)、基因泰克公司的伊那利塞(Inavolisib)[12]. 氘代芦可替尼是ATP竞争性的JAK1/2激酶抑制剂, 用于治疗斑秃[99]. 恩沙替尼是ATP竞争性的ALK激酶抑制剂, 用于治疗ALK阳性的非小细胞肺癌[100]. 拉泽替尼是I1/2型ATP竞争性的三代EGFR激酶抑制剂, 用于治疗携带EGFRDel19或EGFRL858R等激活性突变的非小细胞肺癌患者[101]. 托沃拉非尼是II型ATP竞争性的B-Raf激酶抑制剂, 用于治疗儿童低恶性胶质瘤[102]. 伊那利塞是ATP竞争性的PI3Kα激酶抑制剂, 用于治疗具有PI3Kα基因突变、激素受体阳性(HR+)、HER2阴性、局部晚期或转移性乳腺癌的成年患者[103]. 2025年(截至5月31日), FDA批准了4款激酶药物, 包括SpringWorks公司的米尔德替尼(Mirdametinib)、小野制药的维姆塞替尼(Vimseltinib)和Verastem公司的艾沃美替尼(Avutometinib)、地法替尼(Defactinib)[12]. 米尔德替尼是III型的MEK变构激酶抑制剂, 用于治疗I型神经纤维瘤[45]. 维姆塞替尼是II型ATP竞争性的CSF1R激酶抑制剂, 用于治疗腱鞘巨细胞瘤[104]. 艾沃美替尼通过诱导MEK与RAF形成非活性复合物, 抑制MEK/RAF活性, 用于治疗KRAS突变的低级别浆液性卵巢癌[105]. 地法替尼是I型ATP竞争性的FAK激酶抑制剂, 用于治疗KRAS突变的低级别浆液性卵巢癌[106].2.2 大分子激酶药物(抗体) 1998年, 罗氏公司的曲妥珠单抗(Trastuzumab)获批上市, 用于治疗HER2阳性乳腺癌, 是首个应用于实体肿瘤的人源化单抗. 该药物是抗HER2的单克隆抗体, 通过结合到HER2的胞外结构域IV, 阻止其与其他HER2形成同源二聚体, 从而抑制下游的信号传导路径, 阻止肿瘤细胞的增殖, 以及引发抗体依赖的细胞毒作用[12,107]. 2004年, 默克公司的西妥昔单抗(Cetuximab)获批上市, 用于治疗结肠直肠癌和头颈癌. 该药物是抗EGFR的单克隆抗体, 与EGFR胞外域结合, 阻断其二聚活化, 抑制细胞增殖, 以及引发抗体依赖的细胞毒作用[12,108]. 2006年, 安进公司的帕尼单抗(Panitumumab)获批上市, 用于治疗结直肠癌. 该药物也是抗EGFR的单克隆抗体[12,109]. 2012年, 罗氏公司的帕妥珠单抗(Pertuzumab)获批上市, 用于治疗HER2阳性乳腺癌. 该药物也是抗HER2单克隆抗体, 结合到HER2的胞外结构域II, 阻止HER2与其他EGFR家族受体(HER1、HER3、HER4)形成二聚体, 抑制肿瘤细胞增殖[12,110]. 2013年, 罗氏公司的恩美曲妥珠单抗(Trastuzumab-emtansine)获批上市, 用于治疗HER2阳性乳腺癌. 该药物是由抗HER2靶向药物曲妥珠单抗与抑制微管聚集的化疗药物美坦新通过硫醚连接子连接而成的抗体偶联物(antibody-drug conjugate, ADC)[12,111]. 2014年, 礼来公司的雷莫芦单抗(Ramucirumab)和尼妥珠单抗(Nimotuzumab)获批上市[12]. 雷莫芦单抗是抗VEGFR2单克隆抗体, 结合VEGFR2胞外域的末端, 诱导受体构象的改变, 阻止配体与VEGFR2结合, 从而抑制下游信号传导, 用于治疗胃癌或胃食管交界处癌[112]. 尼妥珠单抗也是一种EGFR单克隆抗体, 用于与放疗联合治疗EGFR阳性的鼻咽癌[113]. 2016年, 礼来公司的奥拉单抗(Olaratumab)获批上市, 用于治疗软组织肉瘤. 该药物是PDGFRα单克隆抗体, 结合人PDGFRα并阻断其与配体PDGFs结合, 抑制下游信号通路[12,114]. 