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Effective targeting of PDGFRA-altered high-grade glioma with avapritinib
Journal article   Open access   Peer reviewed

Effective targeting of PDGFRA-altered high-grade glioma with avapritinib

Lisa Mayr, Sina Neyazi, Kallen Schwark, Maria Trissal, Alexander Beck, Jenna Labelle, Sebastian K. Eder, Liesa Weiler-Wichtl, Joana G. Marques, Carlos A.O. de Biagi-Junior, …
Cancer cell, Vol.43(4), pp.740-756.e8
04/14/2025
DOI: 10.1016/j.ccell.2025.02.018
PMCID: PMC12121847
PMID: 40086436
url
https://doi.org/10.1016/j.ccell.2025.02.018View
Published (Version of record) Open Access

Abstract

PDGFRA is crucial to tumorigenesis and frequently genomically altered in high-grade glioma (HGG). In a comprehensive dataset of pediatric HGG (n = 261), we detect PDGFRA mutations and/or amplifications in 15% of cases, suggesting PDGFRA as a therapeutic target. We reveal that the PDGFRA/KIT inhibitor avapritinib shows (1) selectivity for PDGFRA inhibition, (2) distinct patterns of subcellular effects, (3) in vitro and in vivo activity in patient-derived HGG models, and (4) effective blood-brain barrier penetration in mice and humans. Furthermore, we report preliminary clinical real-world experience using avapritinib in pediatric and young adult patients with predominantly recurrent/refractory PDGFRA-altered HGG (n = 8). Our early data demonstrate that avapritinib is well tolerated and results in radiographic response in 3/7 cases, suggesting a potential role for avapritinib in the treatment of HGG with specific PDGFRA alterations. Overall, these translational results underscore the therapeutic potential of PDGFRA inhibition with avapritinib in HGG. [Display omitted] •Avapritinib effectively and selectively inhibits PDGFRA signaling in gliomas•Avapritinib shows CNS penetrance and efficacy in pediatric high-grade glioma models•Safety profile of avapritinib is favorable in pediatric high-grade glioma patients•A subset of patients with PDGFRA-altered HGG shows clinical response to avapritinib PDGFRA is commonly altered in pediatric HGG. Mayr et al. report that the PDGFRA/KIT inhibitor avapritinib demonstrates on-target activity, brain penetrance, and survival benefit in pre-clinical H3K27M DMG models. In pediatric HGG patients, avapritinib treatment is well tolerated and results in radiographic and clinical response in a subset of patients.
avapritinib brain penetrance diffuse midline glioma glioblastoma high-grade glioma PDGFRA alteration PDGFRA amplification PDGFRA inhibitor PDGFRA mutation tyrosine kinase inhibitor

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