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Hummel JR, Xiao KJ, Yang JC, Epling LB, Mukai K, Ye Q, Xu M, Qian D, Huo L, Weber M, Roman V, Lo Y, Drake K, Stump K, Covington M, Kapilashrami K, Zhang G, Ye M, Diamond S, Yeleswaram S, Macarron R, Deller MC, Wee S, Kim S, Wang X, Wu L, Yao W. Discovery of (4-Pyrazolyl)-2-aminopyrimidines as Potent and Selective Inhibitors of Cyclin-Dependent Kinase 2. J Med Chem 2024; 67:3112-3126. [PMID: 38325398 DOI: 10.1021/acs.jmedchem.3c02287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
CDK2 is a critical regulator of the cell cycle. For a variety of human cancers, the dysregulation of CDK2/cyclin E1 can lead to tumor growth and proliferation. Historically, early efforts to develop CDK2 inhibitors with clinical applications proved unsuccessful due to challenges in achieving selectivity over off-target CDK isoforms with associated toxicity. In this report, we describe the discovery of (4-pyrazolyl)-2-aminopyrimidines as a potent class of CDK2 inhibitors that display selectivity over CDKs 1, 4, 6, 7, and 9. SAR studies led to the identification of compound 17, a kinase selective and highly potent CDK2 inhibitor (IC50 = 0.29 nM). The evaluation of 17 in CCNE1-amplified mouse models shows the pharmacodynamic inhibition of CDK2, measured by reduced Rb phosphorylation, and antitumor activity.
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Affiliation(s)
- Joshua R Hummel
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Kai-Jiong Xiao
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Jeffrey C Yang
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Leslie B Epling
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Ken Mukai
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Qinda Ye
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Meizhong Xu
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Dingquan Qian
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Lu Huo
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Michael Weber
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Valerie Roman
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Yvonne Lo
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Katherine Drake
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Kristine Stump
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Maryanne Covington
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Kanishk Kapilashrami
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Guofeng Zhang
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Min Ye
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Sharon Diamond
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Swamy Yeleswaram
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Ricardo Macarron
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Marc C Deller
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Susan Wee
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Sunkyu Kim
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Xiaozhao Wang
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Liangxing Wu
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Wenqing Yao
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
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2
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Ye Q, Liu K, Ye HF, Pan J, Sokolsky A, Wang A, Zhang K, Hummel JR, Kong L, Behshad E, He X, Conlen P, Stump K, Ye M, Diamond S, Covington M, Yeleswaram S, Atasoylu O, Vechorkin O, Yao W. Discovery of Pyrazolopyridine Derivatives as HPK1 Inhibitors. ACS Med Chem Lett 2023; 14:5-10. [PMID: 36655125 PMCID: PMC9841581 DOI: 10.1021/acsmedchemlett.2c00238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022] Open
Abstract
In spite of the great success of immune checkpoint inhibitors in immune-oncology therapy, an urgent need still exists to identify alternative approaches to broaden the scope of therapeutic coverage. Hematopoietic progenitor kinase 1 (HPK1), also known as MAP4K1, functions as a negative regulator of activation signals generated by the T cell antigen receptor. Herein we report the discovery of novel pyrazolopyridine derivatives as selective inhibitors of HPK1. The structure-activity relationship campaign led to the discovery of compound 16, which has shown promising enzymatic and cellular potency with encouraging kinome selectivity. The outstanding pharmacokinetic profiles of 16 in rats and monkeys supported further evaluations of its efficacy and safety in preclinical models.
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Affiliation(s)
- Qinda Ye
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Kai Liu
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Hai-Fen Ye
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Jun Pan
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Alexander Sokolsky
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Anlai Wang
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Ke Zhang
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Joshua R. Hummel
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Ling Kong
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Elham Behshad
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Xin He
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Patricia Conlen
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Kristine Stump
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Min Ye
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Sharon Diamond
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Maryanne Covington
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Swamy Yeleswaram
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Onur Atasoylu
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Oleg Vechorkin
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Wenqing Yao
- Incyte Research Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
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3
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Sokolsky A, Vechorkin O, Hummel JR, Styduhar ED, Wang A, Nguyen MH, Ye HF, Liu K, Zhang K, Pan J, Ye Q, Atasoylu O, Behshad E, He X, Conlen P, Stump K, Ye M, Diamond S, Covington M, Yeleswaram S, Yao W. Potent and Selective Biaryl Amide Inhibitors of Hematopoietic Progenitor Kinase 1 (HPK1). ACS Med Chem Lett 2023; 14:116-122. [PMID: 36655134 PMCID: PMC9841582 DOI: 10.1021/acsmedchemlett.2c00241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 12/07/2022] [Indexed: 12/15/2022] Open
Abstract
Herein we report the discovery of a novel biaryl amide series as selective inhibitors of hematopoietic protein kinase 1 (HPK1). Structure-activity relationship development, aided by molecular modeling, identified indazole 5b as a core for further exploration because of its outstanding enzymatic and cellular potency coupled with encouraging kinome selectivity. Late-stage manipulation of the right-hand aryl and amine moieties surmounted issues of selectivity over TRKA, MAP4K2, and STK4 as well as generating compounds with balanced in vitro ADME profiles and promising pharmacokinetics.
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Affiliation(s)
- Alexander Sokolsky
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Oleg Vechorkin
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Joshua R. Hummel
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Evan D. Styduhar
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Anlai Wang
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Minh H. Nguyen
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Hai Fen Ye
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Kai Liu
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Ke Zhang
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Jun Pan
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Qinda Ye
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Onur Atasoylu
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Elham Behshad
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Xin He
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Patricia Conlen
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Kristine Stump
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Min Ye
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Sharon Diamond
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Maryanne Covington
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Swamy Yeleswaram
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
| | - Wenqing Yao
- Incyte Research
Institute, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United
States
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4
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Chen X, Xun Z, Yuska B, McGee R, Yeleswaram S. Itacitinib Population Pharmacokinetics and Exposure-Response in Patients With Acute Graft-Versus-Host Disease. J Clin Pharmacol 2023; 63:622-632. [PMID: 36601737 DOI: 10.1002/jcph.2202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023]
Abstract
This article presents the population pharmacokinetic (PopPK) analysis and exposure-response analyses for the primary efficacy end point-acute graft-versus-host disease (aGVHD) day 28 response-and select safety measures (incidence of thrombocytopenia, hypertriglyceridemia, and cytomegalovirus infection) from a phase 3 randomized, double-blind study comparing itacitinib plus corticosteroids versus placebo plus corticosteroids for the treatment of aGVHD. The PopPK data set contained sparse data from patients with aGVHD and select enriched data from healthy volunteers. The structural model was a 2-compartment model with first-order elimination and dose-dependent nonlinear absorption with dual first-order absorption pathways with lag times. Strong cytochrome P450 (CYP) 3A inhibitor coadministration, moderate renal impairment, and participant population (healthy volunteers vs patients with aGVHD) were covariates on apparent clearance. Participant population was also a covariate on apparent intercompartmental clearance and lag time of the secondary absorption compartment. Apparent clearance decreased 42% with coadministration of strong CYP3A inhibitors. Simulations supported the following dose reductions with concomitant use of a strong CYP3A inhibitor: 300 mg once daily to 200 mg once daily, 400 mg once daily to 300 mg once daily, and 600 mg once daily to 400 mg once daily. No dose adjustment is recommended for any other covariate based on the magnitude of impact when they were retained in the model. The exposure-response relationship was characterized between itacitinib exposure and probability of aGVHD day 28 response using a linear logistic regression model. Both itacitinib exposure and aGVHD risk status were significant predictors of response. There was no relationship between itacitinib exposure and thrombocytopenia, hypertriglyceridemia, or cytomegalovirus infection.
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5
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Sokolsky A, Winterton S, Kennedy K, Drake K, Stump K, Huo L, Lo Y, Ye M, Covington M, Diamond S, Yang YO, Kim S, Yeleswaram S, Wu L, Yao W. Discovery of 5,7-Dihydro-6 H-pyrrolo[2,3- d]pyrimidin-6-ones as Highly Selective CDK2 Inhibitors. ACS Med Chem Lett 2022; 13:1797-1804. [PMID: 36385925 PMCID: PMC9661707 DOI: 10.1021/acsmedchemlett.2c00408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/03/2022] [Indexed: 11/30/2022] Open
Abstract
A series of exceptionally selective CDK2 inhibitors are described. Starting from an HTS hit, we successfully scaffold hopped to a 5,7-dihydro-6H-pyrrolo[2,3-d]pyrimidin-6-one core structure, which imparted a promising initial selectivity within the CDK family. Extensive further SAR identified additional factors that drove selectivity to above 200× for CDKs 1/4/6/7/9. General kinome selectivity was also greatly improved. Finally, use of in vivo metabolite identification allowed us to pinpoint sulfonamide dealkylation as the primary metabolite, which was ameliorated through the deuterium effect.
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Affiliation(s)
- Alexander Sokolsky
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
| | - Sarah Winterton
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
| | - Keith Kennedy
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
| | - Katherine Drake
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
| | - Kristine Stump
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
| | - Lu Huo
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
| | - Yvonne Lo
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
| | - Min Ye
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
| | - Maryanne Covington
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
| | - Sharon Diamond
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
| | - Yan-ou Yang
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
| | - Sunkyu Kim
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
| | - Swamy Yeleswaram
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
| | - Liangxing Wu
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
| | - Wenqing Yao
- Incyte
Research Institute, Incyte Corporation, 1801 Augustine Cut-off, Wilmington, Delaware 19803, United States
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6
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Zhang C, Xu M, He C, Zhuo J, Burns DM, Qian DQ, Lin Q, Li YL, Chen L, Shi E, Agrios C, Weng L, Sharief V, Jalluri R, Li Y, Scherle P, Diamond S, Hunter D, Covington M, Marando C, Wynn R, Katiyar K, Contel N, Vaddi K, Yeleswaram S, Hollis G, Huber R, Friedman S, Metcalf B, Yao W. Discovery of 1'-(1-phenylcyclopropane-carbonyl)-3H-spiro[isobenzofuran-1,3'-pyrrolidin]-3-one as a novel steroid mimetic scaffold for the potent and tissue-specific inhibition of 11β-HSD1 using a scaffold-hopping approach. Bioorg Med Chem Lett 2022; 69:128782. [PMID: 35537608 DOI: 10.1016/j.bmcl.2022.128782] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/19/2022] [Accepted: 05/02/2022] [Indexed: 11/15/2022]
Abstract
11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) has been identified as the primary enzyme responsible for the activation of hepatic cortisone to cortisol in specific peripheral tissues resulting in the concomitant antagonism of insulin action within these tissues. Dysregulation of 11β-HSD1, particularly in adipose tissues, has been associated with metabolic syndrome and type 2 diabetes mellitus. Therefore, inhibition of 11β-HSD1 with a small nonsteroidal molecule is therapeutically desirable. Implementation of a scaffold-hopping approach revealed a three-point pharmacophore for 11β-HSD1 that was utilized to design a steroid mimetic scaffold. Reiterative optimization provided valuable insight into the bioactive conformation of our novel scaffold and led to the discovery of INCB13739. Clinical evaluation of INCB13739 confirmed for the first time that tissue-specific inhibition of 11β-HSD1 in patients with type 2 diabetes mellitus was efficacious in controlling glucose levels and reducing cardiovascular risk factors.
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Affiliation(s)
- Colin Zhang
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Meizhong Xu
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Chunhong He
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Jincong Zhuo
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - David M Burns
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Ding-Quan Qian
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Qiyan Lin
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Yun-Long Li
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Lihua Chen
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Eric Shi
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Costas Agrios
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Linkai Weng
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Vaqar Sharief
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Ravi Jalluri
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Yanlong Li
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Peggy Scherle
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Sharon Diamond
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Deborah Hunter
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Maryanne Covington
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Cindy Marando
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Richard Wynn
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Kamna Katiyar
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Nancy Contel
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Kris Vaddi
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Swamy Yeleswaram
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Gregory Hollis
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Reid Huber
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Steve Friedman
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Brian Metcalf
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | - Wenqing Yao
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA.
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7
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Burns DM, He C, Li YL, Zhuo J, Qian DQ, Chen L, Jalluri R, Diamond S, Covington MB, Li Y, Wynn R, Scherle P, Yeleswaram S, Hollis G, Friedman S, Metcalf B, Yao W. Discovery of a novel 2-spiroproline steroid mimetic scaffold for the potent inhibition of 11β-HSD1. Bioorg Med Chem Lett 2022; 73:128884. [PMID: 35835377 DOI: 10.1016/j.bmcl.2022.128884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 07/01/2022] [Accepted: 07/05/2022] [Indexed: 11/30/2022]
Abstract
11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) has been identified as the primary enzyme responsible for the activation of hepatic cortisone to cortisol in specific peripheral tissues, resulting in the concomitant antagonism of insulin action within these tissues. Dysregulation of 11β-HSD1, particularly in adipose tissues, has been associated with a variety of ailments including metabolic syndrome and type 2 diabetes mellitus. Therefore, inhibition of 11β-HSD1 with a small nonsteroidal molecule is therapeutically desirable. Implementation of a scaffold-hopping approach revealed a 3-point pharmacophore for 11β-HSD1 that was utilized to design a 2-spiroproline derivative as a steroid mimetic scaffold. Reiterative optimization provided valuable insight into the bioactive conformation of our novel scaffold and led to the discovery of several leads, such as compounds 39 and 51. Importantly, deleterious hERG inhibition and pregnane X receptor induction were mitigated by the introduction of a 4-hydroxyl group to the proline ring system.
