Mecbotamab vedotin

With increasing biomarker-driven cancer treatments, TEPMETKO benefits from growing adoption in precision oncology. Competition from other MET inhibitors like TABRECTA (capmatinib) exists, but TEPMETKO's once-daily dosing and efficacy profile offer differentiation. LAS VEGAS, March 6, 2025 /PRNewswire/ -- DelveInsight's " TEPMETKO Market Size, Forecast, and Market Insight Report" highlights the details around TEPMETKO, a kinase inhibitor indicated for the treatment of adult patients with metastatic NSCLC harboring MET exon 14 skipping alterations. The report provides product descriptions, patent details, and competitor products (marketed and emerging therapies) of TEPMETKO. The report also highlights the historical and forecasted sales from 2020 to 2034 segmented into 7MM [the United States, the EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan]. EMD Serono's TEPMETKO (tepotinib) Overview TEPMETKO is a kinase inhibitor prescribed for adult patients with metastatic non-small cell lung cancer (NSCLC) carrying MET exon 14 skipping alterations. The active component is Tepotinib (as hydrochloride monohydrate), administered orally. Patients should be cautioned about the heightened risk of severe or fatal interstitial lung disease/pneumonitis, liver toxicity, and potential embryo-fetal toxicity, necessitating effective contraception during and shortly after treatment. Tepotinib specifically targets MET, including variants with exon 14 skipping mutations. It blocks HGF-dependent and independent MET phosphorylation, disrupting MET-driven signaling pathways. Additionally, at clinically relevant concentrations, Tepotinib inhibits melatonin 2 and imidazoline 1 receptors. In vitro studies show that it suppresses tumor cell proliferation, anchorage-independent growth, and migration of MET-dependent cancer cells. In mouse models with MET-driven tumors, including those with MET exon 14 skipping alterations, Tepotinib reduced tumor growth, sustained MET phosphorylation inhibition, and, in one case, decreased metastasis formation. The recommended dose of TEPMETKO is 450 mg taken orally once daily until disease progression or intolerable toxicity occurs. Patients should take it at the same time each day, swallowing tablets whole without chewing, crushing, or splitting them. If a dose is missed and less than eight hours remain until the next scheduled dose, patients should skip it. In cases of vomiting after taking TEPMETKO, the next dose should be taken at the usual time. Learn more about TEPMETKO projected market size for