Drug Discovery Overview
Transcription
Drug Discovery Overview
Drug Discovery Overview Hits to the Clinic 1 Chatterjee – Lecture at TSRI Oct 29 2014 Outline • Medicinal chemistry strategies – Physiochemical properties – General terms – On-target g versus off-tissue effects – Target-based optimization case study • Mdm-2/p53 – Cell-based optimization case study • Malaria – Pharmacokinetic optimization Leeson and Sprinhthorpe Nature Reviews Drug Discovery, 2007, 881890. • Effects on cardiotoxicity (S1P1 agonists) • Take home messages – Principals for optimization • Structure-based and physiochemical property based • Pharmacokinetic based (and interplay with toxicity) – Understanding compound progression schemes • Lots of compounds so need clear benchmarks for success (attrition-based strategy) • Close interplay between chemistry, biology, pharmacology, toxicology 2 Chatterjee – Lecture at TSRI Oct 29 2014 S1P1 Receptor and Immune Diseases Mechanism of Action p agonists g such as FTY720 ((spingolipids) p g p ) • S1P Receptor leads to S1P1 down-regulation and prevents lymphocyte egress. Clin Neuropharmacol. 2010 ; 33(2): 91–101. Key issues • On-target bradychardia (slow heart rate defined as less than 60 bpm) p ) upon p first dosing g – Likely a Cmax effect • Truly on-target toxicity? S1P3 receptor • Can one modulate this effect my pushing out Tmax and “flattening the PK curve”? 3 Chatterjee – Lecture at TSRI Oct 29 2014 Physicochemical properties for BBB permeability Multiple-color band Radar chart, a tool for lead optimization. Here the combined shaded area represents the property ranges of 95% of approved CNS drugs. drugs The green band represents the most densely populated property range containing 50% of the approved CNS drugs. The red line represents the properties of the test molecule (amitriptyline, a tertiary amine tricyclic antidepressant, is structurally related to both the skeletal muscle relaxant cyclobenzaprine and the thioxanthene antipsychotics such as thiothixene). During lead optimization, it is often found that even after ROF type rules have been satisfied the lead optimization process does not achieve the goal. In such cases, optimizing the physicochemical properties ti toward t d the th green region i may have h a better chance of success. < ACS Chem. Chem Neurosci. Neurosci 2012, 2012 3 3, 50−68 > 4 Chatterjee – Lecture at TSRI Oct 29 2014 Check points for the CNS drugs to Penetrate Blood Brain Barrier Free Drug Hypothesis (total clearance adjusted for free fraction) 5 Chatterjee – Lecture at TSRI Oct 29 2014 Structure-based Design • p53/MDM-2 interaction blocker – p53 is key tumor suppressor and 1st gen compound mimic MDM-2 peptide (though the interactions span ~120 residues and subsequent peptides tid d do nott h have good d orall exposure)) – HTS led to nutlins and subsequent optimization • Top. Med Chem 2012, 8; 57-80. Flexible pocket 6 Chatterjee – Lecture at TSRI Oct 29 2014 MDM2/p53 • 10 compounds in clinical trials – – – – – – Phase1/2- ALRN-6924 (peptide) Phase 1 – RG-7775 Phase 1 – HDM-201/CGM-097 HDM 201/CGM 097 (Novartis) Phase 1 – RO-6839921 Phase 1 – AMG-232 Phase 1 – SAR-405838 7 Chatterjee – Lecture at TSRI Oct 29 2014 Protease inhibitors Examples of efficient bond-construction HCV NS3/4 p protease inhibitor ((MK-7009)) Convergent olefin cross-metathesis O NH N 8 Chatterjee – Lecture at TSRI Oct 29 2014 O O HN NH N O S1P1 binding sites Science 2012, 335, 851 9 Chatterjee – Lecture at TSRI Oct 29 2014 Current Clinical Compounds FTY720 BAF312 (Phase 3 – Novartis) 200 nM Bradyarrhythmia y y at 10 mg/day g y SEW2871 (HTS hit J. Biol. Chem 2004, 13839.) WO 2011/060392 10 Chatterjee – Lecture at TSRI Oct 29 2014 WO 2012/158550 20 pM 20h human t1/2 Tmax pushed out (1 7h versus 7h) (1.7h Cell-based Optimization of Novel Antiparasitics 11 Chatterjee – Lecture at TSRI Oct 29 2014 Drug Discovery Infrastructure Target Validation HTS Exploratory Chemistry Candidate Selection Point Full Lead Optimization Clinic D0 D1 Lead Discovery • Large, diverse compound library • Fully robotic uHTS system capable of >2 million data points/day • Automated compound profiling system • Screening informatics infrastructure (LDDB) 12 Chatterjee – Lecture at TSRI Oct 29 2014 D2 • • • • D3 Medicinal & Analytical Chemistry Automated library synthesis Experienced medicinal chemistry staff High-throughput analytical and purification technology Sophisticated compound management Tox studies • • • Pharmacology/ADMET In vitro and in vivo ADMET capabilities State-of-the-art bioanalytical technology In vivo efficacy models in metabolic disease, immunology and oncology Infectious Diseases of the Developing World • Objective – Identification of new pharmacophore drug candidates to improve treatment options for infectious diseases in low and middle income countries • Scientific Rationale – Prioritized disease targets where current drugs are toxic/ ineffective and current drug discovery activities are low relative to medical burden – Deprioritized where other approaches are likely to be more effective (vaccines, sanitation) – Programs focused on Malaria Malaria, Tuberculosis Tuberculosis, Kinetoplastid Diseases • Approach – Reduction in burden of infectious agent will lead to improved clinical outcomes – Reliance on phenotypic screens for hit finding – Deconvolution of mechanism of resistance through genetic selection 13 Chatterjee – Lecture at TSRI Oct 29 2014 Mosquito P.falciparum Human M.tuberculosis Sand fly L.donovani Kissing bug T.cruzi Tsetse fly T.brucei Scope and Scientific Approaches • Whole pathogen cell-based screening approach – – – – • Majority of anti-infectives discovered through cell-based screening • Facilitates simultaneous interrogation of multiple nodes/ pathways • Consideration of compound permeability and metabolism in-built Target-based approaches have been less successful, including internal programs HTS on >2 million compounds for all pathogens, with broad compound profiling in secondary assays Closely coordinated chemistry, pharmacology and biology teams Target identification methods – – – Lab-evolved ab e o ed sstrains a s resistant es s a to o co compound pou d treatment ea e followed o o ed by ge genetic e ca analysis a ys s Promoter signature profiling Compound affinity pull-downs • Ensures no shared in vitro resistance mechanism with current drugs • Target identification enables biochemical optimization approach for follow-on compounds Presentation will highlight work in Malaria, Leishmania and Chagas Disease 14 Chatterjee – Lecture at TSRI Oct 29 2014 Malaria Medical Need • 500 00 million illi cases annually ll worldwide ld id – • Resistance to current therapies widespread with exception of artemisinin derivatives – – • Nearly 1 million deaths/yr, >75% under age of 5 Increased parasite clearance times for Artemisinin-based therapies seen in Thai-Cambodian border Current artemisinin-based combination therapies (ACTs) contraindicated in 1st trimester No current therapies address need for blood-stage, liver-stage, and transmission blocking activity Re-infects mosquitoes Overview of the malaria parasite life cycle Only primaquine works k on hypnozoites 15 Chatterjee – Lecture at TSRI Oct 29 2014 The NGBS consortium • Novartis Institute for Tropical Diseases (NITD), Singapore – Team leaders: Bryan Yeung, Zou Bin, Christophe Bodenreider • Genomic Institute of the Novartis Research Foundation (GNF) – Team leaders: Arnab Chatterjee, Kelli Kuhen and Elizabeth Winzeler • Biomedical Primates Research Center (BPRC), Rijswijk (NL) – Team leader: Clemens Kocken • Swiss Tropical Institute (STI), Basel (CH) – Team leader: Matthias Rottmann • The NGBS (NITD (NITD, GNF, GNF BPRC, BPRC STI) consortium – Program Head: Thierry Diagana (NITD) • NGBS is funded by: 16 Chatterjee – Lecture at TSRI Oct 29 2014 GNF Malaria Cell-based Screening Summary • > 2M compounds screened at 1.25 M (3d7) • 4851 hits < 1.2 M EC50 vs W2 and/or 3d7 – “Malaria Box” public resource for malaria l i research h community it – https://www.ebi.ac.uk/chembldb/index.p hp/compound • 1,256 < 200 nM EC50 vs 3d7 • >200 scaffolds represented in the reconfirmed compound set • A much smaller subset active on liver-stages g of infection ~270 cmpds How to best prioritize chemistry h i t resources? ? Bl d t Blood-stage HTS reported t d in: i Plouffe Pl ff and d co-workers k PNAS 2008, 2008 9059 9059. 