Likelihood of side effects depends on desired clinical impact: Affinities within a very small set of targets enables inference of promiscuity or specificity of kinase inhibitors

Q. Tran, V. Andreev, Ariel Fernández
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Abstract

As the heterogeneous nature of cancer starts to emerge, the focus of molecular therapy is shifting progressively towards multi-target drugs. For example, drug-based interference with several signaling pathways controlling different aspects of cell fate provides a multi-pronged attack that is proving more effective than magic bullets in hampering development and progression of malignancy. Such therapeutic agents typically target kinases, the basic signal transducers of the cell. Because kinases share common evolutionary backgrounds, they also share structural attributes, making it difficult for drugs to tell apart paralogs of clinical importance from off-target kinases. Thus, multi-target kinase inhibitors (KIs) tend to have undesired cross-reactivities with potentially lethal or debilitating side effects. As multi-target therapies are favored, a pressing issue takes the stakes: which type of clinical impact can only be achieved with a promiscuous drug, and conversely, which clinical effect lends itself to drug specificity? Combining statistical analysis with data mining and machine learning, we determine extremely small inferential bases with 3-5 targets that enable a kinomewide assessment of promiscuity and specificity with over 97% accuracy. Thus, the likelihood of side effects in molecular therapy arising from undesired cross-activities is pivotally dependent on the intended clinical impact restricted to checking a few relevant targets.
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副作用的可能性取决于期望的临床影响:在非常小的靶标组内的亲和力可以推断激酶抑制剂的混杂性或特异性
随着癌症的异质性开始显现,分子治疗的重点逐渐转向多靶点药物。例如,基于药物的干扰控制细胞命运不同方面的几个信号通路提供了一种多管齐下的攻击,在阻碍恶性肿瘤的发展和进展方面被证明比灵丹妙药更有效。这类治疗剂通常以激酶为靶点,激酶是细胞的基本信号转导器。由于激酶具有共同的进化背景,它们也具有相同的结构属性,这使得药物很难区分具有临床重要性的同源物和脱靶激酶。因此,多靶点激酶抑制剂(KIs)往往具有不希望的交叉反应性,具有潜在的致命或使人衰弱的副作用。随着多靶点治疗受到青睐,一个紧迫的问题出现了:哪种类型的临床效果只能通过混杂药物来实现,相反,哪种临床效果可以通过药物特异性来实现?将统计分析与数据挖掘和机器学习相结合,我们确定了具有3-5个目标的极小的推断基础,从而能够在全基因组范围内评估混杂性和特异性,准确率超过97%。因此,分子治疗中由不希望的交叉活性引起的副作用的可能性主要取决于仅限于检查几个相关靶点的预期临床影响。
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