NSCLC @ TEPMETKO Market Potential Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for 81% of all diagnosed cases. Early detection greatly improves outcomes, but diagnosing NSCLC and other lung cancers is challenging because their symptoms are often mistaken for common illnesses or the long-term effects of smoking. Consequently, 80% of NSCLC cases are already at advanced stages by the time they are identified, making treatment more difficult. Around 80% of EGFR mutations in NSCLC involve either exon 19 deletions or the exon 21 L858R substitution, both of which are classified as sensitizing mutations. Until the last decade, chemotherapy was the primary treatment for advanced and metastatic lung cancer. However, this changed in 2015 with the approval of the first immune checkpoint inhibitor (ICI), KEYTRUDA (pembrolizumab), as a second-line therapy for advanced cases. This was followed by TECENTRIQ (atezolizumab) in 2016. Both therapies were later approved for first-line treatment, broadening their use to a larger patient population. In 2020, the combination of OPDIVO (nivolumab) and ipilimumab also received approval as a first-line treatment for metastatic NSCLC. According to DelveInsight, the NSCLC market size across the 7MM is projected to grow from USD 30 billion in 2024, with a substantial CAGR through 2034. This growth is largely driven by the introduction of emerging therapies during the forecast period (2025–2034). Discover more about the NSCLC market in detail @ Non-small Cell Lung Cancer Market Report Emerging Competitors of TEPMETKO The NSCLC pipeline is very robust with the promising therapies such as Telisotuzumab vedotin (AbbVie), Patritumab deruxtecan (Daiichi Sankyo/AstraZeneca), Datopotamab deruxtecan (Daiichi Sankyo/AstraZeneca), Eftilagimod alpha (Immutep), BNT311/GEN1046 (acasunlimab) (Genmab), V940 (mRNA-4157) + Pembrolizumab (Moderna Therapeutics/Merck), Plinabulin + Docetaxel (BeyondSpring), Olomorasib (LY3537982) (Eli Lilly and Company), Zipalertinib (Cullinan Oncology/Taiho Pharma), Ceralasertib (AZD6738) (AstraZeneca), TEDOPI (EP-2101; IDM 2101; OSE-2101) (OSE Immuno-therapeutics), Sigvotatug vedotin (PF08046047) (Pfizer), ANKTIVA (N-803) (ImmunityBio), Aumolertinib/Almonertinib/HS-10206 (Jiangsu Hansoh Pharmaceutical), Niraparib (GSK), Savolitinib (AstraZeneca/Hutchison MediPharma), TRODELVY (Gilead Sciences), Pyrotinib (Jiangsu HengRui Medicine), Ociperlimab (BGB-A1217) (BieGene), Volrustomig (AstraZeneca), Gotistobart (BNT316/ONC-392) (OncoC4/BioNTech), Ivonescimab (AK112/SMT112) (Akeso Biopharma/Summit