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Affiliation(s)
- David M Burns
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA.
| | - Chunhong He
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | | | - Jincong Zhuo
- Prelude Therapeutics, 200 Powder Mill Road, Wilmington, DE 19803, USA
| | - Ding-Quan Qian
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | | | | | - Sharon Diamond
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | | | - Yanlong Li
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
| | | | - Peggy Scherle
- Prelude Therapeutics, 200 Powder Mill Road, Wilmington, DE 19803, USA
| | - Swamy Yeleswaram
- Incyte Research Institute, 1801 Augustine Cut-off, Wilmington, DE 19880, USA
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8
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Ji T, Chen X, Yeleswaram S. Evaluation of drug–drug interaction potential for pemigatinib using physiologically based pharmacokinetic modeling. CPT Pharmacometrics Syst Pharmacol 2022; 11:894-905. [PMID: 35506332 PMCID: PMC9286713 DOI: 10.1002/psp4.12805] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 11/13/2022] Open
Abstract
Pemigatinib is a potent inhibitor of fibroblast growth factor receptor being developed for oncology indications. It is primarily metabolized by cytochrome P450 (CYP) 3A4, and the ratio of estimated concentration over concentration required for 50% inhibition ratio for pemigatinib as an inhibitor of P‐glycoprotein (P‐gp), organic cation transporter‐2 (OCT2), and multidrug and toxin extrusion protein‐1 (MATE1) exceeds the cutoff values established in regulatory guidance. A Simcyp minimal physiologically based pharmacokinetic (PBPK) with advanced dissolution, absorption, and metabolism absorption model for pemigatinib was developed and validated using observed clinical pharmacokinetic (PK) data and itraconazole/rifampin drug–drug interaction (DDI) data. The model accurately predicted itraconazole DDI (approximate 90% area under the plasma drug concentration–time curve [AUC] and approximate 20% maximum plasma drug concentration [Cmax] increase). The model underpredicted rifampin induction by 100% (approximate 6.7‐fold decrease in AUC and approximate 2.6‐fold decrease in Cmax in the DDI study), presumably reflecting non‐CYP3A4 mechanisms being impacted. The verified PBPK model was then used to predict the effect of other CYP3A4 inhibitors/inducers on pemigatinib PK and pemigatinib as an inhibitor of P‐gp or OCT2/MATE1 substrates. The worst‐case scenario DDI simulation for pemigatinib as an inhibitor of P‐gp or OCT2/MATE1 substrates showed only a modest DDI effect. The recommendation based on this simulation and clinical data is to reduce pemigatinib dose for coadministration with strong and moderate CYP3A4 inhibitors. No dose adjustment is required for weak CYP3A4 inhibitors. The coadministration of strong and moderate CYP3A4 inducers with pemigatinib should be avoided. PBPK modeling suggested no dose adjustment with P‐gp or OCT2/MATE1 substrates.
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Affiliation(s)
- Tao Ji
- Incyte Research Institute Wilmington Delaware USA
| | - Xuejun Chen
- Incyte Research Institute Wilmington Delaware USA
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Nguyen MH, Atasoylu O, Wu L, Kapilashrami K, Pusey M, Gallagher K, Lai CT, Zhao P, Barbosa J, Liu K, He C, Zhang C, Styduhar ED, Witten MR, Chen Y, Lin L, Yang YO, Covington M, Diamond S, Yeleswaram S, Yao W. Discovery of Novel Pyrazolopyrimidines as Potent, Selective, and Orally Bioavailable Inhibitors of ALK2. ACS Med Chem Lett 2022; 13:1159-1164. [DOI: 10.1021/acsmedchemlett.2c00206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Minh H. Nguyen
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Onur Atasoylu
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Liangxing Wu
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Kanishk Kapilashrami
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Michelle Pusey
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Karen Gallagher
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Cheng-Tsung Lai
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Peng Zhao
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Joseph Barbosa
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Kai Liu
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Chunhong He
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Colin Zhang
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Evan D. Styduhar
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Michael R. Witten
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Yaoyu Chen
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Luping Lin
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Yan-ou Yang
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Maryanne Covington
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Sharon Diamond
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Swamy Yeleswaram
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Wenqing Yao
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
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Koblish HK, Wu L, Wang LCS, Liu PC, Wynn R, Rios-Doria J, Spitz S, Liu H, Volgina A, Zolotarjova N, Kapilashrami K, Behshad E, Covington M, Yang YO, Li J, Diamond S, Soloviev M, O'Hayer K, Rubin S, Kanellopoulou C, Yang G, Rupar M, DiMatteo D, Lin L, Stevens C, Zhang Y, Thekkat P, Geschwindt R, Marando C, Yeleswaram S, Jackson J, Scherle P, Huber R, Yao W, Hollis G. Characterization of INCB086550: A Potent and Novel Small-Molecule PD-L1 Inhibitor. Cancer Discov 2022; 12:1482-1499. [PMID: 35254416 PMCID: PMC9394386 DOI: 10.1158/2159-8290.cd-21-1156] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/22/2021] [Accepted: 02/28/2022] [Indexed: 01/07/2023]
Abstract
Blocking the activity of the programmed cell death protein 1 (PD-1) inhibitory receptor with therapeutic antibodies against either the ligand (PD-L1) or PD-1 itself has proven to be an effective treatment modality for multiple cancers. Contrasting with antibodies, small molecules could demonstrate increased tissue penetration, distinct pharmacology, and potentially enhanced antitumor activity. Here, we describe the identification and characterization of INCB086550, a novel, oral, small-molecule PD-L1 inhibitor. In vitro, INCB086550 selectively and potently blocked the PD-L1/PD-1 interaction, induced PD-L1 dimerization and internalization, and induced stimulation-dependent cytokine production in primary human immune cells. In vivo, INCB086550 reduced tumor growth in CD34+ humanized mice and induced T-cell activation gene signatures, consistent with PD-L1/PD-1 pathway blockade. Preliminary data from an ongoing phase I study confirmed PD-L1/PD-1 blockade in peripheral blood cells, with increased immune activation and tumor growth control. These data support continued clinical evaluation of INCB086550 as an alternative to antibody-based therapies. SIGNIFICANCE We have identified a potent small-molecule inhibitor of PD-L1, INCB086550, which has biological properties similar to PD-L1/PD-1 monoclonal antibodies and may represent an alternative to antibody therapy. Preliminary clinical data in patients demonstrated increased immune activation and tumor growth control, which support continued clinical evaluation of this approach. See related commentary by Capparelli and Aplin, p. 1413. This article is highlighted in the In This Issue feature, p. 1397.
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Affiliation(s)
| | | | | | | | | | - Jonathan Rios-Doria
- Incyte Research Institute, Wilmington, DE
- Corresponding Author: Jonathan Rios-Doria, Incyte Corporation, 1801 Augustine Cut Off, Wilmington, DE 19803. Phone: 302-498-6914; E-mail:
| | | | - Hao Liu
- Incyte Research Institute, Wilmington, DE
| | | | | | | | | | | | | | - Jingwei Li
- Incyte Research Institute, Wilmington, DE
| | | | | | | | | | | | | | - Mark Rupar
- Incyte Research Institute, Wilmington, DE
| | | | - Luping Lin
- Incyte Research Institute, Wilmington, DE
| | | | - Yue Zhang
- Incyte Research Institute, Wilmington, DE
| | | | | | | | | | | | | | - Reid Huber
- Incyte Research Institute, Wilmington, DE
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Bissonnette R, Call RS, Raoof T, Zhu Z, Yeleswaram S, Gong X, Lee M. A Maximum-Use Trial of Ruxolitinib Cream in Adolescents and Adults with Atopic Dermatitis. Am J Clin Dermatol 2022; 23:355-364. [PMID: 35368221 PMCID: PMC9142470 DOI: 10.1007/s40257-022-00690-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/22/2022] [Indexed: 01/29/2023]
Abstract
BACKGROUND Ruxolitinib cream is a topical formulation of ruxolitinib, an inhibitor of Janus kinase 1 and Janus kinase 2. OBJECTIVE We aimed to determine the safety, tolerability, and bioavailability of 1.5% ruxolitinib cream under maximum-use conditions in patients with atopic dermatitis. Efficacy was evaluated as an exploratory objective. METHODS Eligible patients aged ≥ 12-65 years with atopic dermatitis, an Investigator's Global Assessment score ≥ 2, and ≥ 25% affected body surface area were enrolled in an open-label, maximum-use phase I study conducted in the USA and Canada. Patients applied 1.5% ruxolitinib cream twice daily to lesions identified at baseline for the first 28 days and continued use only on active lesions for an additional 28 days (extension period). Safety was assessed by frequency, duration, and severity of treatment-emergent adverse events. Plasma concentrations of ruxolitinib and pharmacokinetic parameters were assessed as secondary endpoints. RESULTS Overall, 41 patients (median age, 17 years; 51% male) were enrolled and 37 (90.2%) entered the extension period, all of whom completed the study. Treatment-emergent adverse events were reported in 13 patients (31.7%). Treatment-related adverse events were reported in four patients (9.8%). The mean (standard deviation) steady-state plasma concentration was 104 (309) nM during the first 28 days, well below the half-maximal inhibitory concentration of Janus kinase-mediated myelosuppression in the bone marrow (281 nM), and decreased further during the extension period. Higher plasma concentrations were detected in a few patients who were treated for a very high affected body surface area. At day 56, 94.6% of patients achieved ≥ 75% improvement in the Eczema Area and Severity Index. CONCLUSIONS Under maximum-use conditions, ruxolitinib cream was generally well tolerated, with approximately one-third of patients experiencing treatment-emergent adverse events and few treatment-related adverse events. The mean steady-state plasma concentration of ruxolitinib was well below the level expected to affect bone marrow production of blood cells, with a small number of patients exhibiting higher plasma concentrations. In addition, ruxolitinib cream showed a high level of efficacy in patients with atopic dermatitis involving ≥ 25% affected body surface area. CLINICALTRIALS GOV IDENTIFIER NCT03920852.
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Affiliation(s)
- Robert Bissonnette
- Innovaderm Research, 3530 Saint-Laurent Boulevard, Ste 300, Montreal, QC, H2X 2V1, Canada.
| | | | | | | | | | | | - Mark Lee
- Progressive Clinical Research, San Antonio, TX, USA
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Ji T, Chen X, Liu X, Yeleswaram S. Population Pharmacokinetics Analysis of Pemigatinib in Patients With Advanced Malignancies. Clin Pharmacol Drug Dev 2022; 11:454-466. [PMID: 35092702 PMCID: PMC9306536 DOI: 10.1002/cpdd.1038] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/19/2021] [Indexed: 01/16/2023]
Abstract
Pemigatinib is a fibroblast growth factor receptor 1–3 inhibitor used to treat cholangiocarcinoma. A compartmental population pharmacokinetics model was developed using data from 318 patients with cancer enrolled in a phase 1 dose‐escalation/dose‐expansion study, a phase 1 Japanese PK bridging study, and a phase 2 cholangiocarcinoma study. The final model for pemigatinib was a 2‐compartment disposition model with first‐order absorption and linear elimination. All fixed‐ and random‐effect parameters were estimated with good precision, and no apparent biases in the overall model fit were observed. For females, the estimated typical pemigatinib absorption rate constant (ka) and oral clearance (CL/F) were estimated (1.49 L/h and 10.3 L/h, respectively). For males, the typical apparent clearance and ka are 19.0% higher and 56.5% lower, respectively, compared with females. Typical apparent volume of distribution of the central compartment (Vc/F) and peripheral compartment for a 73.3‐kg patient was estimated to be 122.0 L and 80.1 L, respectively; both increased with body weight. Phosphate binder coadministration decreases typical pemigatinib CL/F by 14.1%. Proton pump inhibitor coadministration increases typical pemigatinib apparent Vc/F by 24.4%. Phosphate binders and sex contribute a <20% change to CL/F. The impact of the investigated covariates on pemigatinib pharmacokinetics are not clinically significant.
