Actionable
mutations of RET kinase have been identified as oncogenic
drivers of solid tumors, including thyroid cancer, metastatic colorectal
cancer, and nonsmall cell lung cancer. Although multikinase inhibitors
and RET selective inhibitors are used to treat patients with RET alterations,
there is insufficient research addressing certain issues: which actionable
mutations arise from these therapies, how to improve the clinical
response rate to RET inhibitors, and how to design new inhibitors
to overcome drug resistance. Therefore, the development of sophisticated
tool compounds is required to investigate the molecular mechanisms
of actionable mutations and to develop breakthrough therapeutics for
different RET alterations. Herein, we present our investigation into
the side chains of imidazopyridazine hinge binders that are capable
of inducing protein–ligand interaction patterns from the gatekeeper
to the waterfront regions. Extending the substituents at the second
and sixth positions enhanced the IC50 up to < 0.5 nM
for diverse RET alterations.