[donocco]

Elizabeth

Im mentioning this only because you love to do research. I went back to my notes on Neratinib and found what the mutation is. Its called the T790 and does involve a single amino acid switch. A normal Threonine amino acid residue is exchanged for a Methionine Amino Acid residue. This switch makes Lapatanib inactive.

Ill tell you what I find interesting. Both Lapatanib and Neratinib hit two different proteins, the Epidermal Growth Factor Receptor Tyrosine Kinase and the Her2Neu Receptor Tyrosine Kinase. When you get Lapatanib resistence the amino acid change in both targets is the same: A Methonine residue replaces a Threonine. It is as if the cancer cells could think.

Paul