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Affiliation(s)
- Tao Ji
- Incyte Research Institute Wilmington Delaware USA
| | - Xuejun Chen
- Incyte Research Institute Wilmington Delaware USA
| | - Xiang Liu
- Incyte Research Institute Wilmington Delaware USA
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Gong X, Ji T, Liu X, Chen X, Yeleswaram S. Evaluation of the clinical cardiac safety of pemigatinib, a fibroblast growth factor receptor inhibitor, in participants with advanced malignancies. Pharmacol Res Perspect 2021; 10:e00906. [PMID: 34951522 PMCID: PMC8929369 DOI: 10.1002/prp2.906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/27/2021] [Indexed: 11/14/2022] Open
Abstract
Pemigatinib is a potent inhibitor of the fibroblast growth factor receptor (FGFR) family of receptors that is approved for the treatment of cholangiocarcinoma with FGFR2 fusion or other rearrangements. Data from a first‐in‐human clinical study were used to assess the potential for pemigatinib to produce clinically significant effects on heart rate (HR) and cardiac repolarization (QTc). A central tendency analysis for electrocardiogram (ECG) outliers and a plasma concentration‐QTc analysis were conducted to assess cardiac safety in the first‐in‐human pemigatinib study (FIGHT‐101; NCT02393248). The study included 113 participants who received at least one dose of pemigatinib as monotherapy and had at least one pair of plasma pharmacokinetic (PK) and ECG data points collected. Timed 12‐lead ECGs were performed within 15 min of PK blood draws. The ECG parameters for each dose group in the study varied within expectations for patients with advanced malignancies. Categorical analysis of QT interval corrected for HR by Fridericia's method did not reveal dose dependence in the incidence of outliers, and the results of the central tendency and concentration‐QTc analyses did not suggest a dose‐ or concentration‐dependent drug effect. Least squares mean change from baseline in HR was small and did not indicate a clinically relevant effect on HR, and no effect was observed on cardiac conduction as assessed by PR and QRS intervals. In conclusion, pemigatinib does not exhibit any clinically significant prolongation of QTc or dose‐dependent changes in HR. Clinical trial registration: ClinicalTrials.gov NCT02393248.
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Affiliation(s)
- Xiaohua Gong
- Incyte Research Institute, Incyte Corporation, Wilmington, Delaware, USA
| | - Tao Ji
- Incyte Research Institute, Incyte Corporation, Wilmington, Delaware, USA
| | - Xiang Liu
- Incyte Research Institute, Incyte Corporation, Wilmington, Delaware, USA
| | - Xuejun Chen
- Incyte Research Institute, Incyte Corporation, Wilmington, Delaware, USA
| | - Swamy Yeleswaram
- Incyte Research Institute, Incyte Corporation, Wilmington, Delaware, USA
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Ji T, Rockich K, Epstein N, Overholt H, Wang P, Chen X, Punwani N, Yeleswaram S. Correction to: Evaluation of drug‑drug interactions of pemigatinib in healthy participants. Eur J Clin Pharmacol 2021; 77:1899. [PMID: 34436632 DOI: 10.1007/s00228-021-03198-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Tao Ji
- Incyte Research Institute, 1801 Augustine Cut‑off, Wilmington, DE, 19803, USA.
| | - Kevin Rockich
- Incyte Research Institute, 1801 Augustine Cut‑off, Wilmington, DE, 19803, USA
| | - Noam Epstein
- Incyte Research Institute, 1801 Augustine Cut‑off, Wilmington, DE, 19803, USA.,GlaxoSmithKline, Collegeville, Philadelphia, PA, USA
| | - Heather Overholt
- Incyte Research Institute, 1801 Augustine Cut‑off, Wilmington, DE, 19803, USA
| | - Phillip Wang
- Incyte Research Institute, 1801 Augustine Cut‑off, Wilmington, DE, 19803, USA
| | - Xuejun Chen
- Incyte Research Institute, 1801 Augustine Cut‑off, Wilmington, DE, 19803, USA
| | - Naresh Punwani
- Incyte Research Institute, 1801 Augustine Cut‑off, Wilmington, DE, 19803, USA
| | - Swamy Yeleswaram
- Incyte Research Institute, 1801 Augustine Cut‑off, Wilmington, DE, 19803, USA
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Wu L, Zhang C, He C, Qian D, Lu L, Sun Y, Xu M, Zhuo J, Liu PCC, Klabe R, Wynn R, Covington M, Gallagher K, Leffet L, Bowman K, Diamond S, Koblish H, Zhang Y, Soloviev M, Hollis G, Burn TC, Scherle P, Yeleswaram S, Huber R, Yao W. Discovery of Pemigatinib: A Potent and Selective Fibroblast Growth Factor Receptor (FGFR) Inhibitor. J Med Chem 2021; 64:10666-10679. [PMID: 34269576 DOI: 10.1021/acs.jmedchem.1c00713] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Aberrant activation of FGFR has been linked to the pathogenesis of many tumor types. Selective inhibition of FGFR has emerged as a promising approach for cancer treatment. Herein, we describe the discovery of compound 38 (INCB054828, pemigatinib), a highly potent and selective inhibitor of FGFR1, FGFR2, and FGFR3 with excellent physiochemical properties and pharmacokinetic profiles. Pemigatinib has received accelerated approval from the U.S. Food and Drug Administration for the treatment of adults with previously treated, unresectable locally advanced or metastatic cholangiocarcinoma with a FGFR2 fusion or other rearrangement. Additional clinical trials are ongoing to evaluate pemigatinib in patients with FGFR alterations.
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Affiliation(s)
- Liangxing Wu
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Colin Zhang
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Chunhong He
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Dingquan Qian
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Liang Lu
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Yaping Sun
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Meizhong Xu
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Jincong Zhuo
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Phillip C C Liu
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Ronald Klabe
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Richard Wynn
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Maryanne Covington
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Karen Gallagher
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Lynn Leffet
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Kevin Bowman
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Sharon Diamond
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Holly Koblish
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Yue Zhang
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Maxim Soloviev
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Gregory Hollis
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Timothy C Burn
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Peggy Scherle
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Swamy Yeleswaram
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Reid Huber
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Wenqing Yao
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
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16
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Gong X, Chen X, Kuligowski ME, Liu X, Liu X, Cimino E, McGee R, Yeleswaram S. Pharmacokinetics of Ruxolitinib in Patients with Atopic Dermatitis Treated With Ruxolitinib Cream: Data from Phase II and III Studies. Am J Clin Dermatol 2021; 22:555-566. [PMID: 33982267 PMCID: PMC8200345 DOI: 10.1007/s40257-021-00610-x] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Pathogenesis of atopic dermatitis (AD) involves the Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway. A cream formulation of ruxolitinib, a potent selective JAK1/JAK2 inhibitor, was developed for topical delivery. METHOD Pharmacokinetic data were obtained from three double-blind, vehicle-controlled studies in patients with AD: a phase II study with ruxolitinib cream 0.15%, 0.5%, or 1.5% once daily or 1.5% twice daily (BID), and two phase III studies with 0.75% or 1.5% BID. Effects of baseline characteristics on pharmacokinetics were examined. Correlations were attempted between plasma concentrations and change in hematological parameters over time. RESULTS Ruxolitinib plasma concentrations at steady-state (Css) increased with cream strength in a less-than-dose-proportional manner. In the phase III studies, overall mean (standard deviation [SD]) Css after ruxolitinib cream 0.75% and 1.5% BID (23.8 [35.0] and 35.7 [55.0] nM) were a fraction of the half-maximal inhibitory concentration for thrombopoietin-stimulated phosphorylated STAT3 inhibition (281 nM), a JAK/STAT signaling marker. Three covariates were identified for Css: dose, percent body surface area (%BSA) treated, and baseline Investigator's Global Assessment score. Mean (SD) bioavailability of ruxolitinib cream 1.5% BID was 6.22% (7.66%). There were no correlations between Css and any hematological changes except for a transient increase in platelets at week 2. CONCLUSIONS Plasma ruxolitinib concentrations after treatment with topical ruxolitinib cream in patients with up to 20% BSA affected by AD are not expected to lead to systemic plasma concentrations that may be associated with adverse effects commonly associated with oral JAK inhibitors. CLINICALTRIALS.GOV: NCT03011892; NCT03745638; NCT03745651.
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Affiliation(s)
| | | | | | - Xing Liu
- Incyte Corporation, Wilmington, DE, USA
| | - Xiang Liu
- Incyte Corporation, Wilmington, DE, USA
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Ji T, Rockich K, Epstein N, Overholt H, Wang P, Chen X, Punwani N, Yeleswaram S. Evaluation of the pharmacokinetics of pemigatinib in patients with impaired hepatic or renal function. Br J Clin Pharmacol 2021; 88:237-247. [PMID: 34169560 DOI: 10.1111/bcp.14954] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/02/2021] [Accepted: 06/06/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS Pemigatinib, an inhibitor of the fibroblast growth factor receptor (FGFR) family of receptor tyrosine kinases, is approved for previously treated, unresectable locally advanced or metastatic cholangiocarcinoma. Pemigatinib is predominantly metabolized by CYP3A4 with minimal renal elimination. METHODS Separate hepatic and renal impairment studies were conducted to evaluate the effect of these impairments on pemigatinib pharmacokinetics (PK). Each study was of open-label, parallel-group design, conducted in participants with normal organ function and with hepatic or renal impairment. Plasma concentrations of pemigatinib were quantified by liquid chromatography tandem mass spectrometry (LC-MS/MS) and pemigatinib PK parameters were derived by noncompartmental analysis. Geometric mean ratios and two-sided 90% confidence intervals of Cmax , AUC0-t , and AUC0-∞ were compared by analysis of variance (ANOVA). RESULTS Compared with healthy matched participants: Cmax and AUC0-∞ ratio (90% confidence interval) in participants with moderate hepatic impairment were 96.7% (59.4%, 157%) and 146% (100%, 212%), respectively; Cmax and AUC0-∞ ratio in participants with severe hepatic impairment were 94.2% (68.9%, 129%) and 174% (116%, 261%), respectively; Cmax and AUC0-∞ ratio in participants with severe renal impairment were 64.6% (44.1%, 94.4%) and 159% (95.4%, 264%), respectively; Cmax and AUC0-∞ ratio in participants with end-stage renal disease (ESRD) before haemodialysis (HD) were 77.5% (51.2%, 118%) and 76.8% (54.0%, 109%), respectively; Cmax and AUC0-∞ ratio in participants with ESRD after HD were 90.0% (59.3%, 137%) and 91.3% (64.1%, 130%), respectively. CONCLUSION Pemigatinib dose should be reduced for patients with severe hepatic or renal impairment, and no dose adjustment is required for patients with moderate hepatic impairment or in ESRD patients undergoing HD.
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Affiliation(s)
- Tao Ji
- Incyte Research Institute, Wilmington, Delaware, USA
| | - Kevin Rockich
- Incyte Research Institute, Wilmington, Delaware, USA
| | - Noam Epstein
- Incyte Research Institute, Wilmington, Delaware, USA
| | | | - Phillip Wang
- Incyte Research Institute, Wilmington, Delaware, USA
| | - Xuejun Chen
- Incyte Research Institute, Wilmington, Delaware, USA
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18
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Barbour AM, Rockich K, Cimino E, Zhou G, Leonetti-Whalen C, Chen X, Yeleswaram S, Epstein N, Punwani N. Effect of Hepatic Impairment on the Pharmacokinetics of Itacitinib. J Clin Pharmacol 2021; 61:954-960. [PMID: 33434286 DOI: 10.1002/jcph.1814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/05/2021] [Indexed: 11/07/2022]
Abstract
Itacitinib is a potent, selective JAK-1 inhibitor currently in development for the treatment of chronic graft-vs-host-disease in combination with corticosteroids. Itacitinib is primarily eliminated via cytochrome P450 3A metabolism with minimal renal elimination. The purpose of this open-label study was to investigate the effect of hepatic impairment, as determined by Child-Pugh grade, on itacitinib pharmacokinetics. All participants received a single 300-mg dose of itacitinib orally in the fasted state. Blood samples were collected serially through 96 hours after dosing; 4 hours after dosing, an additional sample was collected for protein binding determination. Participants with moderate hepatic impairment (N = 8) had an approximate 2.5-fold increase in total exposure (area under the plasma concentration-time curve from time 0 to infinity [AUC0-∞ ]) and an approximate 2-fold increase in maximal exposure (Cmax ) compared to those with normal hepatic function (N = 8) (geometric mean ratio, 2.51 [90% confidence interval (CI), 1.54-4.08] for AUC0-∞ and 1.95 [90%CI, 1.14-3.35] for Cmax ). Participants with severe hepatic impairment (N = 6) had an approximate 4-fold increase in total exposure (AUC0-∞ ) and an approximate 3.5-fold increase in maximal exposure compared to participants with normal hepatic function (geometric mean ratio, 4.08 [90%CI, 2.41-6.89] for AUC0-∞ and 3.48 [90%CI, 1.94-6.23] for Cmax ). Protein binding was similar between participants with moderate or severe hepatic impairment and participants with normal hepatic function, with average unbound fractions (percent free) of 25.7%, 31.5%, and 25.6%, respectively. There were no serious or fatal treatment-related adverse events. The results of this study combined with exposure, efficacy, and safety data from the pivotal study in the relevant patient population will inform final dosing recommendations.