Therapeutics), ZYNYZ (retifanlimab/INCMGA00012) (Incyte/Macrogenics), Divarasib (GDC-6036) (Roche/Genentech), Tiragolumab (RG6058) (Roche), Sacituzumab Tirumotecan (Merck and Kelun-Biotech), JEMPERLI (dostarlimab/TSR-042) (GSK and AnaptysBio), Zongertinib (BI-1810631) (Boehringer Ingelheim), BAY 2927088 (Bayer), Serplulimab (HLX10) (Shanghai Henlius Biotech), Rilvegostomig (AZD2936) (AstraZeneca), MK-1084 (Merck, Taiho Pharmaceutical, and Astex), Domvanalimab (Arcus Biosciences and Gilead Sciences), OPDUALAG (nivolumab and relatlimab) (Bristol-Myers Squibb), Belrestotug + JEMPERLI (iTeos Therapeutics and GSK), Firmonertinib (ArriVent BioPharma), Sunvozertinib (DZD9008) (Dizal Pharmaceutical), Cobolimab (GSK), Livmoniplimab (AbbVie), Fianlimab (REGN3767) (Regeneron Pharmaceuticals), BNT327/PM8002 (Biotheus/BioNTech), HS-20117 (Hansoh BioMedical), IO102-IO103 + Pembrolizumab (IO Biotech), Naptumomab estafenatox (NeoTX Therapeutics/Active Biotech), FF-10832 (FUJIFILM Corporation), BNT116 (BioNTechSE/Regeneron Pharmaceuticals), CAN-2409 (Candel Therapeutics), Mecbotamab Vedotin (BA3011/CAB-AXL-ADC) (BioAtla), Bemcentinib (BGB 324/BGB-3234/R-428) (BerGenBio/Rigel Pharmaceuticals), DOVBLERON (taletrectinib/AB-106/IBI-344) (Nuvation Bio/Innovent Biologics/Daiichi Sankyo/Nippon Kayaku), Lifileucel (Iovance Biotherapeutics), IBI363 (Innovent Biologics), Sotevtamab (AB-16B5) (Alethia Biotherapeutics), Avutometinib (VS6766) (Verastem Oncology), Vebreltinib (APL-101) (Apollomics), LP-300 (Lantern Pharma), JNJ-90301900 (Johnson & Johnson Innovative Medicine), AMG 193 (Amgen), Luveltamab tazevibulin (Sutro Biopharma), PRT3789 (Prelude Therapeutics), Disitamab vedotin (Seagen), PADCEV (enfortumab vedotin) (Astellas Pharma), RP1 (Replimune), TIVDAK (tisotumab vedotin) (Seagen), Zanidatamab (Jazz Pharmaceuticals), Utidelone injectable (UTD1) (Beijing Biostar Pharmaceuticals), REGN5093-M114 (Regeneron Pharmaceuticals), SLC-391 (SignalChem Lifesciences), fulzerasib (GenFleet), Davutamig (REGN5093) (Regeneron Pharmaceuticals), TAS3351 (Taiho Oncology), H002 (RedCloud Bio), JIN-A02 (J INTS BIO), FWD1509 (Forward Pharma), Sabestomig (AZD7789) (AstraZeneca), Sasanlimab (Pfizer), Selvigaltin (GB1211) (Galecto Biotech), Vepafestinib Helsinn (Healthcare/Taiho Pharmaceutical), EP0031 (A400/ KL590586) (Ellipses Pharma/Kelun-Biotech), Pamvatamig (MCLA-129) (Merus), Zidesamtinib (NVL-520) (Nuvalent), NVL-655 (Nuvalent), RMC-4630 (Revolution Medicines), REQORSA (quaratusugene ozeplasmid) (Genprex), PDC*lung01 (PDC*line Pharma), Evalstotug (BA3071) (BioAtla and