2019年, 第一三共公司的德曲妥珠单抗(Trastuzumab-Deruxtecan)获批上市, 用于治疗HER2阳性的乳腺癌和胃癌. 该药物是一种ADC, 由抗HER2单克隆抗体与DNA拓扑异构酶I抑制剂依沙替康衍生物组成[12,115]. 2020年, MacroGenics公司的马吉妥昔单抗(Margetuximab)获批上市, 用于治疗HER2阳性乳腺癌. 该药物是一种抗HER2的单克隆抗体[12,116]. 2021年, 强生公司的埃万妥单抗(Amivantamab)获批上市, 用于治疗EGFR外显子20插入突变的非小细胞肺癌. 该药物是一种直接针对EGFR和MET的双特异性抗体, 可以与EGFR和MET的胞外域结合, 同时抑制EGFR和MET信号通路[12,117]. 2024年, 百济神州公司的泽尼达妥单抗(Zanidatamab)和Merus公司的泽妥珠单抗(Zenocutuzumab)获批上市[12]. 泽尼达妥单抗是HER2双特异性抗体, 用于治疗HER2阳性胆道癌. 该抗体可同时与HER2上两个不同表位结合, 既可以阻断HER2信号, 也可以促进内化, 导致肿瘤细胞表面受体减少从而抑制肿瘤细胞增长[118]. 泽妥珠单抗是靶向HER2/HER3的双特异性抗体, 用于治疗非小细胞肺癌和胰腺癌. 该药物通过阻止NRG1与HER3结合, 抑制HER2/HER3二聚化并诱导NRG1基因融合肿瘤细胞死亡[119]. 2025年, 艾伯维的特立妥珠单抗(Telisotuzumab)获批上市, 用于治疗c-Met高表达的非鳞状非小细胞肺癌. 该抗体由c-Met靶向抗体、可裂解连接子和单甲基奥瑞他汀E (MMAE)载荷组成的ADC. 针对肿瘤细胞表面的c-Met突变进行追踪, 并释放抗有丝分裂药物MMAE抑制肿瘤细胞增长[12,120]. 3 总结与展望从1995年第一个激酶抑制剂法舒地尔获批30年以来, FDA共批准了110个激酶药物, 包括96个小分子药物和14个大分子药物. 分析这96个激酶小分子药物, 我们得到如下结论. (1) 在这96种药物中, 除了有95种不同类型的激酶抑制剂, 还包含1个丙酮酸激酶变构激活剂米他匹伐. 尽管目前仅有一款激酶激活剂获批用于疾病治疗, 但这有力证实了激活相关激酶是治疗疾病的可行策略, 拓展了激酶药物研发的空间. (2) 53种药物靶向受体酪氨酸激酶, 22种药物抑制非受体酪氨酸激酶, 14种药物拮抗丝氨酸/苏氨酸激酶, 6种药物靶向双特异性蛋白激酶(MEK1/2), 以及1种药物激动糖酵解过程相关的丙酮酸激酶. 由此可知, 尽管在蛋白激酶中, 大部分为丝氨酸/苏氨酸激酶, 但酪氨酸激酶仍然是大部分激酶药物的作用对象. 这可能是因为酪氨酸激酶的病理作用更明确、致癌驱动突变集中, 如EGFR、ALK、BCR-ABL等酪氨酸激酶的突变或融合是多种癌症的直接驱动因素, 而丝氨酸/苏氨酸激酶更多作为下游信号节点(如mTOR、AKT). 另外, 丝氨酸/苏氨酸激酶(如CDKs、PKC)常参与细胞周期、代谢等基础生命活动, 抑制后易导致广泛毒性. 但随着变构调节、蛋白降解及相关生物学技术的发展, 丝氨酸/苏氨酸激酶抑制剂研究将会得到极大助力. (3) 在被批准上市药物的结合模式中, 以吉非替尼为代表的I型ATP竞争性抑制剂达30种, 其结合特点为嘌呤类核心骨架模拟ATP与铰链区形成氢键作用, α-C螺旋处于活性位置(α-C螺旋上的保守谷氨酸与β3折叠上的保守赖氨酸形成离子键), DFG基序为“in”活性构象. 以伊马替尼为代表的II型ATP竞争性抑制剂有15种, 与I型抑制剂不同的是, 其DFG基序为“out”非活性构象. 该构象往往会产生一个新的疏水口袋, 为高选择性化合物的产生带来新的机会. 除去经典的I型或II型结合模式外, 以舒尼替尼为代表的14种药物呈现I1/2型结合模式, 其结构特征为α-C螺旋处于非活性位置, DFG基序为“in”活性构象. 