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Affiliation(s)
| | | | - Evan Cimino
- Incyte Corporation, Wilmington, Delaware, USA
| | - Gongfu Zhou
- Incyte Corporation, Wilmington, Delaware, USA
| | | | - Xuejun Chen
- Incyte Corporation, Wilmington, Delaware, USA
| | | | - Noam Epstein
- Incyte Corporation, Wilmington, Delaware, USA.,GlaxoSmithKline Research & Development, Wilmington, Delaware, USA
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19
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Persaud I, Diamond S, Pan R, Burke K, Harris J, Conlin M, Yeleswaram S. Plasma pharmacokinetics and distribution of ruxolitinib into skin following oral and topical administration in minipigs. Int J Pharm 2020; 590:119889. [PMID: 32949620 DOI: 10.1016/j.ijpharm.2020.119889] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/08/2020] [Accepted: 09/14/2020] [Indexed: 12/30/2022]
Abstract
This preclinical study compared plasma concentrations and distribution of ruxolitinib in the skin of Göttingen minipigs following twice a day oral (40 mg/kg) versus topical administration (1.5% w/w cream applied to 10% of body surface area). Following oral administration, the plasma area-under-the-curve was approximately 31-fold and maximum drug concentration was 38-fold higher than those observed following topical application. Following ruxolitinib cream application, the average plasma concentration at steady-state was 2.7 ± 1.8 nM, a concentration that is not pharmacologically relevant. The average total dermis concentration of ruxolitinib at steady-state after topical administration was 507-fold higher versus that following oral dosing, while the ratio for the total epidermal concentration following topical vs oral dosing was 1989-fold. The concentration of unbound ruxolitinib in the dermis after topical application was predicted to result in sustained and near-complete inhibition of Janus kinase/signal transducer and activator of transcription proteins (JAK/STAT) signaling in this tissue. In contrast, only partial inhibition of downstream signaling was predicted to occur after oral dosing. In conclusion, ruxolitinib cream affords an attractive disposition profile in minipigs, wherein dermis concentrations of ruxolitinib are fully effective whereas corresponding plasma concentrations are negligible. Consequently, this distribution profile should maximize the efficacy of ruxolitinib cream in the skin while minimizing the potential for deleterious systemic effects.
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Affiliation(s)
- Indushekhar Persaud
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA
| | - Sharon Diamond
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA
| | - Rina Pan
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA
| | - Krista Burke
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA
| | - Jennifer Harris
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA
| | - Michelle Conlin
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA
| | - Swamy Yeleswaram
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA.
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20
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Yeleswaram S, Smith P, Burn T, Covington M, Juvekar A, Li Y, Squier P, Langmuir P. Inhibition of cytokine signaling by ruxolitinib and implications for COVID-19 treatment. Clin Immunol 2020; 218:108517. [PMID: 32585295 PMCID: PMC7308779 DOI: 10.1016/j.clim.2020.108517] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 01/08/2023]
Abstract
Approximately 15% of patients with coronavirus disease 2019 (COVID-19) experience severe disease, and 5% progress to critical stage that can result in rapid death. No vaccines or antiviral treatments have yet proven effective against COVID-19. Patients with severe COVID-19 experience elevated plasma levels of pro-inflammatory cytokines, which can result in cytokine storm, followed by massive immune cell infiltration into the lungs leading to alveolar damage, decreased lung function, and rapid progression to death. As many of the elevated cytokines signal through Janus kinase (JAK)1/JAK2, inhibition of these pathways with ruxolitinib has the potential to mitigate the COVID-19-associated cytokine storm and reduce mortality. This is supported by preclinical and clinical data from other diseases with hyperinflammatory states, where ruxolitinib has been shown to reduce cytokine levels and improve outcomes. The urgent need for treatments for patients with severe disease support expedited investigation of ruxolitinib for patients with COVID-19.
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Affiliation(s)
- Swamy Yeleswaram
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA.
| | - Paul Smith
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA.
| | - Timothy Burn
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA.
| | - Maryanne Covington
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA.
| | - Ashish Juvekar
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA.
| | - Yanlong Li
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA.
| | - Peg Squier
- Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA.
| | - Peter Langmuir
- Incyte Corporation, 1801 Augustine Road, Wilmington, DE 19803, USA.
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21
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Li J, Rockich K, Yuska B, Zhou G, Epstein N, Punwani N, Chen X, Yeleswaram S. An Open-Label Study to Assess the Effect of Itraconazole and Rifampin on Parsaclisib Pharmacokinetics When Administered Orally in Healthy Participants. J Clin Pharmacol 2020; 60:1519-1526. [PMID: 32515832 PMCID: PMC7586811 DOI: 10.1002/jcph.1653] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/06/2020] [Indexed: 11/15/2022]
Abstract
Parsaclisib, a selective, potent phosphatidylinositol 3‐kinase delta inhibitor being developed for the treatment of cancer and autoimmune diseases, is primarily metabolized by cytochrome P450 (CYP) 3A4. This study assessed the pharmacokinetics (PK) and safety of parsaclisib alone or combined with itraconazole (potent CYP3A inhibitor) or rifampin (potent CYP3A4 inducer) in healthy participants. In this open‐label, fixed‐sequence study, cohort 1 received oral parsaclisib 10 mg once daily on days 1 and 8 and oral itraconazole 200 mg once daily on days 4‐11; cohort 2 received oral parsaclisib 20 mg once daily on days 1 and 11 and oral rifampin 600 mg once daily on days 4‐12. Parsaclisib plasma concentration was tested and PK parameters calculated by noncompartmental analysis. Geometric mean ratios (GMRs) and 2‐sided 90% confidence intervals (CIs) were estimated by 2‐factor analysis of variance. Thirty‐six healthy participants were enrolled (18 per cohort). Parsaclisib maximum plasma drug concentration (Cmax) and area under the concentration‐time curve extrapolated to infinity (AUC0‐∞) were increased by 21% and 107% with concomitant itraconazole versus parsaclisib alone (GMR, 1.21; 90%CI, 1.14‐1.29; and 2.07; 90%CI, 1.97‐2.17, respectively). Parsaclisib Cmax and AUC were reduced by 43% and 77%, respectively, with concomitant rifampin versus parsaclisib alone (GMR, 0.57; 90%CI, 0.53‐0.60; and 0.23; 90%CI, 0.21‐0.24, respectively). Headache was the most common adverse event, reported by 13.9% of participants (all in cohort 2). Single‐dose parsaclisib alone or combined with itraconazole or rifampin appeared safe and well tolerated in healthy participants. Parsaclisib dose adjustment may be necessary with concomitant administration of strong CYP3A4 inhibitors or inducers.
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Affiliation(s)
- Jia Li
- Incyte Research Institute, Wilmington, Delaware, USA
| | - Kevin Rockich
- Incyte Research Institute, Wilmington, Delaware, USA
| | - Brad Yuska
- Incyte Research Institute, Wilmington, Delaware, USA
| | - Gongfu Zhou
- Incyte Research Institute, Wilmington, Delaware, USA
| | - Noam Epstein
- Incyte Research Institute, Wilmington, Delaware, USA.,Current affiliation: GSK, Collegeville, Pennsylvania, USA
| | | | - Xuejun Chen
- Incyte Research Institute, Wilmington, Delaware, USA
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22
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Shin N, Stubbs M, Koblish H, Yue EW, Soloviev M, Douty B, Wang KH, Wang Q, Gao M, Feldman P, Yang G, Hall L, Hansbury M, O'Connor S, Leffet L, Collins R, Katiyar K, He X, Waeltz P, Collier P, Lu J, Li YL, Li Y, Liu PCC, Burn T, Covington M, Diamond S, Shuey D, Roberts A, Yeleswaram S, Hollis G, Metcalf B, Yao W, Huber R, Combs A, Newton R, Scherle P. Parsaclisib Is a Next-Generation Phosphoinositide 3-Kinase δ Inhibitor with Reduced Hepatotoxicity and Potent Antitumor and Immunomodulatory Activities in Models of B-Cell Malignancy. J Pharmacol Exp Ther 2020; 374:211-222. [PMID: 32345620 DOI: 10.1124/jpet.120.265538] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/20/2020] [Indexed: 12/18/2022] Open
Abstract
The clinical use of first-generation phosphoinositide 3-kinase (PI3K)δ inhibitors in B-cell malignancies is hampered by hepatotoxicity, requiring dose reduction, treatment interruption, and/or discontinuation of therapy. In addition, potential molecular mechanisms by which resistance to this class of drugs occurs have not been investigated. Parsaclisib (INCB050465) is a potent and selective next-generation PI3Kδ inhibitor that differs in structure from first-generation PI3Kδ inhibitors and has shown encouraging anti-B-cell tumor activity and reduced hepatotoxicity in phase 1/2 clinical studies. Here, we present preclinical data demonstrating parsaclisib as a potent inhibitor of PI3Kδ with over 1000-fold selectivity against other class 1 PI3K isozymes. Parsaclisib directly blocks PI3K signaling-mediated cell proliferation in B-cell lines in vitro and in vivo and indirectly controls tumor growth by lessening immunosuppression through regulatory T-cell inhibition in a syngeneic lymphoma model. Diffuse large B-cell lymphoma cell lines overexpressing MYC were insensitive to proliferation blockade via PI3Kδ signaling inhibition by parsaclisib, but their proliferative activities were reduced by suppression of MYC gene transcription. Molecular structure analysis of the first- and next-generation PI3Kδ inhibitors combined with clinical observation suggests that hepatotoxicity seen with the first-generation inhibitors could result from a structure-related off-target effect. Parsaclisib is currently being evaluated in multiple phase 2 clinical trials as a therapy against various hematologic malignancies of B-cell origin (NCT03126019, NCT02998476, NCT03235544, NCT03144674, and NCT02018861). SIGNIFICANCE STATEMENT: The preclinical properties described here provide the mechanism of action and support clinical investigations of parsaclisib as a therapy for B-cell malignancies. MYC overexpression was identified as a resistance mechanism to parsaclisib in DLBCL cells, which may be useful in guiding further translational studies for the selection of patients with DLBCL who might benefit from PI3Kδ inhibitor treatment in future trials. Hepatotoxicity associated with first-generation PI3Kδ inhibitors may be an off-target effect of that class of compounds.
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Affiliation(s)
- Niu Shin
- Incyte Research Institute, Wilmington, Delaware
| | | | | | - Eddy W Yue
- Incyte Research Institute, Wilmington, Delaware
| | | | - Brent Douty
- Incyte Research Institute, Wilmington, Delaware
| | | | - Qian Wang
- Incyte Research Institute, Wilmington, Delaware
| | | | | | | | - Leslie Hall
- Incyte Research Institute, Wilmington, Delaware
| | | | | | - Lynn Leffet
- Incyte Research Institute, Wilmington, Delaware
| | | | | | - Xin He
- Incyte Research Institute, Wilmington, Delaware
| | - Paul Waeltz
- Incyte Research Institute, Wilmington, Delaware
| | | | - Jin Lu
- Incyte Research Institute, Wilmington, Delaware
| | - Yun-Long Li
- Incyte Research Institute, Wilmington, Delaware
| | - Yanlong Li
- Incyte Research Institute, Wilmington, Delaware
| | | | | | | | | | - Dana Shuey
- Incyte Research Institute, Wilmington, Delaware
| | | | | | - Greg Hollis
- Incyte Research Institute, Wilmington, Delaware
| | | | - Wenqing Yao
- Incyte Research Institute, Wilmington, Delaware
| | - Reid Huber
- Incyte Research Institute, Wilmington, Delaware
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23
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Liu PCC, Koblish H, Wu L, Bowman K, Diamond S, DiMatteo D, Zhang Y, Hansbury M, Rupar M, Wen X, Collier P, Feldman P, Klabe R, Burke KA, Soloviev M, Gardiner C, He X, Volgina A, Covington M, Ruggeri B, Wynn R, Burn TC, Scherle P, Yeleswaram S, Yao W, Huber R, Hollis G. INCB054828 (pemigatinib), a potent and selective inhibitor of fibroblast growth factor receptors 1, 2, and 3, displays activity against genetically defined tumor models. PLoS One 2020; 15:e0231877. [PMID: 32315352 PMCID: PMC7313537 DOI: 10.1371/journal.pone.0231877] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 04/02/2020] [Indexed: 01/11/2023] Open
Abstract
Alterations in fibroblast growth factor receptor (FGFR) genes have been
identified as potential driver oncogenes. Pharmacological targeting of FGFRs may
therefore provide therapeutic benefit to selected cancer patients, and
proof-of-concept has been established in early clinical trials of FGFR
inhibitors. Here, we present the molecular structure and preclinical
characterization of INCB054828 (pemigatinib), a novel, selective inhibitor of
FGFR 1, 2, and 3, currently in phase 2 clinical trials. INCB054828
pharmacokinetics and pharmacodynamics were investigated using cell lines and
tumor models, and the antitumor effect of oral INCB054828 was investigated using
xenograft tumor models with genetic alterations in FGFR1, 2, or 3. Enzymatic
assays with recombinant human FGFR kinases showed potent inhibition of FGFR1, 2,
and 3 by INCB054828 (half maximal inhibitory concentration [IC50]
0.4, 0.5, and 1.0 nM, respectively) with weaker activity against FGFR4
(IC50 30 nM). INCB054828 selectively inhibited growth of tumor
cell lines with activation of FGFR signaling compared with cell lines lacking
FGFR aberrations. The preclinical pharmacokinetic profile suggests target
inhibition is achievable by INCB054828 in vivo with low oral doses. INCB054828
suppressed the growth of xenografted tumor models with FGFR1, 2, or 3
alterations as monotherapy, and the combination of INCB054828 with cisplatin
provided significant benefit over either single agent, with an acceptable
tolerability. The preclinical data presented for INCB054828, together with
preliminary clinical observations, support continued investigation in patients
with FGFR alterations, such as fusions and activating mutations.