17 Chatterjee – Lecture at TSRI Oct 29 2014 Selection criteria for cell-based HLO at GNF • ~5K reconfirmed blood-stage hits from HTS identified for further evaluation were determined by – Less than 1.25 µM EC50 with activity in 15 stain resistance panel • Less than 5-fold potency shift between strains – High selectivity in 6-cell line toxicity panel (SI > 20-fold) – Novel chemotype for malaria – Ease of synthesis (less than 7 steps) – Good solubility, solubility metabolic stability and limited CYP450 inhibition – Multiple actives within a scaffold (if library diversity allows) • OPI algorithm used for clustering (developed at GNF) Yan, et al. J. Chem. Inf. Model. 2005 45, 45 1784 -1790 1790 • Integrates SAR information into analysis of HTS data to prioritize interesting singletons as well as lower activity compounds that have good SAR from the screen Thi presentation This i will ill focus f on 1 series i prioritized i i i d from f this hi clustering l i 18 Chatterjee – Lecture at TSRI Oct 29 2014 Imidazolopiperazines Hit series GNF-Pf-5069 EBI ID HTS W2 EC50 (µM) GNF-Pf-5179 GNF-Pf-5466 HTS 3D7 EC50 (µM) HTS Huh7 EC50 (µM) Powder W2 EC50 (µM) Powder 3D7 EC50 (µM) Powder Huh7 EC50 (µM) GNF-Pf- 0.097 5069 0.063 >10 0.198, 0.473 0.161, 0.46 >100 GNF-Pf- 0.271 5179 0.235 >10 0.122 0.119 >79 GNF-Pf- 0.119 5466 0.116 >10 0.029 0.030 42.82 19 Chatterjee – Lecture at TSRI Oct 29 2014 Imidazolopiperazines Hit Series • Strengths – Unique scaffold for malaria, no biological activity annotation with structure – 4 step synthesis – Veryy g good solubility; y; no activityy on Cyp450s yp – Not identified in >100 HTS screens performed at GNF • Issues – Moderate in vitro potency – In vivo snapshot PK: poor oral exposure • Likely due to catechol and glycinamide – hERG inhibition (35% at 10 M, patch clamp) 20 Chatterjee – Lecture at TSRI Oct 29 2014 Compound Progression Scheme MedChem Output Falciparum Resistance Panel (15) Protein binding shift Human Serum shift of Pf EC50 PBFS <10 Huh7, HeLa, BaF3, CHO, 293T, HEp2 SI > 50 EC50 < 200nM; <5x shift Tier I In Vitro ADME Mouse snapshot PK Tier II In Vitro ADME Ex vivo o in vitro t o P berghei be g e Solubility > 50 µM Low to moderate metabolism: hu, rat, ms, dog, monkey microsomes CyP inhibition, 5 isoforms (>1 µM) Caco-2 > 3 x 10-6 cm/sec (A-B) GNF NITD/NIBR Swiss Tropical Institute (STI) Scaffold characterization of (selected analogs): Liver-stage assays, Stage of action, Rate of action In vivo PK MTD Cmax >10x EC50, %F >20%, T½ >2-4hr, qd preferred MTD (single-dose) > 5x efficacious dose Safety and P/C profiling PCP P5 Panel Kinase/Protease Panels In vitro tox (hERG, AMES, MNT) yp induction and timeCyp dependent inhibition CPP assessment Efficacy in vivo vs. P berghei T Transmission i i and d P vivax i assays “Late lead” nomination 21 Chatterjee – Lecture at TSRI Oct 29 2014 Cell line Tox Panel (6) 3d7, W2, FCR3, FCB, HB3, Dd2, C188, NF54, D6, D10, K1, CAMP-R, TM, 7G8, 3BA6 IC50 ≥ 5 µM (no prohibitive activity) hERG potential (Patch clamp >10 µM) Micronucleus: Negative Ames: Negative Cure at fully tolerated dose, 3 day dosing >99% reduction parasitemia ED50/90/99 measured Hit-to-lead optimization Summary H2N O N N N NH O • O • Compound GNF776 GNF-Pf-5069 – – – – – – Pf 3D7 (EC50): 460 nM hERG (binding) IC50 = 19 µM Mouse metabolic stability (ER): 0.24 Solubility (pH 6.8): > 175 µM PO Cmax (D.N.) = 16 nM / (mg/kg) PO AUC0-5h g g) 0 5h ((D.N.)) = 48.6 h*nM / ((mg/kg) Poor exposure limited any further work (*D.N.: dose normalized) – – – – – – – Pf 3D7 (EC50): 20 nM hERG (binding) IC50 = 3.95 µM CL = 60 mL/min/kg; Vss = 23.7 L/kg; T½ = 6.2 h PO Cmax (D.N.) = 60 nM / (mg/kg) PO AUC0-inf (D.N.) = 596.5 h*nM / (mg/kg) F (%) = 87 Efficacy achieved in p berghei mouse model Wu, et.al. J. Med. Chem. 2011, 5116. Still need to improve hERG and potency 22 Chatterjee – Lecture at TSRI Oct 29 2014 Groebke-Blackburn Cyclization Route P falciparum 3D7 EC50 = 30 nM • 4 steps and 53% overall yield • No column chromatography 23 Chatterjee – Lecture at TSRI Oct 29 2014 Imidazolopiperazine Core Optimization 8,8-dimethyl substitution significantly improves profile • GNF179 • GNF268 – – – – – – – – Pf W2 (EC50): 9 nM hERG (binding) IC50 = 6.6 µM CL = 1179 mL/min/kg; L/ i /k Vss = 106.76 106 76 L/k L/kg Oral T½ = 2.2 h PO Cmax (D.N.) = 3.3 nM / (mg/kg) PO AUCinf (D.N.) = 30 hr*nM F (%) = 17 30x cross-resistance to GNF-Pf-5069 lab evolved resistance strain – – – – – – – – Pf W2 (EC50): 6 nM hERG (binding) IC50 = 7.2 µM CL = 21.92 21 92 mL/min/kg; L/ i /k Vss = 11.8 11 8 L/k L/kg Oral T½ = 8.4 h PO Cmax (D.N.) = 60.5 nM / (mg/kg) PO AUCinf (D.N.) = 1035 hr*nM (mg/kg) F (%) = 58 7x cross-resistance to GNF-Pf-5069 lab evolved resistance strain (*D.N.: dose normalized) gem-Dimethyl group on piperazine improves potency and PK in mice J. Med. Chem. 2012, in press. 