此外, 上市药物还包括以曲美替尼为代表的5种III型变构抑制剂, 以阿西米尼为代表的2种IV型变构抑制剂和以阿法替尼为代表的11种共价抑制剂. 因此, 我们看到激酶抑制剂的作用模式呈现出丰富的多样性. 特别值得注意的是, 近些年上市的药物中, 以艾沃美替尼为代表, 通过诱导形成新蛋白-蛋白相互作用, 从而抑制激酶活性的小分子药物或将成为激酶药物开发的全新方向. (4) 从化学结构多样性角度分析, 上市激酶药物主要可以分为三类: 以首个激酶抑制剂法舒地尔为代表的六元稠环骨架, 包括喹啉、异喹啉及喹唑啉类, 共计20个; 六元芳环氨基嘧啶、氨基吡啶、氨基哒嗪已成为最常用的ATP模拟物骨架, 以伊马替尼为代表的上市药物共计26个; 第三类骨架为五元并六元稠环骨架, 包括吡咯并嘧啶、嘌呤、氧杂吲哚、吡咯或咪唑三嗪等, 共计23个. 其余抑制剂骨架还包括五元并六元稠环的氨基类似物, 非芳香的羧酰胺结构. 由此可见, 目前激酶抑制剂使用的骨架仍然比较局限. 但随着近些年化学合成特别是手性合成的巨大进步, 具有更加立体特性的新型激酶抑制剂骨架有望得到拓展. (5) 1999~2012年间, 有22个激酶小分子药物获批, 在随后的五年(2013~2018)间, 有29个激酶小分子药物上市, 从2019年之后, 药物获批速度进一步加快, 总计45个激酶小分子药物获批上市, 凸显了激酶药物研发的加速趋势. (6) 在适应证上, 81种激酶抑制剂获批用于治疗实体瘤或者非实体瘤. 其中依维莫司和伊布替尼也被用于预防移植物抗宿主病. 17种药物被用于治疗非肿瘤类疾病. 例如, 托法替尼、尼达尼布、阿布希替尼、氘可来昔替尼等用于治疗类风湿性关节炎、肺纤维化、特应性皮炎、银屑病等免疫性疾病. 这些非肿瘤激酶药物的获批, 证实激酶药物的广泛应用价值, 也为激酶药物的应用空间拓展提供了充分的依据. 相信未来我们将看到激酶药物用于更多其他非肿瘤疾病的治疗. (7) 给药方式上, 93种小分子抑制剂采用口服给药的方式, 只有替西罗莫司与曲拉西利采用静脉注射给药方式, 奈舒地尔由于适应证为眼部疾病, 采用滴眼液给药方式. 因此, 口服因其便捷性仍然是激酶药物优选服药方式. 值得一提的是, 截至2025年5月31, 中国国家药品监督管理局(National Medical Products Administration, NMPA)批准上市的国产原研激酶药物也达40个(表1), 包括我们团队研发的奥雷巴替尼和利厄替尼. 在临床肿瘤治疗中, 激酶靶点的选择大致遵循两种策略: 首先, 重点关注已获批激酶抑制剂靶点突变耐药的患者, 开发对突变型激酶具有良好活性的下一代药物. 其次, 针对全新致病激酶靶点, 开发全新的激酶抑制剂. 我国在对现有靶点的下一代药物开发中取得了重要进展, 以奥雷巴替尼为例, 该药物对携带BCR-ABLT315I突变的慢性髓性白血病患者显示出了良好效果, 接连获得美国FDA和欧洲药品管理局孤儿药认可. 但对于针对全新靶点的激酶药物, 我国临床转化领域仍存在较大空白, 亟需针对尚未探索的激酶开发首创小分子调节剂. 另外, 近年来, 更多的FDA批准的激酶药物被应用于非肿瘤类疾病治疗, 包括类风湿性关节炎、肺纤维化、特应性皮炎、银屑病等免疫性疾病, 而我国批准的激酶药物仍集中于癌症, 亟需往更多非癌疾病拓展. Table 1 NMPA-approved domestically developed original kinase-targeted drugs 上市时间药品名(商品名) 靶标批准适应证原研公司 2011 埃克替尼(凯美纳) EGFR 非小细胞肺癌贝达药业 2014 阿帕替尼(艾坦) VEGFR-2 胃癌; 肝细胞癌江苏恒瑞 2018 安罗替尼(福可维) VEGFR/PDGFR/FGFR/C-KIT 非小细胞肺癌正大天晴 2018 