BeiGene), PT-112 (Promontory Therapeutics), MRT-2359 (Monte Rosa Therapeutics), GAIA-102 (GAIA BioMedicine), Rigosertib (Traws Pharma), HMBD-001 (Hummingbird Bioscience), PLB1004 (Avistone Biotechnology), ANS03 (Avistone Biotechnology), MYTX-011 (Mythic Therapeutics), A166 (Sichuan Kelun-Biotech Bio-pharmaceutical), Atamparib (BN-2397) (Ribon Therapeutics), DELTACEL (KB-GDT-01) (Kiromic BioPharma), Carotuximab (ENV-105) (Kairos Pharma), YL202 (MediLink Therapeutics), and others. To know more about the number of competing drugs in development, visit @ TEPMETKO Market Positioning Compared to Other Drugs Key Milestones of TEPMETKO In February 2024, the FDA granted traditional approval to TEPMETKO for adult patients with metastatic NSCLC harboring MET exon 14 skipping alterations. In February 2022, the EC approved TEPMETKO as monotherapy for the treatment of adult patients with advanced NSCLC harboring alterations leading to METex14 skipping who require systemic therapy following prior treatment with immunotherapy and/or platinum-based chemotherapy. In February 2021, Merck announced that the US FDA has approved TEPMETKO following priority review for the treatment of adult patients with metastatic NSCLC harboring MET exon 14 skipping alterations. This indication was approved under accelerated approval based on ORR and DOR. In October 2020, TEPMETKO received ODD for treating NSCLC with MET genomic tumor aberrations In March 2020, EMD Serono (the biopharmaceutical business of Merck KGaA), announced that the MHLW approved TEPMETKO for the treatment of patients with unresectable, advanced, or recurrent NSCLC with METex14 skipping alterations. In September 2019, the US FDA granted BTD for tepotinib in patients with metastatic NSCLC harboring METex14 skipping alterations who progressed following platinum-based cancer therapy Discover how TEPMETKO is shaping the NSCLC treatment landscape @ TEPMETKO NSCLC TEPMETKO Market Dynamics TEPMETKO competes in a growing but highly specialized market where MET-targeted therapies are gaining traction due to their efficacy in addressing MET-altered tumors. The market for MET inhibitors is expanding as precision oncology advances and molecular diagnostics become more widely available, enabling better identification of patients who would benefit from targeted treatments like TEPMETKO. A key factor shaping TEPMETKO's market dynamics is competition. It directly competes with Novartis' TABRECTA (capmatinib), another MET inhibitor approved for the same indication. While TEPMETKO offers the advantage of once-daily