24 Chatterjee – Lecture at TSRI Oct 29 2014 SAR Summary • Optimization of the Imidazolopiperazine scaffold: – Introduction of 8,8-dimethylgroup on piperazine improves in vitro and in vivo potency by 10-fold – Required glycine functionality is primary cause for hERG activity Amino acid SAR • Aryl required •NH2 preferred; but also can use NHR, NR2, OH and alkyl groups • Para and meta substituted aromatic preferred • 1-2 carbon spacer to NH2 preferred •Dimethylglycine improves in vivo PK relative to glycine (mouse and rat) • Ortho substituted aromatic not preferred H2 N • Glycine least active on hERG (2-3 fold), while all other amino acids in similar range O N N F N • Strong electron-withdrawing group not preferred NH Piperazine ring SAR • 8-substitution helps with potency and mouse exposure (dimethyl > valine, alanine > hydrogen) • 5-dimethyl and 6-dimethyl moderately helps potency, no real effect on PK • Cyclic lactams (6-oxo) (6 oxo) derivatives active with 8,8-dimethyl substitution and reduces metabolism 25 Chatterjee – Lecture at TSRI Oct 29 2014 F • Aniline required with unsubstituted piperazine series • Nitrogen required required, but N-H N H is not in unsubstituted piperazines • Variety of aromatics help potency (para and meta preferred) • Heteroaromatics and cycloaliphatics not active in unsubstituted piperazine series, but active with 8-dimethyl groups • Can modestly effect hERG activity hERG Optimization Targeting the amine functionality Modulate amine basicity: GNF824 P. falciparum 3D7 EC50 = 50 nM pKa = 3.3 Glycine amine pKa = 7.5 hERG (Dofetilide binding) IC50 = 12.47 M Solubility (pH 6.8) 6 8) = 34 mg/L Replacement of amine with alcohol: GNF711 P falciparum 3D7 EC50 = 300 nM hERG (Dofetilide binding) IC50 > 30 M Solubility (pH 6.8) = 110 mg/L GNF557 Optimize P. falciparum potency P. falciparum 3D7 EC50 = 20 nM Unable to progress due to poor metabolic stability and Log D 26 Chatterjee – Lecture at TSRI Oct 29 2014 SAR of the 3-position (aniline group) pH 6.8 Solubilit y (µM) Rat ER hERG (binding) (µM) Cmpd X R Pf 3D7 EC50 (nM) GNF156 NH 4 F Ph 4-F-Ph 10 >1000 0 52 0.52 64 6.4 GNF877 CH2 4-F-Ph 8 >1000 0.49 2.7 GNF767 O 4-F-Ph 3 >175 0.13 4.0 GNF765 S 4-Me-Ph 8 42 ND 4.2 GNF772 SO 4-Me-Ph 42 >175 0.37 26.0 GNF771 SO2 4 M Ph 4-Me-Ph 5210 (NF54) ND ND ND GNF713 SO 3-F-Ph 481 ND ND 12.0 GNF714 SO 4-F-Ph 70 ND ND >30 GNF715 SO 3,5-Me2Ph 381 ND ND 15.0 GNF716 SO 3,4-F2-Ph 89 ND ND 27.0 Sulfoxide linkage is a good balance of potency, solubility and hERG 27 Chatterjee – Lecture at TSRI Oct 29 2014 Profile of Preclinical candidate: GNF156 • • • • In vitro Activity Profile of Imidazolopiperazines – P. falciparum W2 potency: EC50 = 0.006 μM – Compound exhibits < 5-fold shift across 15 strains – Selectivity vs. Huh7 cells: >10,000 fold – Complete transmission blocking at 500 nM GNF156 In vivo Profile – Good G d orall PK/bi PK/bioavailability il bilit and d exposure; T1/2 > 4 h – In vivo efficacy in P. berghei mouse model: ED99 = 2.2 mg/kg – Causal prophylaxis data: Fully protective at 20 mg/kg ADME/Safety/Physicochemical Profile – ADMET: solubility: >1000 µM @ pH1 and @ pH 6.8; no GSH trapping; no Cyp induction or phototoxicity flags – Clean PCP receptor panel, Ames, MNT and good metabolic stability – Formulation suitable for tox studies identified (35x exposure multiples achieved in rats and 16x in dogs) – hERG activity at 6.6 µM in binding assay; 13 µM in automated patch clamp assay Unique activity for blood/liver-stage blood/liver stage infections and transmission blocking 28 Chatterjee – Lecture at TSRI Oct 29 2014 GNF156: Current Synthesis Route 29 Chatterjee – Lecture at TSRI Oct 29 2014 10 step route, but minimal purifications 27% overall yield Low cost of goods for starting materials GNF156: In vivo efficacy in P. berghei model Compound # of animals per dose ED50 (mg/kg) ED90 (mg/kg) ED99 (mg/kg) Chloroquine 5 1.9 5.2 8.4 Mefloquine 5 3.8 5.0 8.6 At Artesunate t 5 50 5.0 20 5 20.5 119 Imidazolopiperazine GNF156 5 0.48 1.13 2.2 Oral Exposure in mouse at efficacious dose (2 mg/kg) Cmax = 112 ± 5 nM Tmax = 1 h T1/2 = 4.8 ± 0.8 h AUCinf = 945 ± 110 nM*h %F = 32 ± 4 30 Chatterjee – Lecture at TSRI Oct 29 2014 GNF156 PK Properties in Mouse, Rat and Dog GNF156 Single Dose PK in Mice Mouse PK (5 / 20 mg/kg, n=3) GNF156 Single Dose PK in Rat Rat PK (3 / 10 mg/kg, n=3) GNF156 Single Dose PK in Dog Dog PK (0.5 / 2 mg/kg, n=3) CL (ml / min•kg) 49 (mod) CL (ml / min•kg) 24 (low)** CL (ml / min•kg) 5 (low) Vss (l/kg) 10 (high) Vss (l/kg) 26 (high) Vss (l/kg) 11 (high) t1/2term. (h) 1/2t 67 6.7 t1/2term. (h)) 1/2term ( 4.9 t1/2term. (h) 28 5 28.5 AUC (h•nM) p.o. 12156 AUC (h•nM) p.o. 975 AUC (h•nM) p.o. 16142 Cmax (nM) p.o. 1539 Cmax (nM) p.o. 91 Cmax (nM) p.o. 553 Tmax p.o. (h) 1.0 Tmax p.o. (h) 1.6 Tmax p.o. (h) 1.7 Oral BA (%F) 74 O l BA (%F) Oral 20 Oral BA (%F) 89 ** Adjusted for RBC partitioning • In rat whole blood, GNF156 showed moderate RBC partition with blood to plasma ratio of 3.5. • GNF156 exhibits low to moderate blood CL,, high g Vss, and reasonable bioavailability y across species p • Exposure multiple of 16 achieved in dogs (AUCeff ~1000 h*nM at 2 mg/kg in mice). Long T1/2 in dogs. 31 Chatterjee – Lecture at TSRI Oct 29 2014 GNF156: Human efficacious dose projections Species Units Mice Rat Dog Human Body weight kg 0.025 0.25 8.7 70 Dose mg/kg 5 3 0.5 1 Vss L/kg 10.2 25.7 10.9 10.2 to 25.7 CL mL/min/kg 49.2 84.4 4.8 0.9 to 4.5 T1/2 h 2 49 4.9 28 5 28.5 14 5 to 71 14.5 F % 66 47 89 67 Efficacy y : ED99 in mice for KAF156 is 2.2 mg/kg. g g Bioavailability : F was estimated to be 67% in humans Clearance : 0.9 to 4.5 ml/min/kg using various methods. Human efficacious dose (to show similar efficacy to the mouse 99% parasitemia reduction) was predicted to be 2.3 to 48mg based on the following assumption Efficacy is similar in P.b infected mice and P.f infected human PK is similar in normal mice and P.b P b infected mice 32 Chatterjee – Lecture at TSRI Oct 29 2014 Imidazolopiperazines Block Transmission Novel activity for a potent blood-stage antimalarial Stage V gametocyte transmission mosquito feeding experimental procedure: 1. The compounds are added to a bloodmeal with NF54 gametocytes 2. Six days after the fed mosquitoes are dissected and checked for oocysts 3 Compounds can have an effect on 3. mosquitoes, therefore the mortality of the mosquitoes is checked every day Control GNF776 (0.7 M) GNF776 (7 M) % infected mosquitoes # Oocysts/ mosquito 95 49 60 1.5 0 0 Data furnished by Sauerwein lab 33 Chatterjee – Lecture at TSRI Oct 29 2014 Conclusions and path forward: • GNF776 (lead cmpd) inhibits oocyst development dose-dependently • Optimized GNF156 blocks transmission completely at 500 nM • This novel activity is critical for potential eradication goals GNF156 preclinical safety summary No significant tox at up to 30-45 (rat) or 135-250 (dog) fold over ED99 exposure Genotoxicity Mini Ames mutagenicity assay: negative Phototoxicity 3T3 NRU assay: negative (PIF = 1.4) 2-week rat toxicity at 10, 30, and 100 mg/kg/day 100 mg/kg/day: salivation, respiratory distress, lymphocyte counts and WBC mild thyroid follicular hypertrophy/hyperplasia WBC, hypertrophy/hyperplasia, and possibly testicular degeneration (1/5 rats but not in controls) ≥30 mg/kg/day: platelets (17-20%), in 3/5 rats at 30 and all rats at 100 mg/kg/day, mild-mod creatinine (up to 2-fold); mild (15%) globulin All doses: CK (-16- 56%) and glucose (-6 - 15%) in several rats per group Dog rising dose with telemetry at 2, 10, 30, 100, 250 mg/kg 250 mg/kg: Transient heart rate increase without ECG changes 34 Chatterjee – Lecture at TSRI Oct 29 2014 Visceral Leishmaniasis • Disease caused by kinetoplastids from Leishmania genus (L. donovani, L. infantum / chagasi) • Endemic to 82 countries with > 90% cases found in 3 regions: - India / Bangladesh / Nepal - Sudan / Ethiopia / Kenya - Brazil • Prevalence - 500,000 new cases per year - Mortality conservatively estimated as 100,000 deaths per year • Routes of infection – through bite of Leishmania-infected sandfly • Visceral Leishmaniasis natural history - Most infections have sub-clinical character - Incubation period typically 2-8 months - clinical features : fever >80%, wasting > 70%, splenomegaly > 90% (almost universal), hepatomegaly > 50%, anemia > 60% y fatal,, cause of death usuallyy - untreated disease almost always concurrent illness (pneumonia, tuberculosis, dysentery) • Current therapies - Pentavalent antimonials, amphotericin B, paromomycin, miltefosine p amphotericin p B), ), toxicityy - Drawbacks include cost ((liposomal (antimonials, amphotericin B, miltefosine), drug resistance (antimonials) 35 Chatterjee – Lecture at TSRI Oct 29 2014 Leishmania Lih i spp. Extracellular promastigotes in insect gut Sandfly (Phl b t (Phlebotomus, Lutzomyia) Regurgitated R it t d b by iinsectt iinto t bite wound Propagates as amastigote g in vacuole of macrophages & dendritic cells Parasites transmitted back to insect during blood meal Selection of Hit Scaffolds from L. donovani HTS Phenotypic, axenic amastigote HTS (~700,000 compounds) Lead Discovery Database (LDDB) at GNF for integration HTS and med chem data 1,035 confirmed hits with EC50 less than 4 M dose response heat map BAF/Tel-AlK BAF/Tel-Ros BAF/Tel-InsR BAF/Tel-IGF1R BAF/Tel-TRKA BAF/Tel-TRKB BAF/Tel-TRKC BAF/Tel-MET BAF/Tel-MER BAF/Tel-RET BAF/Tel-RON BAF/Tel-FGFR4 BAF/Tel-FGFR2 BAF/Tel-FGFR3 BAF/Tel-KDR Column 22 BAF/Tel-FLT1 Column 19 BAF/Tel-FLT4 BAF/Tel-Kit Column 16 BAF/Tel-FMS Column 13 BAF/Tel-FLT3 Column 10 b BAF/Tel-PDGFRb Column 7 BAF/Tel-Tie1 Column 4 BAF/Tel-TIE2 Column 1 BAF/Tel-EphA3 wtBAF/ Confirmation axenic amastigote assay: 87/89 confirmed BAF/Tel-EphB2 Clustering and purified compound order of representative scaffolds: 89 compounds BAF/bRaf Pim1-1 BAF/Tel-Syk BAF/Tel-ZAP70 BAF/Bcr-Abl BAF/Tel-BMX BAF/Tel-Lyn BAF/Tel-Src BAF/Tel-Lck BAF/Tel-FGR BAF/Tel-TYK2 BAF/Tel-JAK1 BAF/Tel-JAK2 High selectivity in Huh7 cell line toxicity (SI > 10-fold) BAF/Tel-JAK3 3.7 1.5 2.6 3.7 1.6 0.9 3.3 0.8 1.8 2.3 7.0 3.0 4.4 4.2 4.4 3.7 2.8 3.2 2.4 4.4 5.4 6.1 3.9 2.6 1.9 2.8 3.5 3.7 3.7 2.5 2.1 1.9 1.4 4.3 4.8 2.6 3.5 3.4 0.5 No/ minimal annotation in > 60 HTS Tier 1 ADME: microsome stability; Cyp inhibition; solubility: 43/89 tested Preliminary Cost of Goods assessment 12 scaffolds for confirmation for activity in macrophage infection model 36 Chatterjee – Lecture at TSRI Oct 29 2014 Efficacy Comparison - Hits vs. Known Drugs • • • • 8 of 12 scaffolds show activity y < 10 M on intracellular amastigotes 2 of these 8 scaffolds have no activity y on axenic amastigotes – fail to reconfirm 4 of 12 scaffolds no activity y on intracellular amastigotes at 50 M Several interesting g scaffolds (on right) were not optimized for chemistry despite amastigote activity Compound ID Axenic Amastigote IC50 (M) Macrophage infection IC50 (M) GNF6372 1.41 > 50 GNF6513 2.56 > 50 GNF7674 2.24 > 50 GNF3336 0.63 > 50 A h Amphotericin i i B 1 42 1.42 0 13 0.13 Miltefosine G GNF6372 GNF7674 37 Chatterjee – Lecture at TSRI Oct 29 2014 4.12 GNF6513 GNF3336 Leishmania Project Current Hit-to-Lead Status • 8 scaffolds have been identified with following properties – Good SAR from screen (active and inactive members within a scaffold) ff ld) – All commercially available compounds, not annotated with any antiinfective activity – Preliminary in vitro ADME assessed, including: • Liver microsome stability (mouse and human) • CyP450 3A4 reversible inhibition (for DDIs) • Solubility assessment in pH 6.8 and in simulated GI fluid buffer (Fassif) – ~1000 1000 compounds made on these series since Feb 2011 • Goal for project is to find 1-2 lead scaffold with in vivo potency similar to miltefosine 38 Chatterjee – Lecture at TSRI Oct 29 2014 Triazolothiazoles hit GNF8023 Axenic HTS hit with moderate macrophage activity Unable Unable to measure oral exposure mouse plasma instability Instability arises from cleavage of the methyl ester Series S i h has steep t SAR SAR: Acid compound (GNF5410) is inactive on the parasite, along with