吡咯替尼(艾瑞妮) HER2 乳腺癌江苏恒瑞 2018 呋喹替尼(爱优特) VEGFR 结直肠癌和记黄埔 2019 泽布替尼(百悦泽) BTK 套细胞淋巴瘤; 慢性淋巴细胞白血病/小淋巴细胞淋巴瘤百济神州 2019 氟马替尼(豪森昕福) BCR-ABL 费城染色体阳性的慢性髓性白血病翰森制药 2020 阿美替尼(阿美乐) EGFR-T790M 非小细胞肺癌豪森药业 2020 恩沙替尼(贝美纳) ALK 非小细胞肺癌贝达药业 2020 奥布替尼(宜诺凯) BTK 套细胞淋巴瘤; 慢性淋巴细胞白血病/小淋巴细胞淋巴瘤北京诺诚健华 2021 索凡替尼(苏泰达) CSF-1R/FGFR1/VEGFR 神经内分泌瘤和记黄埔 2021 伏美替尼(艾弗沙) EGFR-T790M 非小细胞肺癌艾力斯医药 2021 多纳非尼(泽普生) 多激酶肝细胞癌; 甲状腺癌苏州泽璟 2021 赛沃替尼(沃瑞沙) MET 非小细胞肺癌和记黄埔 2021 奥雷巴替尼(耐立克) BCR-ABL-T315I 耐药慢性髓细胞白血病亚盛医药 2022 林普利塞(因他瑞) PI3Kδ 滤泡性淋巴瘤上海璎黎 2023 谷美替尼(海益坦) c-MET 非小细胞肺癌上海海和 2023 伏罗尼布(伏美纳) 多激酶肾细胞癌; 多癌症贝达药业 2023 舒沃替尼(舒沃哲) EGFR 非小细胞肺癌迪哲医药 2023 贝福替尼(赛美纳) EGFR-T790M 非小细胞肺癌贝达药业 2023 伯瑞替尼(万比锐) c-MET 非小细胞肺癌; 脑胶质瘤北京浦润奥 2023 伊鲁阿克(启欣可) ALK, ROS1 非小细胞肺癌齐鲁制药 2024 妥拉美替尼(科露平) MEK1/2 黑色素瘤科州制药 2024 安奈克替尼(安柏尼) ROS1, ALK, c-Met 非小细胞肺癌正大天晴 2024 瑞齐替尼(瑞必达) EGFR-T790M 非小细胞肺癌上海倍而达 2024 氟泽雷塞(达伯特) KRAS-G12C 非小细胞肺癌信达生物 2024 依奉阿克(安洛晴) ALK 非小细胞肺癌正大天晴 2024 瑞厄替尼(圣瑞沙) EGFR-T790M 非小细胞肺癌圣和药业 2024 戈利昔替尼(高瑞哲) JAK1 外周T细胞淋巴瘤迪哲医药 2024 佐利替尼(泽瑞尼) EGFR-19del/L858R 非小细胞肺癌江苏晨泰医药 2024 他雷替尼(达伯乐) ROS1 非小细胞肺癌葆元生物 2025 利厄替尼(奥壹新) EGFR-T790M 非小细胞肺癌奥赛康 2025 艾玛昔替尼(艾速达) JAK1 强直性脊柱炎江苏恒瑞 2025 吡洛西利(轩悦宁) CDK4/6 乳腺癌轩竹生物 2025 来罗西利(汝佳宁) CDK4/6 乳腺癌嘉和生物 2025 伏维西利(复妥宁) CDK4/6 乳腺癌复星医药/奥鸿药业 2025 法米替尼(艾比特) 多靶点(RTKs) 宫颈癌江苏恒瑞 2025 芦沃美替尼(复迈宁) MEK1/2 朗格汉斯细胞组织细胞增生症; 组织细胞肿瘤; 神经纤维瘤(儿童/青少年) 复星医药 2025 吉卡昔替尼(泽普平) JAK, ACVR1 骨髓纤维化苏州泽璟 2025 戈来雷塞(艾瑞凯) KRAS-G12C 非小细胞肺癌加科思/艾力斯医药总的来说, 30年来的激酶药物研发取得了丰硕成果. 但激酶领域仍然有许多问题值得进一步研究, 如提高激酶抑制剂选择性、克服激酶抑制剂耐药性以及靶向激酶的非酶功能等. 综合采用共价结合、蛋白降解、变构调节等多种策略, 以及结合组学和人工智能技术进行激酶小分子调节剂研究是解决这些需求的重要路径. 基于此, 我们认为, 激酶仍然是未来药物研发的重要方向. 声明：发表/转载本文仅仅是出于传播信息的需要，并不意味着代表本公众号观点或证实其内容的真实性。据此内容作出的任何判断，后果自负。若有侵权，告知必删！长按关注本公众号粉丝群/投稿/授权/广告等请联系公众号助手觉得本文好看，请点这里↓