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MESH Headings
- Administration, Oral
- Animals
- Cell Line, Tumor
- Female
- Half-Life
- Humans
- Mice
- Mice, Inbred C57BL
- Mice, Nude
- Mice, SCID
- Morpholines/chemistry
- Morpholines/pharmacokinetics
- Morpholines/therapeutic use
- Neoplasms/drug therapy
- Neoplasms/pathology
- Protein Kinase Inhibitors/chemistry
- Protein Kinase Inhibitors/pharmacokinetics
- Protein Kinase Inhibitors/therapeutic use
- Pyrimidines/chemistry
- Pyrimidines/pharmacokinetics
- Pyrimidines/therapeutic use
- Pyrroles/chemistry
- Pyrroles/pharmacokinetics
- Pyrroles/therapeutic use
- Rats
- Rats, Nude
- Receptor, Fibroblast Growth Factor, Type 1/antagonists & inhibitors
- Receptor, Fibroblast Growth Factor, Type 1/metabolism
- Receptor, Fibroblast Growth Factor, Type 2/antagonists & inhibitors
- Receptor, Fibroblast Growth Factor, Type 2/metabolism
- Receptor, Fibroblast Growth Factor, Type 3/antagonists & inhibitors
- Receptor, Fibroblast Growth Factor, Type 3/metabolism
- Xenograft Model Antitumor Assays
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Affiliation(s)
- Phillip C. C. Liu
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Holly Koblish
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
- * E-mail:
| | - Liangxing Wu
- Discovery Chemistry, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Kevin Bowman
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Sharon Diamond
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Darlise DiMatteo
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Yue Zhang
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Michael Hansbury
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Mark Rupar
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Xiaoming Wen
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Paul Collier
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Patricia Feldman
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Ronald Klabe
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Krista A. Burke
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Maxim Soloviev
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Christine Gardiner
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Xin He
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Alla Volgina
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Maryanne Covington
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Bruce Ruggeri
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Richard Wynn
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Timothy C. Burn
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Peggy Scherle
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Swamy Yeleswaram
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Wenqing Yao
- Discovery Chemistry, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Reid Huber
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
| | - Gregory Hollis
- Discovery Biology, Incyte Research Institute, Wilmington, Delaware,
United States of America
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24
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Srinivas N, Barbour AM, Epstein N, Zhou G, Petusky S, Xun Z, Yuska B, Marbury T, Chen X, Yeleswaram S, Punwani N. The Effect of Renal Impairment on the Pharmacokinetics and Safety of Itacitinib. J Clin Pharmacol 2020; 60:1022-1029. [PMID: 32149388 PMCID: PMC7496630 DOI: 10.1002/jcph.1601] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 02/06/2020] [Indexed: 01/03/2023]
Abstract
Itacitinib is a novel, selective, Janus kinase 1 inhibitor in development for treatment of graft‐versus‐host disease. The objective of this study was to assess pharmacokinetics and safety of 300‐mg itacitinib dosed in participants with normal renal function (n = 10), severe renal impairment (n = 8), and end‐stage renal disease (ESRD) on hemodialysis (n = 8). Serial plasma and urine samples (urine from normal and severe groups only) were collected before dosing until 72 hours after dosing. In the ESRD group, itacitinib was evaluated in 2 periods, when dosed before (period 1) and after (period 2) a hemodialysis session. Geometric mean ratios (90% confidence interval) in participants with severe renal impairment, ESRD period 1 and ESRD period 2 relative to participants with normal renal function were 1.65 (1.13‐2.39), 0.71 (0.49‐1.03), and 0.83 (0.57‐1.20) for maximum plasma drug concentration and 2.23 (1.56‐3.18), 0.81 (0.57‐1.16), and 0.95 (0.66‐1.35) for area under the plasma concentration–time curve from time zero to infinity. Itacitinib was well tolerated, and 3 grade 1 treatment‐emergent adverse events were reported over the course of the study. Given the magnitude of exposure changes in participants with severe renal impairment or ESRD and the historic risk‐benefit profile, no dose adjustment is recommended for itacitinib in patients with impaired renal function, although the final dosage recommendation will be based on cumulative pharmacokinetics and safety from this study and from the pivotal graft‐versus‐host disease trial. Additionally, itacitinib may be administered to patients undergoing dialysis regardless of the time of dialysis.
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Affiliation(s)
| | | | | | - Gongfu Zhou
- Incyte Corporation, Wilmington, Delaware, USA
| | | | - Zhinyin Xun
- Incyte Corporation, Wilmington, Delaware, USA
| | - Brad Yuska
- Incyte Corporation, Wilmington, Delaware, USA
| | | | - Xuejun Chen
- Incyte Corporation, Wilmington, Delaware, USA
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25
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Gong X, Darpo B, Xue H, Punwani N, He K, Barbour AM, Epstein N, Landman R, Chen X, Yeleswaram S. Evaluation of Clinical Cardiac Safety of Itacitinib, a JAK1 Inhibitor, in Healthy Participants. Clin Pharmacol Drug Dev 2019; 9:677-688. [DOI: 10.1002/cpdd.758] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 11/06/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Xiaohua Gong
- Incyte Research Institute Wilmington Delaware USA
| | - Borje Darpo
- eRT/iCardiac Technologies Rochester New York USA
| | - Hongqi Xue
- eRT/iCardiac Technologies Rochester New York USA
| | | | - Kevin He
- Incyte Corporation Wilmington Delaware USA
| | | | - Noam Epstein
- Incyte Research Institute Wilmington Delaware USA
| | | | - Xuejun Chen
- Incyte Research Institute Wilmington Delaware USA
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Ji T, Lihou C, Asatiani E, Féliz L, Overholt H, Landman R, Chen X, Yeleswaram S. Abstract C071: Pharmacokinetics and pharmacodynamics of pemigatinib, a potent and selective inhibitor of FGFR 1, 2, and 3, in patients with advanced malignancies. Mol Cancer Ther 2019. [DOI: 10.1158/1535-7163.targ-19-c071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Pemigatinib is a potent inhibitor of fibroblast growth factor receptors (FGFR) 1, 2, and 3 with selectivity against other kinases and is currently being studied in solid tumors expressing FGFR translocations and/or mutations. A first-in-man phase 1 study (FIGHT-101) was conducted in patients with solid tumors who are refractory to approved treatments, to establish the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of pemigatinib. The study was conducted in 3 parts to allow dose escalation, dose expansion, and food-effect and combination treatments, respectively. Both intermittent (2 wks on/1 wk off) and continuous daily dosing were evaluated. A total of 116 patients have received monotherapy and 44 received combination therapy, as of February 19, 2019. Serial blood samples were collected to enable PK/PD analyses, and plasma samples were assayed for pemigatinib by a validated LC-MS/MS method with a linear validated range of 1 to 1000 nM in human plasma. With multiple-dose administration in the fasted state, pemigatinib plasma concentrations attained peak values (Cmax) typically at 1–2 hours (median Tmax) post-dose, and subsequently exhibited a bi-exponential decay, with a steady-state geometric mean terminal-phase disposition half-life (t½) of approximately 15 hours that was not dose-dependent. The geometric mean accumulation ratio was approximately 1.6 for area under the curve from time 0 to 24 hours (AUC0-24). Within the dose range of 1 to 20 mg once daily (QD), increases in the pemigatinib steady-state Cmax and AUC0-24 were proportional to dose; that is, pemigatinib exhibited linear PK over the dose range studied. Pemigatinib exhibited a low steady-state oral clearance with geometric mean of 9.88–11.7 L/h and moderate volume of distribution with geometric mean of 173–244 L. At the recommended part 2 dose of 13.5 mg QD, the geometric mean (CV%) of t½, steady-state Cmax, and AUC0-24 were 15.4 h (51.6%), 236 nM (56.4%), and 2620 h*nM (54.1%), respectively. The PK parameters of pemigatinib following combination therapy were similar to that of monotherapy. Administration of a standardized high-fat and high-calorie breakfast prolonged the median pemigatinib Tmax to 4 hours, decreased the geometric mean steady-state Cmax by 18%, and increased the geometric mean steady-state AUC0-24 by 11%. The 90% CI of geometric mean ratio for steady-state Cmax and AUC0-24 were (0.648–1.03) and (0.935–1.31), respectively. The effect of food on pemigatinib plasma exposures was considered as modest and not clinically meaningful. Therefore, pemigatinib can be administered without regard to food. The geometric mean fraction of pemigatinib excreted in urine was 1.19% (range, 0.226–7.24%) with a geometric mean renal clearance of 0.133 L/h based on exploratory urine excretion data, indicating minor contribution from renal clearance towards total systemic clearance. Hyperphosphatemia is an expected on-target pharmacologic effect of FGFR inhibition. The increase in serum phosphorus observed after treatment with pemigatinib was exposure-dependent and followed a sigmoidal relationship. In conclusion, pemigatinib exhibits rapid absorption, linear PK, and a t½ consistent with QD dosing. Pemigatinib is predominantly cleared by metabolism and there are no active metabolites.
Citation Format: Tao Ji, Christine Lihou, Ekaterine Asatiani, Luis Féliz, Heather Overholt, Robert Landman, Xuejun Chen, Swamy Yeleswaram. Pharmacokinetics and pharmacodynamics of pemigatinib, a potent and selective inhibitor of FGFR 1, 2, and 3, in patients with advanced malignancies [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics; 2019 Oct 26-30; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2019;18(12 Suppl):Abstract nr C071. doi:10.1158/1535-7163.TARG-19-C071
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Affiliation(s)
- Tao Ji
- Incyte Corporation, Wilmington, DE
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Yue EW, Li YL, Douty B, He C, Mei S, Wayland B, Maduskuie T, Falahatpisheh N, Sparks RB, Polam P, Zhu W, Glenn J, Feng H, Zhang K, Li Y, He X, Katiyar K, Covington M, Feldman P, Shin N, Wang KH, Diamond S, Li Y, Koblish HK, Hall L, Scherle P, Yeleswaram S, Xue CB, Metcalf B, Combs AP, Yao W. INCB050465 (Parsaclisib), a Novel Next-Generation Inhibitor of Phosphoinositide 3-Kinase Delta (PI3Kδ). ACS Med Chem Lett 2019; 10:1554-1560. [PMID: 31749910 DOI: 10.1021/acsmedchemlett.9b00334] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/17/2019] [Indexed: 01/21/2023] Open
Abstract
A medicinal chemistry effort focused on identifying a structurally diverse candidate for phosphoinositide 3-kinase delta (PI3Kδ) led to the discovery of clinical candidate INCB050465 (20, parsaclisib). The unique structure of 20 contains a pyrazolopyrimidine hinge-binder in place of a purine motif that is present in other PI3Kδ inhibitors, such as idelalisib (1), duvelisib (2), and INCB040093 (3, dezapelisib). Parsaclisib (20) is a potent and highly selective inhibitor of PI3Kδ with drug-like ADME properties that exhibited an excellent in vivo profile as demonstrated through pharmacokinetic studies in rats, dogs, and monkeys and through pharmacodynamic and efficacy studies in a mouse Pfeiffer xenograft model.
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Affiliation(s)
- Eddy W. Yue
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Yun-Long Li
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Brent Douty
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Chunhong He
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Song Mei
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Brian Wayland
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Thomas Maduskuie
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Nikoo Falahatpisheh
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Richard B. Sparks
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Padmaja Polam
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Wenyu Zhu
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Joseph Glenn
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Hao Feng
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Ke Zhang
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Yanlong Li
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Xin He
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Kamna Katiyar
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Maryanne Covington
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Patricia Feldman
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Niu Shin
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Kathy He Wang
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Sharon Diamond
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Yu Li
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Holly K. Koblish
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Leslie Hall
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Peggy Scherle
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Swamy Yeleswaram
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Chu-Biao Xue
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Brian Metcalf
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Andrew P. Combs
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
| | - Wenqing Yao
- Incyte Research Institute, Incyte Corporation, 1801 Augustine Cut-Off, Wilmington, Delaware 19803, United States
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Falchook G, Rosen S, LoRusso P, Watts J, Gupta S, Coombs CC, Talpaz M, Kurzrock R, Mita M, Cassaday R, Harb W, Peguero J, Smith DC, Piha-Paul SA, Szmulewitz R, Noel MS, Yeleswaram S, Liu P, Switzky J, Zhou G, Zheng F, Mehta A. Development of 2 Bromodomain and Extraterminal Inhibitors With Distinct Pharmacokinetic and Pharmacodynamic Profiles for the Treatment of Advanced Malignancies. Clin Cancer Res 2019; 26:1247-1257. [PMID: 31527168 DOI: 10.1158/1078-0432.ccr-18-4071] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 06/13/2019] [Accepted: 09/11/2019] [Indexed: 01/17/2023]
Abstract
PURPOSE Bromodomain and extraterminal (BET) proteins are key epigenetic transcriptional regulators, inhibition of which may suppress oncogene expression. We report results from 2 independent first-in-human phase 1/2 dose-escalation and expansion, safety and tolerability studies of BET inhibitors INCB054329 (study INCB 54329-101; NCT02431260) and INCB057643 (study INCB 57643-101; NCT02711137). PATIENTS AND METHODS Patients (≥18 years) with advanced malignancies, ≥1 prior therapy, and adequate organ functions received oral INCB054329 (monotherapy) or INCB057643 (monotherapy or in combination with standard-of-care) in 21-day cycles (or 28-day cycles depending on standard-of-care combination). Primary endpoints were safety and tolerability. RESULTS Sixty-nine and 134 patients received INCB054329 and INCB057643, respectively. Study INCB 54329-101 has been completed; INCB 57643-101 is currently active, but not recruiting (no patients were receiving treatment as of January 8, 2019). Terminal elimination half-life was shorter for INCB054329 versus INCB057643 (mean [SD], 2.24 [2.03] vs. 11.1 [8.27] hours). INCB054329 demonstrated higher interpatient variability in oral clearance versus INCB057643 (CV%, 142% vs. 45.5%). Most common (>20%) any-grade treatment-related adverse events were similar for both drugs (INCB054329; INCB057643): nausea (35%; 30%), thrombocytopenia (33%; 32%), fatigue (29%; 30%), decreased appetite (26%; 22%). Two confirmed complete responses and 4 confirmed partial responses with INCB057643 were reported as best responses. CONCLUSIONS INCB057643 exhibited a more favorable PK profile versus INCB054329; exposure-dependent thrombocytopenia was observed with both drugs which limited the target inhibition that could be safely maintained. Further efforts are required to identify patient populations that can benefit most, and an optimal dosing scheme to maximize therapeutic index.