dosing compared to TABRECTA's twice-daily regimen, both drugs have similar efficacy profiles, making physician and patient preference an important differentiator. Additionally, broader competition from next-generation MET inhibitors and combination therapies in clinical trials could impact TEPMETKO's long-term market position. Regulatory approvals and market access play a crucial role in TEPMETKO's adoption. The drug has been approved in multiple regions, including the U.S., Europe, and Japan, but reimbursement and pricing strategies vary by market. Payer policies, along with the cost-benefit analysis of MET inhibitors compared to other targeted therapies, influence prescription trends. Furthermore, real-world evidence and post-marketing studies will be critical in demonstrating TEPMETKO's sustained effectiveness and safety, which could support expanded indications and increased market penetration. Looking ahead, the MET inhibitor market is expected to grow with advances in biomarker-driven therapy, further refining patient selection. TEPMETKO's success will depend on continued clinical development, potential label expansions, and strategic partnerships to strengthen its competitive edge. As new entrants emerge, Merck KGaA's ability to differentiate TEPMETKO through combination strategies or enhanced formulations may determine its long-term sustainability in this evolving landscape. Dive deeper to get more insight into TEPMETKO's strengths & weaknesses relative to competitors @ TEPMETKO Market Drug Report Table of Contents Related Reports Non-small Cell Lung Cancer Market Non-small Cell Lung Cancer Market Insights, Epidemiology, and Market Forecast – 2034 report deliver an in-depth understanding of the disease, historical and forecasted epidemiology, as well as the market trends, market drivers, market barriers, and key NSCLC companies including Daiichi Sankyo, AstraZeneca, Gilead Sciences, BieGene, AbbVie, Roche, Merck, Novartis, Pfizer, Takeda Pharmaceuticals, Eli Lilly, BerGenBio, GlaxoSmithKline, Duality biologics, among others. Non-small Cell Lung Cancer Pipeline Non-small Cell Lung Cancer Pipeline Insight – 2025 report provides comprehensive insights about the pipeline landscape, pipeline drug profiles, including clinical and non-clinical stage products, and the key non-small cell lung cancer companies, including BridgeBio Pharma, Daiichi Sankyo, EMD Serono, Merck, BridgeBio Pharma, Abbvie, Pfizer, Eli Lilly and Company BioNTech SE, Shenzhen TargetRx, Taiho Pharmaceutical, Chong Kun Dang, Bristol Myers Squibb, Innovent