上市批准

2025-07-28

·Business Wire

Deciphera Announces Positive CHMP Opinion for ROMVIMZA™ (vimseltinib) for the Treatment of Tenosynovial Giant Cell Tumor (TGCT)

OSAKA, Japan & WALTHAM, Mass.--(BUSINESS WIRE)--Deciphera Pharmaceuticals, LLC, a biopharmaceutical company focused on discovering, developing, and commercializing important new medicines, and Ono Pharmaceutical Co., Ltd. (Headquarters: Osaka, Japan; President and COO: Toichi Takino; “Ono”), today announced that the European Medicines Agency’s (EMA) Committee for Medicinal Products for Human Use (CHMP) has adopted a positive opinion recommending the approval of vimseltinib for the treatment of adult patients with symptomatic tenosynovial giant cell tumor (TGCT) associated with clinically relevant physical function deterioration and in whom surgical options have been exhausted or would induce unacceptable morbidity or disability. The positive CHMP opinion is a scientific recommendation for marketing authorization and one of the final steps before the European Commission (EC), which has the authority to approve medicines in the European Union (EU), issues a decision on Deciphera's marketing authorization application (MAA) for vimseltinib. This decision is expected in the second quarter of the fiscal year ending March 31, 2026. “CHMP’s positive opinion is an important milestone for the TGCT community in the European Union (EU), where there are currently no approved treatments for TGCT, and for vimseltinib, which is now one step closer to potential EU regulatory approval,” said Ryota Udagawa, President and Chief Executive Officer of Deciphera. “We look forward to building upon vimseltinib’s positive CHMP opinion as we work to bring this medicine to TGCT patients around the world in need of new treatment options.” The positive CHMP opinion is supported by compelling efficacy and safety results from the pivotal Phase 3 MOTION study of vimseltinib in patients with TGCT not amenable to surgery with no prior anti-CSF1/CSF1R therapy (prior therapy with imatinib or nilotinib allowed), compared to placebo, as well as the Phase 1/2 study of vimseltinib. In MOTION, vimseltinib demonstrated a statistically significant and clinically meaningful objective response rate (ORR) at Week 25 in the intent-to-treat (ITT) population, as assessed by blinded independent radiologic review (BIRR) per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1), versus placebo (40% in vimseltinib arm vs 0% in placebo arm, p <0.0001). The primary endpoint was supported by statistically significant and clinically meaningful improvements in active range of motion, patient-reported physical functioning, and patient-reported pain observed in the vimseltinib arm compared to the placebo arm at week 25. The safety profile of vimseltinib is manageable and consistent with results previously disclosed in the Phase 1/2 clinical trial. About vimseltinib Vimseltinib is an oral switch-control tyrosine kinase inhibitor specifically designed to selectively and potently inhibit CSF1R. Vimseltinib has been developed using Deciphera’s proprietary switch-control kinase inhibitor platform. ROMVIMZA™ (vimseltinib) is a kinase inhibitor approved in the United States for adult patients with symptomatic tenosynovial giant cell tumor (TGCT) for which surgical resection will potentially cause worsening functional limitation or severe morbidity. About Tenosynovial Giant Cell Tumor (TGCT) TGCT is caused by a translocation in colony-stimulating factor 1 (CSF1) gene resulting in overexpression of CSF1 and recruitment of colony-stimulating factor 1 receptor (CSF1R)-positive inflammatory cells into the lesion. TGCT is a rare, non-malignant tumor that develops inside or near joints. TGCT is caused by dysregulation of the CSF1 gene leading to overproduction of CSF1. TGCT is also known as giant cell tumor of the