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Affiliation(s)
- Gerald Falchook
- Sarah Cannon Research Institute at HealthONE, Denver, Colorado.
| | - Seth Rosen
- Hematology-Oncology Associates of Treasure Coast, Port St Lucie, Florida
| | | | - Justin Watts
- Sylvester Comprehensive Cancer Center, Miami, Florida
| | | | - Catherine C Coombs
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | | | | | - Monica Mita
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Ryan Cassaday
- University of Washington and Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Wael Harb
- Horizon Oncology Center, Lafeyette, Indiana
| | | | | | | | | | - Marcus S Noel
- University of Rochester, Wilmot Cancer Center, Rochester, New York
| | - Swamy Yeleswaram
- Incyte Research Institute, Incyte Corporation, Wilmington, Delaware
| | - Phillip Liu
- Incyte Research Institute, Incyte Corporation, Wilmington, Delaware
| | | | | | - Fred Zheng
- Incyte Corporation, Wilmington, Delaware
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Barbour AM, Punwani N, Epstein N, Landman R, Cimino E, Yuska B, Wang P, He K, Chen X, Yeleswaram S. Effect of Itraconazole or Rifampin on Itacitinib Pharmacokinetics When Administered Orally in Healthy Subjects. J Clin Pharmacol 2019; 59:1641-1647. [PMID: 31282592 DOI: 10.1002/jcph.1484] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/17/2019] [Indexed: 11/07/2022]
Abstract
Itacitinib is a potent, selective JAK-1 inhibitor currently in phase 3 development for the treatment of acute and chronic graft-versus-host disease (GVHD) in combination with corticosteroids. Itacitinib is primarily eliminated via metabolism by cytochrome P-450 (CYP)3A4 with minimal renal elimination. A drug-drug interaction study was conducted to evaluate the impact of the strong CYP3A inhibitor itraconazole or the strong CYP3A4 inducer rifampin on the pharmacokinetics of itacitinib in healthy volunteers. In cohort 1, subjects received 200 mg sustained release (SR) tablets of itacitinib on days 1 and 6 and 200 mg itraconazole on days 2-7. In cohort 2, subjects received 200 mg SR itacitinib on days 1 and 9 and 600 mg rifampin on days 2-9. Thirty-six subjects were enrolled, 18 in each cohort with 17 completing itacitinib dosing in cohort 1 and 15 completing itacitinib dosing in cohort 2. Coadministration of itraconazole with itacitinib resulted in a nearly 5-fold increase in area under the concentration-time curve (AUC0-∞ ) (geometric mean ratio [GMR] 4.88, 90%Cl 4.17-5.72) and an ∼3-fold increase in peak concentration (Cmax ) (GMR 3.15, 90%Cl 2.58-3.54). Coadministration of rifampin with itacitinib resulted in a nearly 80% decrease in AUC0-∞ (GMR 0.208, 90%Cl 0.173, 0.249) and Cmax (GMR 0.231, 90%Cl 0.195, 0.274). Results of this study informed the study design of the phase 3 GVHD protocols with regard to coadministration of strong CYP3A inhibitors and CYP3A4 inducers. These data combined with phase 3 data will inform final dosing recommendations.
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Affiliation(s)
| | | | | | | | | | | | | | - Kevin He
- Incyte Corporation, Wilmington, DE, USA
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Abstract
Abstract
Background: INCMGA00012, a humanized, hinge-stabilized, IgG4κ monoclonal antibody that recognizes human PD-1, is being developed for the treatment of multiple solid tumor types, both as monotherapy and in combination with other potentially immunoactive agents. Flat dosing is preferred to weight-based dosing for multiple reasons, including convenience of preparation and administration, reduced errors in preparation calculation, and minimization of drug waste. A modeling and simulation approach was employed to support flat doses for later phase studies.
Patients and Methods: INCMGA00012 has been administered to approximately 200 participants in a Phase 1 study (Study INCMGA 0012-101) at weight-based doses ranging from 1 to 10 mg/kg Q2W or Q4W and at flat doses of 500 mg Q4W and 750 mg Q4W. PK data from weight-based doses were used for population PK model development and data from flat doses were used for model validation. Simulations were performed to support the selection of RP2 flat dose.
Results: The concentrations of INCMGA00012 were adequately described by a 2-compartment model with first-order elimination. Higher clearance was estimated for 1 mg/kg (23.5 mL/h) than the other dose groups (13.5 mL/h). Body weight dependence of clearance and volume of distribution for central compartment were characterized by power relationships with exponents of 0.911 and 0.493, respectively. The model was validated using PK data from participants who received INCMGA00012 500 mg Q4W and 750 mg Q4W, respectively, in the cohort expansion phase. Median steady state trough concentrations of 500 mg Q4W and 750 mg Q4W exceeded the target value.
Conclusion: Modeling and simulation provide justification for 500 mg Q4W for further clinical development of INCMGA00012 based upon favorable safety, PK characteristics and presumed flat exposure-response relationships for efficacy.
Citation Format: Xuejun chen, Phil Wang, Sanjeev Kaul, Bradley Sumrow, Swamy Yeleswaram. Assessment of flat dosing strategy for INCMGA00012 in patients with advanced tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr LB-268.
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Affiliation(s)
| | - Phil Wang
- 1Incyte Research Institute, Wilmington, DE
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Zhang Y, Bowman K, Maleski J, Diamond S, Yeleswaram S. Effects of Epacadostat on Brain Extracellular Fluid Concentrations of Serotonin-an Intracerebral Microdialysis Study in Sprague-Dawley Rats. Drug Metab Dispos 2019; 47:710-714. [PMID: 31010933 DOI: 10.1124/dmd.118.084053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 04/19/2019] [Indexed: 11/22/2022] Open
Abstract
Epacadostat (EPAC) is an indoleamine 2,3-dioxygenase 1 (IDO1) inhibitor that has been examined in multiple clinical trials. The substrate for IDO1 is tryptophan and there is a theoretical concern that inhibition of IDO1 may increase the concentrations of tryptophan and subsequently serotonin, potentially leading to serotonin syndrome (SS). The objective of this study was to evaluate the effect of EPAC, either alone or with linezolid, a monoamine oxidase inhibitor (MAOI), on brain extracellular fluid (ECF) concentrations of serotonin in rats, using microdialysis. While fluoxetine, a selective serotonin reuptake inhibitor, increased the serotonin ECF concentration by 2-fold, the combination of fluoxetine with linezolid (a positive control used in the study) resulted in a 9-fold increase. Neither EPAC monotherapy nor combination with linezolid had any effect on serotonin concentration. In addition, EPAC was shown to have poor penetration across the rat blood-brain barrier. Across multiple phase I/II clinical studies with EPAC, four SS-like episodes were observed out of 2490 subjects, but none of the incidences were confirmed as a true case of SS. These data suggest that EPAC is unlikely to cause SS following either monotherapy or in combination with MAOIs. Thus, the exclusion of MAOI from clinical studies with EPAC has been lifted.
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Affiliation(s)
- Yan Zhang
- Departments of Drug Metabolism Pharmacokinetics and Clinical Pharmacology (Y.Z., K.B., S.D., S.Y.), and Clinical Development (J.M.), Incyte Corporation, Wilmington, Delaware
| | - Kevin Bowman
- Departments of Drug Metabolism Pharmacokinetics and Clinical Pharmacology (Y.Z., K.B., S.D., S.Y.), and Clinical Development (J.M.), Incyte Corporation, Wilmington, Delaware
| | - Janet Maleski
- Departments of Drug Metabolism Pharmacokinetics and Clinical Pharmacology (Y.Z., K.B., S.D., S.Y.), and Clinical Development (J.M.), Incyte Corporation, Wilmington, Delaware
| | - Sharon Diamond
- Departments of Drug Metabolism Pharmacokinetics and Clinical Pharmacology (Y.Z., K.B., S.D., S.Y.), and Clinical Development (J.M.), Incyte Corporation, Wilmington, Delaware
| | - Swamy Yeleswaram
- Departments of Drug Metabolism Pharmacokinetics and Clinical Pharmacology (Y.Z., K.B., S.D., S.Y.), and Clinical Development (J.M.), Incyte Corporation, Wilmington, Delaware
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Verstovsek S, Yeleswaram S, Hou K, Chen X, Erickson-Viitanen S. Sustained-release ruxolitinib: Findings from a phase 1 study in healthy subjects and a phase 2 study in patients with myelofibrosis. Hematol Oncol 2018; 36:701-708. [PMID: 30105794 PMCID: PMC6221065 DOI: 10.1002/hon.2544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 06/28/2018] [Accepted: 06/29/2018] [Indexed: 11/10/2022]
Abstract
Ruxolitinib is the first Janus kinase (JAK) inhibitor approved for the treatment of myelofibrosis, where its efficacy is often associated with cytopenia. It is possible that the severity of cytopenia is in part driven by Cmax. A once‐daily sustained‐release (SR) formulation of ruxolitinib was therefore developed to decrease the Cmax/Cmin ratio relative to twice‐daily immediate‐release (IR) ruxolitinib. An SR formulation was identified based on pharmacokinetic evaluation in a phase 1 study in healthy adults (N = 9). This was followed by an open‐label phase 2 study in patients with myelofibrosis (N = 41). Ruxolitinib SR treatment was well tolerated with blood cell counts relatively unchanged through week 16. In terms of efficacy, 7 patients (17.1%) had clinical improvement and 33 (80.5%) had stable disease. While this study has raised the possibility of an increased therapeutic index for ruxolitinib via an SR formulation, further studies are required to validate the hypothesis.
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Affiliation(s)
- Srdan Verstovsek
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Kevin Hou
- Incyte Corporation, Wilmington, DE, USA
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Stubbs MC, Burn TC, Sparks R, Maduskuie T, Diamond S, Rupar M, Wen X, Volgina A, Zolotarjova N, Waeltz P, Favata M, Jalluri R, Liu H, Liu XM, Li J, Collins R, Falahatpisheh N, Polam P, DiMatteo D, Feldman P, Dostalik V, Thekkat P, Gardiner C, He X, Li Y, Covington M, Wynn R, Ruggeri B, Yeleswaram S, Xue CB, Yao W, Combs AP, Huber R, Hollis G, Scherle P, Liu PCC. The Novel Bromodomain and Extraterminal Domain Inhibitor INCB054329 Induces Vulnerabilities in Myeloma Cells That Inform Rational Combination Strategies. Clin Cancer Res 2018; 25:300-311. [PMID: 30206163 DOI: 10.1158/1078-0432.ccr-18-0098] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 06/20/2018] [Accepted: 09/07/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE Bromodomain and extraterminal domain (BET) proteins regulate the expression of many cancer-associated genes and pathways; BET inhibitors have demonstrated activity in diverse models of hematologic and solid tumors. We report the preclinical characterization of INCB054329, a structurally distinct BET inhibitor that has been investigated in phase I clinical trials. EXPERIMENTAL DESIGN We used multiple myeloma models to investigate vulnerabilities created by INCB054329 treatment that could inform rational combinations. RESULTS In addition to c-MYC, INCB054329 decreased expression of oncogenes FGFR3 and NSD2/MMSET/WHSC1, which are deregulated in t(4;14)-rearranged cell lines. The profound suppression of FGFR3 sensitized the t(4;14)-positive cell line OPM-2 to combined treatment with a fibroblast growth factor receptor inhibitor in vivo. In addition, we show that BET inhibition across multiple myeloma cell lines resulted in suppressed interleukin (IL)-6 Janus kinase-signal transducers and activators of transcription (JAK-STAT) signaling. INCB054329 displaced binding of BRD4 to the promoter of IL6 receptor (IL6R) leading to reduced levels of IL6R and diminished signaling through STAT3. Combination with JAK inhibitors (ruxolitinib or itacitinib) further reduced JAK-STAT signaling and synergized to inhibit myeloma cell growth in vitro and in vivo. This combination potentiated tumor growth inhibition in vivo, even in the MM1.S model of myeloma that is not intrinsically sensitive to JAK inhibition alone. CONCLUSIONS Preclinical data reveal insights into vulnerabilities created in myeloma cells by BET protein inhibition and potential strategies that can be leveraged in clinical studies to enhance the activity of INCB054329.
