Cited by 844Click Chemistry and ApplicationsProtein Degradation and InhibitorsComputational Drug Discovery Methods

The DOI matches its Crossref record; 223 of the 223 references it cites were found in a registry or an index; 9 of the 201 sources its claims cite were checked for support.

Advances in covalent drug discovery

Open access
Boike, Lydia, Henning, Nathaniel J., Nomura, Daniel K.·2022·Nature Reviews Drug Discovery

Abstract

Covalent drugs have been used to treat diseases for more than a century, but tools that facilitate the rational design of covalent drugs have emerged more recently. The purposeful addition of reactive functional groups to existing ligands can enable potent and selective inhibition of target proteins, as demonstrated by the covalent epidermal growth factor receptor (EGFR) and Bruton’s tyrosine kinase (BTK) inhibitors used to treat various cancers. Moreover, the identification of covalent ligands through ‘electrophile-first’ approaches has also led to the discovery of covalent drugs, such as covalent inhibitors for KRAS(G12C) and SARS-CoV-2 main protease. In particular, the discovery of KRAS(G12C) inhibitors validates the use of covalent screening technologies, which have become more powerful and widespread over the past decade. Chemoproteomics platforms have emerged to complement covalent ligand screening and assist in ligand discovery, selectivity profiling and target identification. This Review showcases covalent drug discovery milestones with emphasis on the lessons learned from these programmes and how an evolving toolbox of covalent drug discovery techniques facilitates success in this field. The rational discovery of covalent drugs depends on an expanding toolset of techniques. Here, Daniel Nomura and colleagues highlight covalent drugs that have achieved success over the past decade and discuss the tools and strategies that facilitate their discovery, describing two complementary approaches, namely, ligand-first and electrophile-first strategies.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review traces covalent drug discovery from serendipitous historical agents to rational ligand-first and electrophile-first programmes, highlighting approved inhibitors for EGFR, BTK, KRAS(G12C), SARS-CoV-2 Mpro and other targets. It argues that chemoproteomics, covalent screening and structure-guided design now form an integrated toolbox for tackling previously undruggable proteins.

Key findings

  • Covalent drugs can gain potency and selectivity by adding mildly reactive electrophiles to reversible ligands or by screening electrophilic libraries; examples include osimertinib and ibrutinib, with 2020 sales of US$8.43 billion and US$4.33 billion respectively, and sotorasib, approved in 2021 for KRASG12C-mutated NSCLC.
  • Electrophile-first discovery was validated by KRAS(G12C) inhibitors: an initial tethering screen of 480 disulfide fragments and later a 3,300-acrylamide screen contributed to sotorasib; KRAS is mutated in about 25% of cancers, and KRASG12C accounts for 12–14% of KRAS mutations in NSCLC.
  • Covalent protease inhibitors include nirmatrelvir, which forms a reversible covalent nitrile adduct with SARS-CoV-2 Mpro Cys145 and was authorized as part of Paxlovid in December 2021; HCV NS3/4a ketoamide inhibitors boceprevir and telaprevir were approved in 2011 but later discontinued or withdrawn.
  • Chemoproteomic platforms such as isoTOP-ABPP and SLC-ABPP enable profiling of more than 30,000 reactive cysteines, over 8,000 cysteine sites in 18 min per compound, and show that 97% of E3 ligases possess reactive cysteines, supporting covalent E3 recruiters for targeted protein degradation.

Methods

  • Narrative review, not primary research; it synthesizes published literature, drug approval histories, structural biology and chemoproteomic datasets across covalent drug discovery.
  • Evidence is organized by discovery approach: ligand-first (EGFR, BTK and other kinases), electrophile-first (KRAS(G12C), SARS-CoV-2 Mpro, HCV protease, proteasome, boron-containing drugs, voxelotor) and enabling tools (screening platforms, chemoproteomics, covalent docking).
  • Includes tables comparing key covalent drugs and screening methods, plus figures on development timelines, inhibitor–target structures and isoTOP-ABPP workflow; no systematic search strategy or meta-analysis is described.