tendon sheath (GCT-TS) or pigmented villonodular synovitis (PVNS), a diffuse-type of TGCT. TGCT is a locally aggressive neoplasm that can grow and cause damage to surrounding tissues and structures inducing pain, swelling, and limitation of movement of the joint. Surgery is the main treatment option; however, these tumors tend to recur, particularly in diffuse-type TGCT. If untreated or if the tumor continually recurs, damage and degeneration may occur in the affected joint and surrounding tissues, which may cause significant disability. For a subset of patients, surgical resection will potentially cause worsening functional limitation or severe morbidity, systemic treatment options are limited and a new therapeutic option for TGCT is needed. About Deciphera Pharmaceuticals, LLC Deciphera, a member of Ono Pharmaceutical Co., Ltd., is a biopharmaceutical company focused on discovering, developing, and commercializing important new medicines to improve the lives of people with cancer. Deciphera is leveraging its proprietary switch-control kinase inhibitor platform and deep expertise in kinase biology to develop a broad portfolio of innovative medicines. In addition to advancing multiple product candidates from Deciphera’s platform in clinical studies, QINLOCK® (ripretinib) is Deciphera’s switch-control kinase inhibitor approved in many countries including the European Union and the United States for the treatment of adult patients with advanced gastrointestinal stromal tumor (GIST) who have received prior treatment with 3 or more kinase inhibitors, including imatinib. ROMVIMZA™ (vimseltinib) is a kinase inhibitor approved in the United States for adult patients with symptomatic tenosynovial giant cell tumor (TGCT) for which surgical resection will potentially cause worsening functional limitation or severe morbidity. For more information, visit www.deciphera.com and follow us on LinkedIn and X (@Deciphera). About Ono Pharmaceutical Co., Ltd. Ono Pharmaceutical Co., Ltd. delivers innovative therapies for patients worldwide. Upholding its philosophy of “Dedicated to the Fight against Disease and Pain,” Ono targets areas with unmet medical needs including oncology, immunology, and neurology, and fosters partnerships with academic and biotech organizations to accelerate drug discovery. Through its affiliate, Deciphera Pharmaceuticals, Ono is accelerating clinical development and commercial operations in the US and Europe to drive global business expansion and further its commitment to patient care. For more information, please visit the company's website at https://www.ono-pharma.com/en. Cautionary Note Regarding Forward-Looking Statements In this press release, statements made with respect to current plans, estimates, strategies and beliefs, and other statements that are not historical facts are forward-looking statements about the future performance of the company. These statements are based on current assumptions and beliefs in light of the information currently available and involve known and unknown risks and uncertainties. A number of factors could cause actual results to differ materially from those discussed in the forward-looking statements. Such factors include, but are not limited to: (i) changes in the business environment in the pharmaceutical market and amendments to relevant laws and regulations, (ii) disruptions to product supply due to stagnation or delays in production caused by natural disasters, fires, etc., (iii) the possibility that sales activities for new and existing products may not achieve the expected results, (iv) the emergence of new side effects in post-marketing drugs, and (v) infringements of intellectual property rights by third parties. Information about pharmaceutical products included in this press release is not intended to constitute an advertisement or medical advice.