Biologics, Xuanzhu Biopharmaceutical, Bayer, GeneScience Pharmaceuticals, InventisBio, Apollomics, Imugene, Ono Pharmaceutical, Pierre Fabre, Jiangsu Hengrui Medicine Co., Bristol-Myers Squibb, Surface Oncology, Inhibrx, Sinocelltech, Mirati Therapeutics, REVOLUTION Medicines, Yong Shun Technology Development, Iovance Biotherapeutics, Galecto Biotech, among others. C-MET Metastatic Non-small Cell Lung Cancer Market C-MET Metastatic Non-small Cell Lung Cancer Market Insights, Epidemiology, and Market Forecast – 2034 report deliver an in-depth understanding of the disease, historical and forecasted epidemiology, as well as the market trends, market drivers, market barriers, and key C-MET mNSCLC companies, including Novartis, Merck, EMD Serono, AbbVie, Regeneron Pharmaceuticals, Mythic Therapeutics, Apollomics, Johnson & Johnson Innovation, Haihe Biopharma, among others. C-MET Non-small Cell Lung Cancer Pipeline C-MET Non-small Cell Lung Cancer Pipeline Insight – 2025 report provides comprehensive insights about the pipeline landscape, pipeline drug profiles, including clinical and non-clinical stage products, and the key C-MET non-small cell lung cancer companies, including AbbVie, Janssen Research & Development, Beijing Pearl Biotechnology Limited Liability Company, Novartis, among others. About DelveInsight DelveInsight is a leading Business Consultant and Market Research firm focused exclusively on life sciences. It supports pharma companies by providing comprehensive end-to-end solutions to improve their performance. Get hassle-free access to all the healthcare and pharma market research reports through our subscription-based platform PharmDelve . Contact Us Shruti Thakur [email protected] +14699457679 Logo: SOURCE DelveInsight Business Research, LLP WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED

关注小药说药，一起成长！ 前言 TYRO3、AXL（也称为UFO）和MERTK组成了TAM受体酪氨酸激酶（RTK）家族。TAM受体信号异常与一系列疾病有关，包括癌症、纤维化和病毒感染。实验证据表明，TAM受体在促进凋亡细胞的吞噬作用、防止高反应性免疫反应以及调节血管完整性和血管通透性方面发挥着关键作用。此外，TAM受体也被称为磷脂酰丝氨酸病毒进入增强受体（PVEER），因为它们能够与病毒包膜上存在的磷脂酰丝氨酸（PtdSer）相互作用，促进病毒进入。 在癌症中，TAM受体激活促进细胞增殖和转移，参与上皮-间充质转化（EMT），维持干细胞表型、免疫调节、血管生成以及对传统和靶向治疗的抵抗。与许多RTK不同，TAM受体很少发生突变，受体活性的失调主要是由于其微环境的基因扩增或激活，使其成为理想的治疗靶点，而没有产生突变驱动的耐药性的风险。大多数TAM受体抑制剂，包括小分子和生物制剂，主要开发用于靶向或破坏AXL信号通路。临床上，AXL抑制剂正在各种肿瘤适应症进行多项临床试验，展现出极具潜力的应用前景。 TAM受体家族的结构和信号通路 与许多其他跨膜RTK类似，TAM受体具有一个细胞外结构域，该结构域由两个免疫球蛋白结构域组成，这两个结构域对配体结合至关重要，随后是两个重复的III型纤连蛋白。细胞内激酶结构域在三种受体之间高度保守，它们都具有该RTKs家族特有的KWIAIES序列。 TAM受体主要与两种配体相互作用，即生长停滞特异性蛋白6（GAS6）和维生素K依赖性蛋白S1（PROS1）。AXL受体和GAS6之间1:1相互作用导致AXL和GAS6的同源二聚体形成，进而导致细胞内催化结构域的激活。