small amides ((total of 15 analogs made) Other amines other than piperidine also inactive including azetidines, azetidines pyrrolidines and piperazines Chemistry on hold for this series 39 Chatterjee – Lecture at TSRI Oct 29 2014 GNF8023 GNF5410 Potency Macrophage Infection: 5.5 M Solubility HT-Eq Sol: 119 M Microsomal Stability ER Mouse: 0.97 Cyp Inhibition CYP3A4: 4 M Cytotoxicity Mouse Macrophage: >50 M Mouse Model of Acute Visceral Leishmaniasis L donovani propagation in BALB/c Mouse L. 6 n = 5 animals per group 2 miltefosine doses used (10 mg/kg and 30 mg/kg) p.o. dosing x 5 days (7 through 11 days) liver parasitemia quantified on day 14 (qPCR) 4 Efficacy of miltefosine in BALB/c VL 1.0E+1 2 Liver parasitemia - fold change e Liver para asitemia – fold cha ange tail-vein injection of amastigotes parasitemia quantification in liver by histology and qPCR Acute VL Model Validation 1.0E+0 0 0 7 14 Days Post-infection Post infection 1.0E-1 1.0E-2 1.0E-3 1.0E-4 Vehicle 10 mg/kg 30 mg/kg Treatment Giemsa stain of liver imprints from infected BALB/c mouse on day 14 post-infection. Infected macrophages containing L. donovani amastigotes are indicated with arrows 40 Chatterjee – Lecture at TSRI Oct 29 2014 Results are in agreement with previously published p ED50 for miltefosine against g L. don. data: reported in mice: ∼ 6 mg / kg / day × 5 days) Chagas disease • Disease caused by kinetoplastid Trypanosoma cruzi • Endemic to 18 countries in Central and South America • Prevalence - ~ 200,000 new cases per year - Mortality M t lit estimated ti t d as 50,000 50 000 deaths d th per year • Routes of infection: - 80% of infections attributed to bite of infected insect vector - Blood transfusion - Congenital transmission (4% of babies born to infected mothers) - Orally via contaminated food • Chagas disease natural history - Acute phase: 7-9 days; often passed unnoticed; in 90% cases acute disease resolves spontaneously - Indeterminate phase: ~ 70% patients remain asymptomatic, risk of sudden death due to cardiac abnormalities - Chronic phase: develops 10-30 years after infection in ~ 30% patients; ti t leading l di cause off congestive ti heart h t failure f il in i Latin L ti America; costly treatment • Current therapies - Benznidazole, nifurtimox – nitroheterocycles with side effects (dermatitis diarrhea, (dermatitis, diarrhea nausea, nausea vomiting vomiting, etc etc.)) - Active on acute form of disease (80% cure rate), marginally on chronic form (20% cure rate) 41 Chatterjee – Lecture at TSRI Oct 29 2014 T Trypanosoma cruzii extracellular epimastigotes in insect gut Kissing bug (Triatominae Ti t i ) Transferred T f d by b insect i t feces f deposited near bite wound propagates intracellularly in cytoplasm as amastigote invades many different cell types Parasites are transmitted back to insect during blood meal Cross-Activity of HAT / VL Hits against T. cruzi L. donovani axenic amastigote T. brucei bloodstream form 410 377 93 214 322 175 Active Cmpds L. don. selective 25.8 % T.brucei selective 23.7 % L. don.+T.brucei 5.8 % L.don.+T.cruzi 20.2% T.brucei+T.cruzi 10.1 % Pan-kinetoplastids 13.5 % T t l T. Total T cruzii active ti 44 7% 44.7% L. don. HTS represents a more abundant source of T. cruzi-active compounds d th than T. T brucei b i HTS T. cruzii T 8 day infection assay 42 Chatterjee – Lecture at TSRI Oct 29 2014 Unusually low overlap between L. donovani and T. brucei hits outside of p pan-kinetoplastids p Identification of T. cruzi Amastigote Inhibitors T. cruzi 8 day infection assay (IC50 < 4 M) T. cruzi amastigote proliferation ( (>75% % ((50%) %) inhibition @ 10 M))1 Subset of 574 L. don. / T. brucei – active inhibitors tested f activity for ti it att amastigote ti t proliferation stage1 148 compounds found active (>75% iinhibition) hibiti ) @ 10 M M concentration 409 132 (332) (209) 16 (63) ~90% of amastigote stagespecific ifi iinhibitors hibit were previously identified as T. cruziactive in 8 day assay Significant portion of T. T cruzi cr i – active hits is likely to act at another stage of parasite life cycle 1data obtained and provided by Juan Engel Engel, Sandler Center 43 Chatterjee – Lecture at TSRI Oct 29 2014 T. cruzi Hit-to-lead Chemistry