HS-10375, a selective EGFR C797S tyrosine kinase inhibitor, in advanced non–small cell lung cancer

Abstract Background The C797S mutation is one of the most common mechanisms of acquired resistance to third generation EGFR TKIs, yet no approved therapies have been available to target it. Here we developed a novel selective EGFR C797S inhibitor, HS-10375, and report the results of pre-clinical res...

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Main Authors: Jianhua Zhan, Jinhui Xue, Lin Wu, Zhiye Zhang, Qiming Wang, Yuxiang Ma, Yan Huang, Yunpeng Yang, Yuanyuan Zhao, Wenfeng Fang, Yang Zhang, Qianwen Liu, Wen Xu, Yan Yang, Zhenming Chen, Baili Song, Danni Sun, Xia Sun, Peng Gao, Hongyun Zhao, Li Zhang
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Journal of Translational Medicine
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Online Access:https://doi.org/10.1186/s12967-025-06613-0
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author Jianhua Zhan
Jinhui Xue
Lin Wu
Zhiye Zhang
Qiming Wang
Yuxiang Ma
Yan Huang
Yunpeng Yang
Yuanyuan Zhao
Wenfeng Fang
Yang Zhang
Qianwen Liu
Wen Xu
Yan Yang
Zhenming Chen
Baili Song
Danni Sun
Xia Sun
Peng Gao
Hongyun Zhao
Li Zhang
author_facet Jianhua Zhan
Jinhui Xue
Lin Wu
Zhiye Zhang
Qiming Wang
Yuxiang Ma
Yan Huang
Yunpeng Yang
Yuanyuan Zhao
Wenfeng Fang
Yang Zhang
Qianwen Liu
Wen Xu
Yan Yang
Zhenming Chen
Baili Song
Danni Sun
Xia Sun
Peng Gao
Hongyun Zhao
Li Zhang
author_sort Jianhua Zhan
collection DOAJ
description Abstract Background The C797S mutation is one of the most common mechanisms of acquired resistance to third generation EGFR TKIs, yet no approved therapies have been available to target it. Here we developed a novel selective EGFR C797S inhibitor, HS-10375, and report the results of pre-clinical research and the first-in-human phase 1 trial. Methods Ba/F3 cell lines and patient-derived cells expressing mutant EGFR were used to test the selectively inhibitory potency of HS-10375 in vitro, and cell line-derived xenograft animal models were used to evaluate the anticancer efficacy of HS-10375 in vivo. In the phase 1 trial, HS-10375 was administered orally at six dose levels (10–240 mg) daily (QD) in 21-day cycles, following a rule-based, rolling six design. The primary objectives were the safety, tolerability and maximum tolerated dose (MTD). The secondary objectives included PK parameters and anti-tumor activity. Results HS-10375 showed more potent activity in inhibiting EGFR phosphorylation compared to 1st to 3rd generation EGFR TKIs in C797S triple-mutant cell lines. HS-10375 also exhibited comparable inhibitory activity to 1st- and 2nd- generation EGFR TKIs and superior activity to 3rd-generation EGFR TKIs in C797S double-mutant cell lines. Furthermore, cells harboring EGFR double or triple C797S mutation underwent remarkable apoptosis upon HS-10375 treatment. HS-10375 effectively inhibited tumor growth in C797S triple-mutant mouse models. In the first-in-human trial, 28 patients with advanced or metastatic non–small cell lung cancers who harbored EGFR mutation and who had experienced treatment failure with EGFR TKI treatment received at least one dose of HS-10375. Dose-limiting toxicities were observed in 2 patients at 240 mg QD, and MTD was reached at HS-10375 150 mg QD. The most common treatment-related adverse events were vomit (37.0%), loss of appetite (33.3%), and elevated AST (33.3%). One patient with EGFR mutations showed tumor shrinkage after progression on five-line treatment including gefitinib, almonertinib, chemotherapy, immunotherapy, and EGFRxHER3 antibody–drug conjugate. Conclusions HS-10375 demonstrated potent and mutant-selective activity against the EGFR C797S mutation in preclinical results, and showed an acceptable safety profile and objective response in a first-in-human phase 1 trial. Trial registration This trial is registered on China Drug Trials (CTR20220045), and ClinicalTrials.gov (NCT05435248).