临床结果上市批准临床3期加速审批

2025-07-25

·FiercePharma

Europe's CHMP gives thumbs-up to Lilly's Kisunla and Gilead's long-acting PrEP drug Yeytuo

Europe’s Committee for Medicinal Products for Human Use has reversed its decision on Eli Lilly's Alzheimer's disease treatment Kisunla, giving it a positive opinion in a limited patient population. Four months after giving Eli Lilly’s Alzheimer’s disease treatment a thumbs-down, Europe’s Committee for Medicinal Products for Human Use (CHMP) has recommended it for approval, albeit in a restricted patient population.The positive opinion covers Kisunla's use in patients with early Alzheimer’s symptoms who have one or no copies of the apolipoprotein E ε4 (ApoE4) gene. The drug is not recommended for individuals carrying two copies of the ApoE4 gene. Those patients are more susceptible to amyloid-related imaging abnormalities (ARIA), which are a primary side effect of currently approved Alzheimer’s drugs.The restriction is the same as the one applied by European regulators when it granted marketing authorization to Eisai and Biogen’s Alzheimer’s drug Leqembi three months ago. Those companies went through the same rejection/appeal process as Lilly did with European regulators.Lilly went through the same go-round with regulators in the U.S. before it secured approval of Kisunla in July of last year. Then, earlier this month, the FDA signed off on a new dosing regimen for the treatment, featuring a more gradual titration, which leads to a significantly lower rate of ARIA-related brain swelling. The new dosing regimen also applies to Thursday’s thumbs-up from the CHMP. Endorsement for Gilead’s PrEP injection The CHMP has also provided a positive opinion on Gilead Sciences' HIV pre-exposure prophylaxis (PrEP) Yeytuo (lenacapavir), a twice-a-year subcutaneous injection which has been hailed as one of the most important breakthroughs in the effort to end the epidemic.The FDA blessed the shot last month under its commercial name Yeztugo.The CHMP recommendation applies to adults and adolescents and came under an accelerated pathway, “because it is considered to be of major public health interest in the EU and the rest of the world,” the regulator said.It was also evaluated under the EU-Medicines for all program, which included participation from the World Health Organization and regulators from several African and Asian nations. The program helps speed approvals where “regulatory capacity may be limited,” the CHMP said.“Lenacapavir for PrEP has the potential to become a critical tool for public health, helping to expand prevention options for people who face the highest barriers to care,” Dietmar Berger, M.D., Ph.D., Gilead’s chief medical officer, said in a release. Other CHMP decisions A month after Supernus Pharmaceuticals made a $561 million bet on Zurzuvae, buying out its developer Sage Therapeutics, the CHMP has registered a positive opinion on the treatment for postpartum depression. The Biogen-partnered treatment was endorsed by the FDA in August 2023, along with a rejection from the regulator in a much larger patient population, major depressive disorder.The European regulator has also signed off on rare disease specialist IntraBio’s Aqneursa for the treatment of the lysosomal storage disorder Niemann-Pick disease type C (NPC). The endorsement comes 10 months after the FDA approved two treatments for NPC in consecutive weeks, Aqneursa and Zevra Therapeutics’ Miplyffa, which has yet to win a nod in Europe.Less than three weeks after the FDA approved KalVista Pharmaceuticals' Ekterly for acute attacks of hereditary angioedema (HAE), the CHMP has followed suit. This is the first oral treatment for HAE recommended for approval in Europe, reducing the burden of injection on patients and speeding up the time between onset of attack and administration of the medicine, the CHMP said. Ono Pharmaceuticals has won a CHMP nod for Romvimza, for the treatment of adults with symptomatic tenosynovial giant cell tumor (TGCT), a condition where the tissue surrounding the joints and tendons expands abnormally, forming outgrowths of the joint. The drug, which was acquired last year in Ono’s $2.4 billion buyout of Deciphera Pharmaceuticals, was endorsed by the FDA in February of this year, joining Daiichi Sankyo’s Turalio as the only other marketed treatment for TGCT.Ionis Pharmaceuticals' Tryngolza, for the treatment of adults with familial chylomicronemia syndrome, has gotten a thumbs-up from CHMP. The rare, autosomal recessive inherited disorder is characterized by elevated levels of triglycerides in the blood. The FDA approved the treatment in December of last year.Also receiving a CHMP nod is Servier’s Voranigo for low-grade astrocytoma or oligodendroglioma, two rare malignant brain tumors. The FDA blessed the treatment in August of last year.

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适应症	国家/地区	公司	日期
腱鞘巨细胞瘤	美国	Deciphera Pharmaceuticals, Inc.	2025-02-14

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10 条进展最快的记录,

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适应症	最高研发状态	国家/地区	公司	日期
慢性移植物抗宿主病	临床2期	美国	Deciphera Pharmaceuticals, Inc.	2024-11-21
晚期癌症	临床2期	美国	Deciphera Pharmaceuticals, Inc.	2017-02-16
晚期癌症	临床2期	澳大利亚	Deciphera Pharmaceuticals, Inc.	2017-02-16
晚期癌症	临床2期	加拿大	Deciphera Pharmaceuticals, Inc.	2017-02-16
晚期癌症	临床2期	法国	Deciphera Pharmaceuticals, Inc.	2017-02-16
晚期癌症	临床2期	意大利	Deciphera Pharmaceuticals, Inc.	2017-02-16
晚期癌症	临床2期	荷兰	Deciphera Pharmaceuticals, Inc.	2017-02-16
晚期癌症	临床2期	波兰	Deciphera Pharmaceuticals, Inc.	2017-02-16
晚期癌症	临床2期	西班牙	Deciphera Pharmaceuticals, Inc.	2017-02-16
晚期癌症	临床2期	英国	Deciphera Pharmaceuticals, Inc.	2017-02-16