Limitations

  • The paper states no explicit limitations. Evident: it is a selective narrative review without systematic search criteria or quantitative synthesis, so examples are chosen to illustrate milestones rather than exhaustively cover the field.
  • Evident: many claims depend on cited primary studies and clinical or preclinical data that are not independently reanalysed, and the fast-moving nature of the field may date some coverage.
  • Evident: the review emphasizes cysteine-targeting electrophiles and oncology or infectious disease examples, with comparatively less attention to non-cysteine nucleophilic residues and other covalent strategies.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1038/s41573-022-00542-z

Cites

223 of 223 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

129 Not checked yet · 29 Own interpretation · 14 No basis given · 6 Supported · 1 Partly supported · 1 Couldn’t confirm · accuracy not yet measured

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Show all 97 claims

  • Probably not a substantial claim. 21
  • It may state two separate claims as one. 67
83 of 83
  • The paper relies on this without support.

    Each covalent drug candidate must balance reactivity, potency, and selectivity.

    “each compound must balance reactivity, potency and selectivity.”
  • The paper relies on this without support.

    Cysteine's low abundance provides selectivity but restricts opportunities to covalently target specific proteins.

    “The low abundance of cysteine enables selectivity but limits opportunities for covalently targeting specific proteins of interest.”
  • The paper relies on this without support.

    The ε-amino group of lysine is not nucleophilic enough under physiological conditions, so efficient lysine-targeting covalent ligands require unusually reactive lysines.

    “Owing to the low nucleophilicity of the ε-amino group of lysine under physiological conditions, the discovery of efficient lysine-targeting covalent ligands requires identification of unusually reactive lysines.”
  • The paper relies on this without support.

    Most protein-reactive covalent drugs are electrophilic so that they can react with nucleophilic amino acids.

    “Most protein-reactive covalent drugs tend to be electrophilic, to enable reactions with nucleophilic amino acids.”
  • The paper relies on this without support.

    Nucleophilic drugs can react with electrophilic cofactors and post-translational modifications.

    “By contrast, nucleophilic drugs can react with electrophilic cofactors and post-translational modifications.”
  • The paper relies on this without support.

    Most bifunctional degraders recruit CRBN or VHL, but there are more than 600 E3 ligases with varying substrate scopes.

    “Although most bifunctional degrader molecules (proteolysis-targeting chimeras (PROTACs)) recruit the E3 ligases cereblon (CRBN) or von Hippel–Lindau (VHL) protein to degrade target proteins, there are more than 600 E3 ligases with varying substrate scopes.”
6 of 6

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Citations

Cites

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Research works printed but not linked: 1

  1. McWhirter, C. in Annual Reports in Medicinal Chemistry (eds Ward, R. A. & Grimster, N. P.) vol. 56 1–31 (Elsevier, 2021).

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Metadata

Authors
Boike, L., Henning, N. J., & Nomura, D. K.
Affiliations
Innovative Genomics Institute (US)
Corresponding author
Nomura, Daniel K.
Venue
Nature Reviews Drug Discovery
Published
2022-08-25
Volume
21
Issue
12
Pages
881-898
ISSN
  • 1474-1776 (ISSN-L)
  • 1474-1784
OpenAlex
W4293084539
Cited by
823
References
223
Citations by year
2026: 172 · 2025: 256 · 2024: 236 · 2023: 147 · 2022: 12
FWCI
15.29
Type
journal article
Language
en
Open access
Locations
  • Nature Reviews Drug Discovery (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Science Foundation
  • Mark Foundation For Cancer Research
  • National Institutes of Health
  • National Cancer Institute (F31CA268278, R01CA240981, R35CA263814)
Topics
  • Physical Sciences › Chemistry › Organic Chemistry › Click Chemistry and Applications
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Protein Degradation and Inhibitors
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Drug Discovery › Computational Drug Discovery Methods
Keywords
covalent drug discovery, covalent inhibitors, chemoproteomics, KRAS G12C inhibitors, EGFR inhibitors, BTK inhibitors, reactive functional groups, target identification, selectivity profiling
MeSH terms
Agammaglobulinaemia Tyrosine Kinase, SARS-CoV-2, COVID-19 Drug Treatment, Humans, Ligands, Structure-Activity Relationship, Proto-Oncogene Proteins p21(ras), Protein Kinase Inhibitors, Drug Discovery, ErbB Receptors

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