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spelling doaj-art-2164ca06f6db40d089d4290b823506692025-08-20T02:30:59ZengBMCJournal of Translational Medicine1479-58762025-06-0123111310.1186/s12967-025-06613-0HS-10375, a selective EGFR C797S tyrosine kinase inhibitor, in advanced non–small cell lung cancerJianhua Zhan0Jinhui Xue1Lin Wu2Zhiye Zhang3Qiming Wang4Yuxiang Ma5Yan Huang6Yunpeng Yang7Yuanyuan Zhao8Wenfeng Fang9Yang Zhang10Qianwen Liu11Wen Xu12Yan Yang13Zhenming Chen14Baili Song15Danni Sun16Xia Sun17Peng Gao18Hongyun Zhao19Li Zhang20State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterThe Department of Thoracic Medical Oncology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Hunan Cancer Hospital, Central South UniversityThe First Affiliated Hospital of Henan University of Science and TechnologyDepartment of Internal Medicine, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer HospitalState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterHansoh Pharmaceutical Group Co. Ltd.Hansoh Pharmaceutical Group Co. Ltd.Hansoh Pharmaceutical Group Co. Ltd.Hansoh Pharmaceutical Group Co. Ltd.Hansoh Pharmaceutical Group Co. Ltd.Hansoh Pharmaceutical Group Co. Ltd.Hansoh Pharmaceutical Group Co. Ltd.State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterAbstract Background The C797S mutation is one of the most common mechanisms of acquired resistance to third generation EGFR TKIs, yet no approved therapies have been available to target it. Here we developed a novel selective EGFR C797S inhibitor, HS-10375, and report the results of pre-clinical research and the first-in-human phase 1 trial. Methods Ba/F3 cell lines and patient-derived cells expressing mutant EGFR were used to test the selectively inhibitory potency of HS-10375 in vitro, and cell line-derived xenograft animal models were used to evaluate the anticancer efficacy of HS-10375 in vivo. In the phase 1 trial, HS-10375 was administered orally at six dose levels (10–240 mg) daily (QD) in 21-day cycles, following a rule-based, rolling six design. The primary objectives were the safety, tolerability and maximum tolerated dose (MTD). The secondary objectives included PK parameters and anti-tumor activity. Results HS-10375 showed more potent activity in inhibiting EGFR phosphorylation compared to 1st to 3rd generation EGFR TKIs in C797S triple-mutant cell lines. HS-10375 also exhibited comparable inhibitory activity to 1st- and 2nd- generation EGFR TKIs and superior activity to 3rd-generation EGFR TKIs in C797S double-mutant cell lines. Furthermore, cells harboring EGFR double or triple C797S mutation underwent remarkable apoptosis upon HS-10375 treatment. HS-10375 effectively inhibited tumor growth in C797S triple-mutant mouse models. In the first-in-human trial, 28 patients with advanced or metastatic non–small cell lung cancers who harbored EGFR mutation and who had experienced treatment failure with EGFR TKI treatment received at least one dose of HS-10375. Dose-limiting toxicities were observed in 2 patients at 240 mg QD, and MTD was reached at HS-10375 150 mg QD. The most common treatment-related adverse events were vomit (37.0%), loss of appetite (33.3%), and elevated AST (33.3%). One patient with EGFR mutations showed tumor shrinkage after progression on five-line treatment including gefitinib, almonertinib, chemotherapy, immunotherapy, and EGFRxHER3 antibody–drug conjugate. Conclusions HS-10375 demonstrated potent and mutant-selective activity against the EGFR C797S mutation in preclinical results, and showed an acceptable safety profile and objective response in a first-in-human phase 1 trial. Trial registration This trial is registered on China Drug Trials (CTR20220045), and ClinicalTrials.gov (NCT05435248).https://doi.org/10.1186/s12967-025-06613-0EGFR TKINon-small cell lung cancerHS-10375C797S mutationTargeted therapy
spellingShingle Jianhua Zhan
Jinhui Xue
Lin Wu
Zhiye Zhang
Qiming Wang
Yuxiang Ma
Yan Huang
Yunpeng Yang
Yuanyuan Zhao
Wenfeng Fang
Yang Zhang
Qianwen Liu
Wen Xu
Yan Yang
Zhenming Chen
Baili Song
Danni Sun
Xia Sun
Peng Gao
Hongyun Zhao
Li Zhang
HS-10375, a selective EGFR C797S tyrosine kinase inhibitor, in advanced non–small cell lung cancer
Journal of Translational Medicine
EGFR TKI
Non-small cell lung cancer
HS-10375
C797S mutation
Targeted therapy
title HS-10375, a selective EGFR C797S tyrosine kinase inhibitor, in advanced non–small cell lung cancer
title_full HS-10375, a selective EGFR C797S tyrosine kinase inhibitor, in advanced non–small cell lung cancer
title_fullStr HS-10375, a selective EGFR C797S tyrosine kinase inhibitor, in advanced non–small cell lung cancer
title_full_unstemmed HS-10375, a selective EGFR C797S tyrosine kinase inhibitor, in advanced non–small cell lung cancer
title_short HS-10375, a selective EGFR C797S tyrosine kinase inhibitor, in advanced non–small cell lung cancer
title_sort hs 10375 a selective egfr c797s tyrosine kinase inhibitor in advanced non small cell lung cancer
topic EGFR TKI
Non-small cell lung cancer
HS-10375
C797S mutation
Targeted therapy
url https://doi.org/10.1186/s12967-025-06613-0
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