N • Hit-to-lead chemistry started Oct 2010 • All compounds from academic collaboration compound collection at GNF • 8 total scaffolds tested in footpad efficacy model, developed by Rick Tarleton and coworkers k • Several scaffolds show good in vitro potency and oral exposure, however no efficacy in footpad model N H N O GNF5063 GNF2609 Reasonable oral exposure P Poor selectivity l ti it on h hostt cellll Unable to remove chelating 2pyridine Unable to seperate parasite activity ti it from f human h Cyp C Good oral PK 50% reduction in parasitemia in footpad model GNF8308 Poor selectivity on 3T3 host cell Active on human Cyps (< 2 µM) G d orall PK b Good butt no ffootpad t d efficacy ffi 44 Chatterjee – Lecture at TSRI Oct 29 2014 Cl Chagas Mouse Footpad Model, Tarleton lab • Efficacy model run in-house that employs a T. cruzi strain (CL Brener) expressing tandem dimeric tomato red fluorescent protein (tdTomato) p with 2.5 x 105 T. cruzi tdTomato trypomastigotes yp g and • Mice are infected in the hind footpad the fluorescence signal intensity is measured as a surrogate of parasite load. Vehicle N Day 6 post-infection Day 8 postinfection Day D 6 post-infection t i f ti Day D 8 post-infection t i f ti Day 11 postinfection O N NHBn O2N Benznidazole Day D 11 postt infection Fluorescent tdTomato-expressing T. cruzi parasites imaged post-treatment 45 Chatterjee – Lecture at TSRI Oct 29 2014 Summary / Lessons Learned • Molecular weights greatly effect the cellular optimization – Forces the chemistry to be very atom economical (high ligand efficiencies) • SAR can be challenging, g g, but g getting g hits from HTS with g good SAR is critical – Better to have SAR than absolute potencies off the deck – Potencies can be optimized relatively quickly compared to other parameters • • • • • Weekly cytotoxicity, protein binding shift potency, and cross-resistance data to other scaffold lab-evolved resistance strains really allows for better optimization of other parameters MoA studies in parallel with optimization St t with Start ith a simple i l target t t profile fil (e.g. ( blood-stage bl d t antimalarial, ti l i l th then address dd liver-stages, transmission, etc) Use extensive anti-target screening that has been developed over the last decade due to focus on target-based target based drug discovery Academic collaborations have been very useful in using new assays for medicinal chemistry optimization 46 Chatterjee – Lecture at TSRI Oct 29 2014 Acknowledgements (Kinetoplastids) 47 Chatterjee – Lecture at TSRI Oct 29 2014 Acknowledgements (Malaria Research) Chemistry • Advait Nagle • Tao Wu • Tomoyo Sakata • Robert R b tM Moreau • Jason Roland • Pranab Mishra • David Tully • Valentina Molteni Biology • Kelli Kuhen • Carolyn Francek • Zhong Zh Ch Chen • Kerstin Henson • Rachel Borboa • James Gilligan • Tae Tae-gyu gyu Nam • Neekesh Dharia • David Plouffe • Case McNamara • Stefan Meister • Elizabeth Winzeler 48 Chatterjee – Lecture at TSRI Oct 29 2014 Pharmacology/Analytical • Tove Tuntland • Perry Gordon • Jonathan Chang • Matthew Zimmerman • Liang Wang • Todd Groessl • Barbara Saechao • Bo Liu • Chun Li • David Jones • Wendy Richmond • Kevin Johnson • Tom Hollenbeck • Lucas Westling • Michael Kwok • Tiffany Chuan • John Isbell Swiss Tropical and Public Health Institute • Matthias Rottmann • Christoph Fischli • Sonja Maerki Informatics • John Che • Yingyao Zhou GNF Management • Jennifer Taylor • Richard Ri h d Glynne Gl • Martin Seidel • Peter Schultz NITD • Bryan Yeung • Zou Bin • Anne Goh • Suresh B. Lakshminarayana • Veronique Dartois • Thomas Keller • Thierry Thi Di Diagana External collaborators • Montip Gettayacamin (AFRIMS - Bangkok) • Robert Sauerwein (NCMLS - The Netherlands) • Ian Bathhurst (MMV) Acknowledgements (Malaria - Development) Core team Margaret Weaver Xingmei Han Giancarlo Gi l Francese F Sreehari Babu Rita Ramos Karen Beltz Bo Han Wen Shieh Markus Baenziger Novartis Tropical Medicines Heiner Grueninger Anne-Claire Marrast Paul Aliu Gilbert Lefevre 49 Chatterjee – Lecture at TSRI Oct 29 2014 Clinical team Jens Praestgaard, Praestgaard Ruobing Li External support and advice Marcel Tanner, Swiss Tropical Institute Nick White, Oxford University