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临床结果

适应症

分期

评价

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


NCT05059262 (MOTION, ASCO2025)	临床3期	腱鞘巨细胞瘤 CSF1	83	Vimseltinib 30 mg twice weekly	衊簾繭繭積鹽鏇鹽觸簾(鹽壓衊糧壓構範鏇鑰淵) = 觸繭齋壓簾襯製獵窪襯艱獵鏇齋獵積繭鏇艱衊 (齋艱顧糧糧糧窪窪構範, 29 ~ 51) 更多	积极	2025-05-30
NCT03069469 (ESMO2024)	临床1/2期	腱鞘巨细胞瘤	-	Vimseltinib 30 mg	淵蓋製築簾衊範範願衊(淵鹹鬱窪淵蓋範衊壓選) = Grade 3/4 TEAEs (>5% of pts) were increased creatine phosphokinase, hypertension, and eczema. 鹽獵獵網範觸選廠糧鹹 (窪獵鏇鬱鬱廠糧鹽憲餘 ) 更多	-	2024-09-14
				Placebo
NCT03069469 (ESMO2024)	临床1/2期	腱鞘巨细胞瘤	-	Vimseltinib 30 mg	鹹艱鬱鏇遞鏇繭積範鹽(鏇淵廠衊衊廠衊餘築壓) = 選膚鹹鏇糧築憲遞夢餘製糧鬱遞膚壓鏇願築願 (願選選夢夢襯築鑰鬱淵 ) 更多	-	2024-09-14
NCT05059262 (MOTION, ASCO2024) 人工标引	临床3期	腱鞘巨细胞瘤	123	Vimseltinib 30 mg	製衊選鏇糧獵築窪顧鹽(夢網範願鬱膚選餘繭選) = 鹽憲構膚顧艱簾獵繭鹹淵鏇夢餘網築遞構積鹽 (範壓衊簾鏇選網遞範鑰 ) 更多	积极	2024-05-24
				Placebo	製衊選鏇糧獵築窪顧鹽(夢網範願鬱膚選餘繭選) = 構廠鏇膚壓蓋觸顧膚醖淵鏇夢餘網築遞構積鹽 (範壓衊簾鏇選網遞範鑰 ) 更多
NCT03069469 (Biospace) 人工标引	临床1/2期	腱鞘巨细胞瘤 CSF1R	97	vimseltinib (Phase 1)	鹽衊鑰廠鹽淵鏇廠襯築(膚窪願遞築範範築廠鑰) = 願鑰簾積簾醖憲齋繭壓蓋廠憲膚築膚鑰壓遞淵 (鬱憲構夢廠鏇窪築築製 ) 更多	积极	2023-10-30
				vimseltinib (Phase 2 Cohort A)	鹽衊鑰廠鹽淵鏇廠襯築(膚窪願遞築範範築廠鑰) = 遞窪選膚衊網襯鹹選簾蓋廠憲膚築膚鑰壓遞淵 (鬱憲構夢廠鏇窪築築製 ) 更多
NCT05059262 (MOTION, Biospace \| FDA) 人工标引	临床3期	腱鞘巨细胞瘤	123	vimseltinib	蓋範範廠鹹築糧獵鹹觸(獵蓋夢鹽襯鹹製鑰廠鏇) = 鹽糧淵願鹽艱繭鏇範蓋顧築構醖衊淵遞淵夢蓋 (壓齋網觸淵構獵齋鹹顧, 29 ~ 51) 达到更多	积极	2023-10-30
				Placebo	蓋範範廠鹹築糧獵鹹觸(獵蓋夢鹽襯鹹製鑰廠鏇) = 選憲積選餘夢構衊鹹糧顧築構醖衊淵遞淵夢蓋 (壓齋網觸淵構獵齋鹹顧, 0 ~ 9) 达到更多
NCT03069469 (ESMO2022) 人工标引	临床2期	腱鞘巨细胞瘤	57	Vimseltinib	-	积极	2022-09-10
				Vimseltinib (no prior anti-CSF1/CSF1R therapy except imatinib and/or nilotinib)	壓窪積鑰鑰廠構壓製夢(憲餘獵簾糧範鹹艱醖醖) = 憲艱蓋艱積願襯鏇糧壓鑰選鏇鑰願繭願鑰範餘 (鏇鏇衊網廠顧膚選壓遞 ) 更多
NCT03069469 (ESMO2022)	临床1期	腱鞘巨细胞瘤	32	Vimseltinib	醖蓋鬱鹽夢鑰鏇廠選鏇(齋遞願積壓鏇襯繭壓齋) = 3 pts discontinued treatment due to an adverse event (AE) 壓選壓構鹹蓋襯獵鹹衊 (範鬱顧構願艱鏇淵襯襯 )	-	2022-09-10
NCT05059262 (MOTION, ASCO2022)	临床3期	腱鞘巨细胞瘤	120	Vimseltinib 30 mg twice a week	鬱積衊選糧襯築鑰鏇繭(遞鹽觸衊壓顧獵鬱顧獵) = 範築簾齋鹽遞鑰獵鹹餘餘餘窪衊蓋淵衊積襯膚 (願膚膚淵蓋鑰願顧餘構 )	-	2022-06-02