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Affiliation(s)
| | | | | | | | | | - Mark Rupar
- Incyte Corporation, Wilmington, Delaware
| | | | | | | | | | | | | | | | | | - Jun Li
- Incyte Corporation, Wilmington, Delaware
| | | | | | | | | | | | | | | | | | - Xin He
- Incyte Corporation, Wilmington, Delaware
| | - Yanlong Li
- Incyte Corporation, Wilmington, Delaware
| | | | | | | | | | | | | | | | - Reid Huber
- Incyte Corporation, Wilmington, Delaware
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Diamond M, Lo Y, Chadderton A, Ye M, Roman V, Weber M, He C, Wu L, Yeleswaram S, Roberts A, Yao W, Hollis G, Huber R, Scherle P, Ruggeri B, Lee SH. Abstract 1893: The evaluation of INCB059872, an FAD-directed inhibitor of LSD1, in preclinical models of T-ALL. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-1893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive hematological tumor that is derived from the clonal expansion of immature T-cell progenitors. Multiple genetic and epigenetic alterations are attributed to the development of malignant T cell transformation. Among these, there is supporting evidence for a role of lysine specific demethylase (LSD1) in T-ALL. Oncogenic transcription factors, such as TAL-1, Notch, and ZEB2, form a complex with LSD1 to alter gene expression in T-ALL cells. In addition, LSD1 is aberrantly expressed in ALL, including B-ALL and T-ALL. Furthermore, the overexpression of LSD1 under control of the Sca-1 promoter in transgenic mice triggered T leukemogenesis via acquisition of self-renewal activity and alteration in the differentiation program to T-cell lineages. Together with the known function of LSD1 in regulating the activity of self-renewal in hematological malignancies, these studies prompted evaluation of the efficacy of the potent, selective, and orally bioavailable FAD-directed LSD1 inhibitor, INCB059872, in preclinical models of T-ALL. Expression of LSD1 was abundant in human-T-ALL cell lines as detected by immunoblotting. In vitro, INCB059872 treatment significantly inhibited the proliferation of a subset of human T-ALL cell lines. In vivo, once daily oral administration of INCB059872 inhibited tumor growth significantly in multiple human T-ALL subcutaneous xenograft models including Molt-4, RPMI-8402, CCRF-HSB-2, and CCRF-CEM, but was ineffective against DND-41 xenografts. The anti-tumor efficacy observed with INCB059872 had no clear genetic correlation with Notch mutation status of T-ALL tumors. Combination efficacy studies of INCB059872 with standard care of agents or targeted therapeutic agents in T-ALL models are currently being evaluated. These data suggest exploring the potential clinical development of INCB059872 as a therapy for T-ALL patients.
Citation Format: Melody Diamond, Yvonne Lo, Antony Chadderton, Min Ye, Valerie Roman, Michael Weber, Chunhong He, Liangxing Wu, Swamy Yeleswaram, Alan Roberts, Wenqing Yao, Gregory Hollis, Reid Huber, Peggy Scherle, Bruce Ruggeri, Sang Hyun Lee. The evaluation of INCB059872, an FAD-directed inhibitor of LSD1, in preclinical models of T-ALL [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1893.
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Affiliation(s)
| | | | | | - Min Ye
- Incyte Corporation, Wilmington, DE
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Chadderton A, Ye M, Diamond M, Roman V, Weber M, He C, Wu L, Yeleswaram S, Roberts A, Yao W, Hollis G, Huber R, Scherle P, Ruggeri B, Lee SH. Abstract 1888: The FAD-directed LSD1 specific inhibitor, INCB059872, is a promising epigenetic agent for AML therapy by inducing differentiation of leukemic stem/progenitor cells. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-1888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Numerous studies have elucidated that the most pivotal functions of lysine specific demethylase-1 (LSD1) are associated with regulating normal or malignant hematopoiesis by maintaining stem cell self-renewal and regulating myeloid differentiation. In preclinical models, studies with either pharmacological inhibition or genetic knockdown of LSD1 demonstrated that LSD1 is essential for differentiation of progenitor cells during normal hematopoiesis. In the clinic, AML manifests itself via clonal expansion of abnormal differentiation and proliferation of myeloid cells and, therefore, the inhibition of LSD1 activity with small molecule inhibitors could be a promising therapeutic approach for AML. Previously, we reported upon the identification of a flavin adenine dinucleotide (FAD) directed LSD1 specific inhibitor, INCB059872, which is efficacious in preclinical mouse models utilizing human AML cell lines and primary AML cells by inducing cell differentiation as indicated by the induction of CD11b and CD86 markers. Using a larger panel of myeloid and HSC flow cytometry markers, our currents efforts expanded upon these observations to ascertain whether INCB059872 enhanced lineage commitment at hematopoietic stem cell (HSC) and/ or promoted monocytic/granulocytic differentiation of human primary AML cells ex vivo and in human systemic AML PDX models. In both human AML PDX models and human primary AML samples, INCB059872 increased myeloid differentiation with increasing populations of monocytes (CD14+) and granulocytes (CD15+). Furthermore, INCB059872 induced the differentiation of early hematopoietic progenitors, CD34+/CD38- to more committed CD34+/CD38+ multipotent/oligopotent progenitors, which in turn gave rise to lineage specific progenitors in the human AML PDX models. These studies support further exploration of INCB059872 as a promising novel epigenetic agent for AML therapy whose mechanism of action lies in part through the induction of differentiation of leukemic stem/progenitor cells to more committed hematopoietic lineages.
Citation Format: Antony Chadderton, Min Ye, Melody Diamond, Valerie Roman, Michael Weber, Chunhong He, Liangxing Wu, Swamy Yeleswaram, Alan Roberts, Wenqing Yao, Gregory Hollis, Reid Huber, Peggy Scherle, Bruce Ruggeri, Sang Hyun Lee. The FAD-directed LSD1 specific inhibitor, INCB059872, is a promising epigenetic agent for AML therapy by inducing differentiation of leukemic stem/progenitor cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1888.
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Affiliation(s)
| | - Min Ye
- Incyte Corporation, Wilmington, DE
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Koblish H, Li YL, Shin N, Hall L, Wang Q, Wang K, Covington M, Marando C, Bowman K, Boer J, Burke K, Wynn R, Margulis A, Reuther GW, Lambert QT, Dostalik Roman V, Zhang K, Feng H, Xue CB, Diamond S, Hollis G, Yeleswaram S, Yao W, Huber R, Vaddi K, Scherle P. Preclinical characterization of INCB053914, a novel pan-PIM kinase inhibitor, alone and in combination with anticancer agents, in models of hematologic malignancies. PLoS One 2018; 13:e0199108. [PMID: 29927999 PMCID: PMC6013247 DOI: 10.1371/journal.pone.0199108] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 05/31/2018] [Indexed: 12/17/2022] Open
Abstract
The Proviral Integration site of Moloney murine leukemia virus (PIM) serine/threonine protein kinases are overexpressed in many hematologic and solid tumor malignancies and play central roles in intracellular signaling networks important in tumorigenesis, including the Janus kinase-signal transducer and activator of transcription (JAK/STAT) and phosphatidylinositol 3-kinase (PI3K)/AKT pathways. The three PIM kinase isozymes (PIM1, PIM2, and PIM3) share similar downstream substrates with other key oncogenic kinases and have differing but mutually compensatory functions across tumors. This supports the therapeutic potential of pan-PIM kinase inhibitors, especially in combination with other anticancer agents chosen based on their role in overlapping signaling networks. Reported here is a preclinical characterization of INCB053914, a novel, potent, and selective adenosine triphosphate-competitive pan-PIM kinase inhibitor. In vitro, INCB053914 inhibited proliferation and the phosphorylation of downstream substrates in cell lines from multiple hematologic malignancies. Effects were confirmed in primary bone marrow blasts from patients with acute myeloid leukemia treated ex vivo and in blood samples from patients receiving INCB053914 in an ongoing phase 1 dose-escalation study. In vivo, single-agent INCB053914 inhibited Bcl-2-associated death promoter protein phosphorylation and dose-dependently inhibited tumor growth in acute myeloid leukemia and multiple myeloma xenografts. Additive or synergistic inhibition of tumor growth was observed when INCB053914 was combined with selective PI3Kδ inhibition, selective JAK1 or JAK1/2 inhibition, or cytarabine. Based on these data, pan-PIM kinase inhibitors, including INCB053914, may have therapeutic utility in hematologic malignancies when combined with other inhibitors of oncogenic kinases or standard chemotherapeutics.
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Affiliation(s)
- Holly Koblish
- Incyte Corporation, Wilmington, Delaware, United States of America
- * E-mail:
| | - Yun-long Li
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Niu Shin
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Leslie Hall
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Qian Wang
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Kathy Wang
- Incyte Corporation, Wilmington, Delaware, United States of America
| | | | - Cindy Marando
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Kevin Bowman
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Jason Boer
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Krista Burke
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Richard Wynn
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Alex Margulis
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Gary W. Reuther
- Department of Molecular Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida, United States of America
| | - Que T. Lambert
- Department of Molecular Oncology, H. Lee Moffitt Cancer Center, Tampa, Florida, United States of America
| | | | - Ke Zhang
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Hao Feng
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Chu-Biao Xue
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Sharon Diamond
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Greg Hollis
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Swamy Yeleswaram
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Wenqing Yao
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Reid Huber
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Kris Vaddi
- Incyte Corporation, Wilmington, Delaware, United States of America
| | - Peggy Scherle
- Incyte Corporation, Wilmington, Delaware, United States of America
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Falchook G, Talpaz M, Mita M, Szmulewitz R, Piha-Paul S, Harb W, Morgensztern D, Kaplan J, Munster P, Cornell RF, Zheng F, Yeleswaram S, Zhou G, Cassaday R. Abstract A093: Phase 1/2 study of INCB054329, a bromodomain and extraterminal (BET) protein inhibitor, in patients (pts) with advanced malignancies. Clin Trials 2018. [DOI: 10.1158/1535-7163.targ-17-a093] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lee SH, Diamond M, Chadderton A, Condamine T, Liu H, Roman V, Lu J, Zhang Y, Soloviev M, He C, Wu L, Koblish H, Burn T, Combs A, Yeleswaram S, Roberts A, Yao W, Hollis G, Huber R, Scherle P, Ruggeri B. Abstract A168: The LSD1 specific inhibitor INCB059872 enhances the activity of mechanistically distinct immunotherapeutic agents in the syngeneic 4T1 mouse mammary tumor model. Mol Cancer Ther 2018. [DOI: 10.1158/1535-7163.targ-17-a168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Despite the successes of immune checkpoint blockade for the treatment of a variety of cancers, effective combinatorial therapy strategies are needed to achieve more durable and complete clinical responses in patients. Pharmacologically inducing a more permissive tumor microenvironment to enhance patient responsiveness to immune modulatory therapies may offer a rational approach to address this medical need. In particular, targeting immune suppressive myeloid cells, including myeloid-derived suppressor cells (MDSC), tumor-associated macrophages (TAM), and polymorphonuclear (PMN) cells in the tumor microenvironment may enhance the effectiveness of immune checkpoint blockade. Since MDSCs abundantly infiltrate syngeneic 4T1 mammary tumors compared with other commonly used syngeneic tumor models, this model was chosen for testing the hypothesis that the modulation of MDSC activity enhances antitumor activity driven by adaptive immunity. We have recently demonstrated (#4635, AACR 2017) that the selective Lysine Specific Demethylase 1 (LSD1) inhibitor, INCB059872, redirected myeloid differentiation toward monocyte/macrophages in vitro and in vivo and reduced the PMN-MDSC population in the syngeneic 4T1 murine mammary tumor model. The combination of INCB059872 and PD1/PDL1 axis blockade enhanced antitumor activity and was well tolerated in this model. In this study, we further tested if modulation of MDSCs with INCB059872 could enhance the effect of mechanistically distinct immunotherapeutic agents. The combination of INCB059872 with agonist anti-OX40 or anti-GITR T cell costimulatory monoclonal antibodies significantly augmented antitumor efficacy in the 4T1 model. These results consistently demonstrated that the inhibition of immune suppressive MDSCs increased antitumor activity of immune checkpoint modulatory monoclonal antibodies. Next, we tested the combination of INCB059872 with small-molecule inhibitors targeting the tumor microenvironment. The combination of INCB059872 with highly selective small-molecule immunotherapeutic inhibitors such as epacadostat (IDO1 inhibitor) and ruxolitinib (JAK1/JAK2 inhibitor) demonstrated similar marked increases in antitumor efficacy. The studies to understand mechanism of enhanced activity are under way. In summary, consistent with previous findings, the combination of INCB059872 with a variety of mechanistically distinct immunotherapeutic agents significantly enhanced antitumor efficacy in the syngeneic 4T1 murine mammary tumor model. These results strongly support the hypothesis that reshaping the tumor microenvironment by redirecting myeloid differentiation as a result of LSD1 inhibition enhances the responsiveness of the tumor microenvironment to immunotherapies, supporting the therapeutic rationale for the combination of an LSD1 inhibitor with various immunotherapeutic agents to improve clinical responses in cancer patients.
