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Small molecule inhibitors that target the phosphatidylinositol 3-kinase (PI3K) signaling pathway have received significant interest for the treatment of cancers. The class I isoform PI3Kα is most commonly associated with solid tumors via gene amplification or activating mutations. However, inhibitors demonstrating both PI3K isoform and mutant specificity have remained elusive. Herein, we describe the optimization and characterization of a series of benzoxazepin-oxazolidinone ATP-competitive inhibitors of PI3Kα which also induce the selective degradation of the mutant p110α protein, the catalytic subunit of PI3Kα. Structure-based design informed isoform-specific interactions within the binding site, leading to potent inhibitors with greater than 300-fold selectivity over the other Class I PI3K isoforms. Further optimization of pharmacokinetic properties led to excellent in vivo exposure and efficacy and the identification of clinical candidate GDC-0077 (inavolisib, ), which is now under evaluation in a Phase III clinical trial as a treatment for patients with -mutant breast cancer.
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http://dx.doi.org/10.1021/acs.jmedchem.2c01422 | DOI Listing |
J Clin Oncol
August 2025
Center for Drug Evaluation and Research (CDER), US Food and Drug Administration, Silver Spring, MD.
Purpose: The US Food and Drug Administration (FDA) approved inavolisib with palbociclib and fulvestrant for adults with endocrine-resistant, -mutated, hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative, locally advanced or metastatic breast cancer (MBC), as detected by an FDA-approved test, FoundationOne Liquid CDx assay, after recurrence on or after completing adjuvant endocrine therapy.
Patients And Methods: Approval was based on INAVO120, a randomized, double-blind, placebo-controlled trial in 325 patients with endocrine-resistant, -mutated, hormone receptor-positive, HER2-negative, locally advanced or MBC. Patients were randomly assigned (1:1) to either inavolisib (n = 161) or placebo (n = 164) in combination with palbociclib and fulvestrant.
Annu Rev Pharmacol Toxicol
August 2025
1Department of Pharmacology, School of Basic Medical Sciences, Fudan University, Shanghai, China; email:
Phosphoinositide 3-kinase alpha (PI3Kα) is a pivotal regulator of cell growth, proliferation, and survival. Dysregulation of the PI3K/AKT/mTOR pathway, driven predominantly by mutations (e.g.
View Article and Find Full Text PDFMini Rev Med Chem
July 2025
Department of Chemistry, Korea University, Seoul 02841, Korea (ROK).
This mini-review summarizes the structure-property relationships of seven smallmolecule drugs approved in 2024, providing insights into effective lead-to-candidate optimization strategies. The analysis focused on aprocitentan, flurpiridaz F-18, inavolisib, vorasidenib, ensitrelvir, golidocitinib, and zorifertinib, highlighting the key structural modifications that enhanced their drug-like properties. Notable optimization strategies included the strategic use of five- and sixmembered nitrogen-containing heterocycles as cyclic bioisosteres and solubilizing groups.
View Article and Find Full Text PDFAm J Clin Oncol
July 2025
UCB, Inc., Atlanta, GA.
Objectives: Breast cancer remains the most prevalent cancer among women in the United States, with hormone receptor-positive (HR+) and HER2-negative subtypes comprising a significant proportion of cases. Despite advancements in treatment, resistance to endocrine therapies remains a substantial clinical challenge, especially in patients with mutations in the PIK3CA gene.
Methods: A literature review was conducted to evaluate the safety and efficacy of inavolisib in breast cancer.
Mol Cancer Ther
July 2025
Genentech Inc, South San Francisco, CA, United States.
PIK3CA and KRAS are among the most frequently mutated oncogenes and often co-mutated in colorectal cancers. Understanding how KRAS codon-specific mutations affect cross-talks between the PI3K and MAPK pathways and response to targeted therapies, such as the p110α-specific inhibitor inavolisib (GDC-0077), is critical for advancing precision oncology. Focusing on colorectal PIK3CA+KRAS co-mutated models, we found that KRAS G12D-mutated cells were more sensitive to inavolisib than models with KRAS G13D, or other MAPK pathway mutations, even though the PI3K and MAPK pathways were active in both genotypes.
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