TAM受体催化结构域的自身磷酸化促进与磷脂酰肌醇3-激酶（PI3K）的p85亚基、SRC家族成员和生长因子受体结合蛋白2（GRB2）的结合，导致MEK–ERK信号的激活。 TAM受体的生理功能 TAM受体在各种细胞过程中具有重要的生理作用，如胎儿发育和成人组织稳态。它们作为免疫反应的负调节因子发挥作用，并促进凋亡细胞的吞噬清除。TAM受体信号传导对于保存血管完整性同样至关重要。此外，TAM受体的异常激活会导致免疫、血管系统和男性生殖系统的异常。 免疫反应功能 免疫系统中TAM受体的表达定位于活化的树突状细胞、巨噬细胞、髓系抑制细胞和自然杀伤细胞，所有这些都是先天免疫反应的重要调节因子。TAM受体及其配体在调节免疫反应的大小和强度以及维持先天和适应性免疫途径的复杂稳态方面发挥着重要作用。 此外，病毒可以通过与GAS6或PROS1的结合进入宿主细胞。在受体-配体结合和激活后，TAM受体通过与干扰素-α/β受体-STAT通路相互作用来抑制免疫反应。该途径导致SOCS1和SOCS3介导的Toll样受体（TLR）信号传导的抑制和炎症反应的抑制，帮助病毒逃避免疫监测。 凋亡细胞的吞噬清除 TAM受体有助于吞噬作用和清除各种细胞类型中的细胞碎片，以维持组织稳态，从而避免过度和致病性炎症反应。例如，视网膜中光感受器外段的消除通常由表达MERTK的吞噬性视网膜色素上皮进行。缺乏MERTK的视网膜色素上皮细胞无法清除有毒碎片，由此产生的过度活跃的炎症反应导致光感受器死亡、视网膜变性，最终导致失明。 维持血管功能 由于GAS6和PROS1对内皮细胞和血小板的生长和维持至关重要，TAM受体信号传导与维持血管完整性和通透性有关。有报道指出，AXL通过与VEGFA的相互作用以及通过PI3K和AKT的信号传导来促进血管生长。AXL的缺失会导致体外和体内血管形成受损，而抑制MERTK或TYRO3只会产生轻微效果。 癌症中的TAM受体信号 已有充分的研究证明，癌症生长和发展过程中TAM受体信号异常，这些异常激活的TAM受体可在缺氧和营养缺乏期间驱动转移，促进治疗耐药性，并促进癌细胞存活。 AXL 多项研究表明，在不同组织学来源的癌症中，AXL的表达失调，GAS6–AXL信号传导与各种促肿瘤功能相关。例如，在缺氧条件下，癌细胞分泌缺氧诱导型转录因子1和2（HIF1和HIF2），以激活AXL并促进低氧适应。 AXL促进上皮-间质转化，这是一种关键的癌症转移起始事件，可促进肿瘤细胞的迁移和侵袭能力。内源性AXL信号传导正向调节EMT所需的转录因子，包括TWIST、ZEB1、ZEB2和SLUG，还促进N-钙粘蛋白的表达和E-钙粘蛋白下调以促进EMT。此外，AXL可以促进其他关键致癌途径的激活，如MET、SRC和Ras刺激的致癌途径，以促进EMT。 此外，AXL表达升高通常与血液学肿瘤和实体瘤的治疗耐药性有关。具体而言，AXL信号被认为通过激活AKT和ERK信号通路介导对EGFR抑制剂西妥昔单抗和放疗的耐药性，并通过调节c-ABL的活性来减少肿瘤细胞凋亡。此外，在对各种酪氨酸激酶抑制剂具有耐药性的癌症中经常观察到AXL信号的上调。 MERTK 与在癌症中普遍表达的AXL不同，MERTK表达升高与血液学癌症特别相关。MERTK在血液学癌症中的表达对于逃避先天免疫监测很重要，从而促进恶性肿瘤的生长和增殖，如急性淋巴细胞白血病和急性髓细胞白血病（AML）。30%的儿童B细胞急性淋巴细胞白血病出现MERTK异常表达。 在胶质母细胞瘤中，抑制MERTK导致CD206+抗炎M2样巨噬细胞减少。尽管单独的这种作用不足以延长生存期，但在胶质母细胞瘤动物模型中，MERTK抑制与放疗的结合导致肿瘤生长显著减少，M2样巨噬细胞向M1样巨噬细胞极化转变，并增强促炎免疫反应。 TYRO3 TYRO3在多种恶性肿瘤中表达升高，如鳞状细胞癌、肺癌、前列腺癌、甲状腺癌、神经鞘瘤和多发性骨髓瘤，但其功能作用和临床相关性尚不清楚。TYRO3在调节骨稳态方面显示出其独特的生物活性。TYRO3调节破骨细胞的分化和功能，破骨细胞在正常骨重塑中负责骨吸收。然而，异常的TYRO3信号传导会使病理状况恶化，包括骨质疏松症和骨转移的发展。这些发现表明，TYRO3可能是恢复骨动力学和防止癌症骨转移的一个有前途的治疗靶点。 非癌症疾病中的TAM受体 除了癌症之外，异常的TAM受体信号传导通常是纤维化、自身免疫性疾病和病毒感染等疾病的重要原因。 纤维化 组织纤维化的特征是慢性炎症和组织损伤的导致的细胞外基质（ECM）和基质元素的广泛积累。TAM受体家族在纤维化疾病的组织重塑过程中起着关键作用。在肝硬化中，AXL信号传导被激活以诱导SLUG的转录，SLUG是EMT的关键调节因子。此外，AXL与TGF-β相互作用，以SMAD3依赖的方式促进α-平滑肌肌动蛋白（α-SMA）、胶原和基质金属蛋白酶（MMPs）的沉积。 自身免疫性疾病 自身免疫性疾病的病理学多种多样且极其复杂。然而，大多数临床表现与异常免疫复合物和自身抗体的产生有关。自身免疫性疾病会促进慢性炎症反应，导致正常组织的破坏。TAM受体在免疫调节中的一个重要作用是清除凋亡细胞，这主要由MERTK信号驱动。在许多自身免疫性疾病中发现MERTK信号传导的丧失，包括系统性红斑狼疮和多发性硬化症。 髓磷脂是中枢神经系统的关键组成部分，其破坏是多发性硬化症的标志。MERTK在调节小胶质细胞和巨噬细胞的髓鞘吞噬作用中发挥重要作用，小胶质细胞是参与多发性硬化症病理的关键免疫细胞。小胶质细胞活化和随后的髓鞘再形成需要MERTK。考虑到这些发现，激活MERTK是多发性硬化症的一种很有前途的治疗途径，有可能减轻髓鞘吞噬作用，增强碎片清除率，减少神经炎症。 病毒进入 在整个进化过程中，病毒已经获得了躲避先天免疫反应以成功进入宿主的能力。它们的逃避机制之一是病毒粒子能够包裹在包括宿主细胞质膜的脂质双层中，导致病毒吞噬和释放。这些包膜病毒使用PVEER，包括AXL、MER和TYRO3，进入人类宿主细胞。暴露于PtdSer的包膜病毒可能会在Gla结构域上与GAS6或PROS1形成复合物，从而使它们能够利用所有三种TAM受体进入细胞。 除此机制外，凋亡模拟是包膜病毒以“免疫沉默”方式进入宿主细胞的另一种策略。表达PtdSer的病毒与表达TAM受体的宿主细胞对接，促进内吞吞噬。对接后，病毒还可以通过促进TAM受体介导的TLR信号传导抑制来抑制炎症反应，使其能够逃避免疫监测。 严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）通过与血管紧张素转换酶2（ACE2）结合进入宿主细胞。有研究发现，当ACE2水平较低时，GAS6–AXL受体复合物的存在可以增强SARS-CoV-2的感染。因此，破坏GAS6–AXL–PtdSer复合物可能是减轻SARS-CoV-2感染严重程度的一种潜在治疗方法。 TAM受体抑制剂药物的开发 TAM受体抑制剂在癌症和非癌症疾病的临床前和临床研究中显示出有希望的结果。强有力的证据表明，TAM受体抑制剂与标准护理治疗相结合，可以促进抗肿瘤免疫反应，减少炎症，改善对癌症治疗的反应。随着对TAM受体信号传导的日益了解和新药物的开发，TAM受体抑制剂代表了一种治疗广泛疾病的有前景的方法。 小分子抑制剂 大多数TAM受体抑制剂是化小分子，旨在干扰位于细胞内激酶结构域上的ATP结合部分。针对TAM受体的多种小分子正在临床前和临床开发中。 Bemcentinib（BGB324）是一种处于临床阶段的AXL抑制剂，其与MERTK和TYRO3相比对AXL具有50倍至100倍的选择性。在卵巢癌、胶质母细胞瘤、间皮瘤、胰腺癌、乳腺癌和肺癌的临床前模型中验证了Bemcentinib的疗效。Bemcentinib目前是临床开发中最领先的AXL抑制剂之一，在NSCLC、TNBC和黑色素瘤（NCT03184571、NCT02872259、NCT03184558）中有多个I/II期临床研究。 RXDX-106是一种泛TAM抑制剂，具有缓慢的解离速率以提高其效力。RXDX-106对小鼠模型中显示出增强的抗肿瘤作用。然而，2018年3月开始的RXDX-106的1期研究（NCT03454243）于2019年被申办方终止。 MRX-2843是一种MERTK抑制剂，其也以高效力抑制FLT3。与前几代化合物相比，MRX-2843显示出改善的口服生物利用度、增强的溶解度、药物代谢和药代动力学特性。在动物模型中，它表现出强大的抗癌活性，并降低了T细胞上PD-1的表达，导致免疫介导的治疗活性。目前其正在进行多项临床试验，以研究在复发/难治性转移性实体瘤（NCT03510104）、多种亚型急性白血病（NCT04872478、NCT04946890）以及与EGFR抑制剂奥西替尼联合治疗NSCLC（NCT04762199）中的疗效。 Sitravatinib（MGCD516）抑制TAM受体家族的所有成员。该分子在肾细胞癌、NSCLC、肉瘤和乳腺癌的临床前模型中显示出强大的抗肿瘤功效。Sitravatinib 症在30多项针对各种实体瘤类型的临床试验中进行评估，包括与抗PD-1抗体和化疗的联合治疗（NCT04921358，NCT05461794）。 ONO-7475是AXL和MERTK的抑制剂。在表达AXL、EGFR突变的NSCLC的临床前模型中，ONO-7475治疗使细胞对EGFR酪氨酸激酶抑制剂敏感，导致肿瘤消退和肿瘤生长延迟。然而，在ONO-7475治疗急性白血病患者的临床试验中，招募被终止（NCT03176277）。 生物药 近年来，TAM受体靶向疗法，包括生物制品和其他新型治疗策略，取得了重大进展，为治疗各种癌症类型提供了有前景的分子。 Batiraxcept（AVB-S6-500）是一种工程化的超高亲和力sAXL诱饵受体。与野生型AXL受体相比，其对GAS6的结合亲和力提高了320倍。batiraxcept在卵巢癌、AML、乳腺癌、肾癌和胰腺癌的临床前模型中显示出显著的抗肿瘤活性。在一项Ib期临床试验中，batiraxcept与紫杉醇联合用药的患者显示出34.8%的总有效率，有两例完全缓解（NCT03639246）。然而，batiraxcept与紫杉醇联合的III期研究结果并未显示出治疗效果的显著改善（NCT4729608）。目前，该分子正在其他癌症类型中进行探索，包括肾透明细胞癌（NCT04300140）和胰腺癌（NCT04983407）。 Tilvestamab是一种完全人源化的AXL阻断抗体，主要结合AXL受体，与MERTK或TYRO3仅显示微弱结合。在功能上，Tilvestamab阻断GAS6与AXL的结合，并在AML、NSCLC、胰腺癌和肾癌模型中表现出抗肿瘤活性。Tilvestamab正在一项I期临床试验中测试对复发性、对铂耐药的高级别浆液性卵巢癌的疗效（NCT04893551）。 Enapotamab vedotin（HuMax-AXL-ADC）是一种抗体偶联药物，包括与auristatin E偶联的抗AXL抗体，用于靶向消除表达AXL的癌细胞。2020年其完成了一项I/II期剂量递增试验（NCT02988817），用于评估HuMax AXL ADC在实体瘤患者中的安全性和抗肿瘤活性。不幸的是，由于缺乏足够的临床疗效，该方案被终止。 Mecbotamab vedotin（CAB-AXL-ADC）是另一种靶向表达AXL的肿瘤细胞的抗体偶联药物。其正在进行三项II期临床研究，评估CAB-AXL-ADC作为单一疗法或与PD-1抑制剂联合治疗NSCLC、卵巢癌和其他实体瘤的安全性和有效性（NCT04681131、NCT03425279、NCT04918186）。 小结 近年来，我们在理解TAM受体在正常组织稳态和疾病状态中的作用方面取得了重大进展。令人信服的临床前研究已经促进开发出针对TAM受体家族的治疗药物，包括AXL和MERTK特异性抑制剂。这些分子中的许多正在临床研究中显示出有希望的结果。在接下来的几年中，期待这些分子的临床获得成功，能够早日造福疾病患者。 参考文献： 1. Therapeutic targeting of the functionally elusive TAM receptor family. 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