Citation Format: Sang Hyun Lee, Melody Diamond, Antony Chadderton, Thomas Condamine, Huiqing Liu, Valerie Roman, Jin Lu, Yan Zhang, Maxim Soloviev, Chunhong He, Liangxing Wu, Holly Koblish, Timothy Burn, Andrew Combs, Swamy Yeleswaram, Alan Roberts, Wenqing Yao, Gregory Hollis, Reid Huber, Peggy Scherle, Bruce Ruggeri. The LSD1 specific inhibitor INCB059872 enhances the activity of mechanistically distinct immunotherapeutic agents in the syngeneic 4T1 mouse mammary tumor model [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2017 Oct 26-30; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Ther 2018;17(1 Suppl):Abstract nr A168.
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Affiliation(s)
| | | | | | | | | | | | - Jin Lu
- Incyte Corporation, Wilmington, DE
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Shin N, Li YL, Mei S, Wang KH, Hall L, Katiyar K, Wang Q, Yang G, Rumberger B, Leffet L, He X, Rupar M, Bowman K, Favata M, Li J, Liu M, Li Y, Covington M, Koblish H, Soloviev M, Shuey D, Burn T, Diamond S, Fridman J, Combs A, Yao W, Yeleswaram S, Hollis G, Vaddi K, Huber R, Newton R, Scherle P. INCB040093 Is a Novel PI3Kδ Inhibitor for the Treatment of B Cell Lymphoid Malignancies. J Pharmacol Exp Ther 2017; 364:120-130. [DOI: 10.1124/jpet.117.244947] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 10/31/2017] [Indexed: 01/08/2023] Open
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Shi JG, Chen X, Punwani NG, Williams WV, Yeleswaram S. Potential Underprediction of Warfarin Drug Interaction From Conventional Interaction Studies and Risk Mitigation: A Case Study With Epacadostat, an IDO1 Inhibitor. J Clin Pharmacol 2017; 56:1344-1354. [PMID: 26990117 DOI: 10.1002/jcph.737] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 03/08/2016] [Accepted: 03/09/2016] [Indexed: 11/06/2022]
Abstract
Drug-drug interaction (DDI) studies involving warfarin are typically conducted with subtherapeutic doses of warfarin to ensure the safety of volunteers. However, this approach may potentially have a systemic bias of underestimating pharmacodynamic (PD) DDI effect on warfarin at therapeutic levels of anticoagulation. We demonstrate here the utility of model-based DDI prediction for a clinically relevant warfarin regimen, using the example of epacadostat (INCB024360), the first-in-class indoleamine 2,3-dioxygenase 1 inhibitor in clinical development as a novel orally active immuno-oncological therapy. Observed data from a dedicated clinical DDI study using subtherapeutic warfarin suggested warfarin pharmacokinetics (PK), but not PD (anticoagulation), was significantly affected by concomitant epacadostat. However, subsequent PK/PD modeling and simulations indicated a clinically important DDI effect on warfarin PD at a higher baseline of the international normalization ratio (INR) and enabled recommendation of warfarin dose adjustment that is dependent on epacadostat dosing regimen and target INR.
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Affiliation(s)
- Jack G Shi
- Incyte Corporation, Wilmington, DE, USA.
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Saleh M, Gutierrez ME, Subbiah V, Smith DC, Asatiani E, Lihou CF, Zhen H, Yeleswaram S, Ji T, Nemunaitis J. Abstract CT111: Preliminary results from a phase 1/2 study of INCB054828, a highly selective fibroblast growth factor receptor (FGFR) inhibitor, in patients with advanced malignancies. Clin Trials 2017. [DOI: 10.1158/1538-7445.am2017-ct111] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Liu PC, Lu L, Bowman K, Stubbs MC, Wu L, DiMatteo D, Condon S, Klabe R, Qian DQ, Wen X, Collier P, Gallagher K, Hansbury M, He X, Ruggeri B, Yang YO, Covington M, Burn TC, Diamond-Fosbenner S, Wynn R, Huber R, Yao W, Yeleswaram S, Scherle P, Hollis G. Abstract 2100: Selective inhibition of FGFR4 by INCB062079 is efficacious in models of FGF19- and FGFR4-dependent cancers. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-2100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Aberrant signaling through Fibroblast Growth Factor Receptors (FGFR) has been reported in multiple types of human cancers. FGFR4 signaling contributes to the development and progression of subsets of cancer: in approximately 10 percent of hepatocellular carcinoma (HCC), genetic amplification of FGF19, encoding an endocrine FGF ligand that activates FGFR4-KLB receptors, has been reported. In models with this alteration, FGF19-FGFR4 signaling is oncogenic and antagonism of the FGF19-FGFR4 axis has been shown to be efficacious suggesting that selective targeting of FGFR4 may be an effective strategy for malignancies with FGFR4 activation.
We describe the preclinical characterization of INCB062079 a potent and selective inhibitor of the FGFR4 kinase. In biochemical assays INCB062079 inhibited FGFR4 with low nM potency and exhibited at least 250-fold selectivity against other FGFR kinases and greater than 800-fold selectivity against a large kinase panel. This selectivity derives from the ability of INCB062079 to bind irreversibly to Cys552, a residue within the active site of FGFR4 that is non-conserved among other FGFR receptors. Covalent binding of INCB062079 to Cys552 was demonstrated using a LC/MS/MS-based proteomic analysis that confirmed specificity for the target Cys. In assays using HCC cells with autocrine production of FGF19, INCB062079 inhibited the autophosphorylation of FGFR4 and blocked signal transduction by FGFR4 to downstream markers of pathway activation. Cancer cell lines that have amplification and expression of FGF19 are uniquely sensitive to growth inhibition by INCB062079 (EC50 less than 200 nM) compared with HCC cell lines or normal cells without FGF19-FGFR4 dependence (EC50 > 5000 nM) confirming selectivity for FGFR4. In vivo, oral administration of INCB062079 inhibited the growth and induced significant regressions of subcutaneous xenograft tumors dependent upon FGFR4 activity at doses that were well-tolerated (10-30 mg/kg BID) and did not result in a significant increase in serum phosphate levels which is observed with FGFR1/2/3 inhibition. Suppression of tumor growth correlated with pharmacodynamic inhibition of FGFR4 signaling. Collectively, these preclinical studies demonstrate that INCB062079 potently and selectively inhibits models of FGF19-FGFR4-dependent cancers in vitro and in vivo, supporting clinical evaluation in patients harboring oncogenic FGFR4 activation.
Citation Format: Phillip C.C. Liu, Liang Lu, Kevin Bowman, Matthew C. Stubbs, Liangxing Wu, Darlise DiMatteo, Sindy Condon, Ronald Klabe, Ding-Quan Qian, Xiaoming Wen, Paul Collier, Karen Gallagher, Michael Hansbury, Xin He, Bruce Ruggeri, Yan-ou Yang, Maryanne Covington, Timothy C. Burn, Sharon Diamond-Fosbenner, Richard Wynn, Reid Huber, Wenqing Yao, Swamy Yeleswaram, Peggy Scherle, Gregory Hollis. Selective inhibition of FGFR4 by INCB062079 is efficacious in models of FGF19- and FGFR4-dependent cancers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2100. doi:10.1158/1538-7445.AM2017-2100
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Caimi P, Ramchandren R, Phillips T, Wertheim M, Gutierrez M, Edenfield W, Akard L, Call J, Persky D, DeMarini D, Zhou L, Yeleswaram S, Forero-Torres A. ONGOING PHASE 1/2 STUDY OF INCB050465, A SELECTIVE PI3Kδ INHIBITOR, FOR THE TREATMENT OF PATIENTS (PTS) WITH RELAPSED/REFRACTORY (R/R) B-CELL MALIGNANCIES (CITADEL-101). Hematol Oncol 2017. [DOI: 10.1002/hon.2438_139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- P. Caimi
- Department of Medicine-Gastroenterology; University Hospitals Seidman Cancer Center; Cleveland OH USA
| | - R. Ramchandren
- Hematology/Oncology; Karmanos Cancer Center; Detroit MI USA
| | - T.J. Phillips
- Hematology/Oncology; University of Michigan; Ann Arbor MI USA
| | - M.S. Wertheim
- Hematology/Oncology, Hematology/Oncology Associates of Treasure Coast; Port St Lucie FL USA
| | - M.E. Gutierrez
- Drug Discovery and Phase I Unit; Hackensack University Medical Center; Hackensack NJ USA
| | - W.J. Edenfield
- Hematology; Greenville Health System Cancer Institute; Greenville SC USA
| | - L.P. Akard
- Hematology; Indiana Blood & Marrow Transplantation, LLC; Indianapolis IN USA
| | - J.A. Call
- Hematology/Oncology; Utah Cancer Specialists-Network; Salt Lake City UT USA
| | - D.O. Persky
- Hematology/Oncology; University of Arizona Cancer Center; Tucson AZ USA
| | - D.J. DeMarini
- Clinical Development; Incyte Corporation; Wilmington USA
| | - L. Zhou
- Clinical Development; Incyte Corporation; Wilmington USA
| | - S. Yeleswaram
- Clinical Development; Incyte Corporation; Wilmington USA
| | - A. Forero-Torres
- Hematology/Oncology; University of Alabama Birmingham; Birmingham AL USA
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Ramchandren R, Phillips TJ, Wertheim M, Gutierrez M, Edenfield WJ, Akard LP, Caimi PF, Call J, Persky DO, DeMarini DJ, Zhou L, Yeleswaram S, Forero-Torres A. Ongoing phase 1/2 study of INCB050465 for relapsed/refractory (R/R) B-cell malignancies (CITADEL-101). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.7530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
7530 Background: INCB050465 is a selective PI3Kδ inhibitor with no preclinical hepatotoxicity at clinically relevant doses. We report emerging safety and efficacy data from a phase 1/2 study of INCB050465 in patients (pts) with r/r B-cell malignancies (NCT02018861). Methods: The protocol was initiated with a single patient cohort, treated with INCB050465 5 mg QD PO. Subsequent cohorts used a 3+3 design and evaluated doses of 10–45 mg QD. Based on PK/PD, the 20 and 30 mg QD cohorts were expanded. Responses were assessed Q9W by the Lugano Classification or International Working Group on Chronic Lymphocytic Lymphoma (CLL) criteria. Results: As of the data cutoff (Nov 1, 2016), 52 pts were treated (median age, 65 y [range, 30–88]; baseline tumors: diffuse large B-cell lymphoma [DLBCL], n=14; follicular lymphoma [FL], n=10; Hodgkin lymphoma [HL], n=9; marginal zone lymphoma [MZL], n=8; CLL, n=6; mantle cell lymphoma [MCL], n=5; 62% had >3 prior systemic regimens). Median duration of therapy was 3.3 mo (range, 0.6–13.4); no DLTs were identified. 67% of pts discontinued therapy (disease progression, 31%; AEs, 25%); 33% had dose interruption; 4% had reduction. Most common nonhematologic AEs (all grade [Gr]; Gr ≥3): nausea (38%; 0%), diarrhea (31%; 6%), vomiting (25%; 0%); Gr ≥3 hematologic AEs: neutropenia (21%), lymphopenia (17%), thrombocytopenia (10%), anemia (4%). 40% of pts had serious AEs, most frequently colitis, diarrhea, hypotension (all n=3). 1 pt had Gr 3 pneumonitis; none had Pneumocystis jirovecii pneumonia (PJP) or Gr ≥2 elevated transaminase. Objective responses (ORs) occurred at all doses (Table), except 5 mg QD; 90% were observed at first assessment. Conclusions: INCB050465 demonstrated manageable toxicities with no clinically meaningful transaminitis/PJP. OR rates were generally high, with 90% observed at first assessment. Different dosing regimens/schedules, long-term safety, and disease-specific cohorts are being evaluated. Clinical trial information: NCT02018861. [Table: see text]
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Affiliation(s)
| | | | - Michael Wertheim
- Hematology Oncology Associates of the Treasure Coast, Port Saint Lucie, FL
| | | | | | - Luke Paul Akard
- Indiana Blood and Marrow Transplantation, LLC, Indianapolis, IN
| | - Paolo Fabrizio Caimi
- Adult Hematologic Malignancies and Stem Cell Transplant Section, Seidman Cancer Center, University Hospitals Case Medical Center, Cleveland, OH
| | | | | | | | - Li Zhou
- Incyte Corporation, Wilmington, DE
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Zhang Q, Zhang Y, Boer J, Shi JG, Hu P, Diamond S, Yeleswaram S. In Vitro Interactions of Epacadostat and its Major Metabolites with Human Efflux and Uptake Transporters: Implications for Pharmacokinetics and Drug Interactions. Drug Metab Dispos 2017; 45:612-623. [DOI: 10.1124/dmd.116.074609] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Accepted: 03/03/2017] [Indexed: 11/22/2022] Open
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Shi JG, Bowman KJ, Chen X, Maleski J, Leopold L, Yeleswaram S. Population Pharmacokinetic and Pharmacodynamic Modeling of Epacadostat in Patients With Advanced Solid Malignancies. J Clin Pharmacol 2016; 57:720-729. [PMID: 27990653 DOI: 10.1002/jcph.855] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 11/10/2016] [Indexed: 12/29/2022]
Abstract
Epacadostat (EPA, INCB024360) is a selective inhibitor of the enzyme indoleamine 2,3-dioxygenase 1 (IDO1) and is being developed as an orally active immunotherapy to treat advanced malignancies. In the first clinical study investigating the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of EPA in oncology patients, increasing doses of EPA ranging from 50 mg once daily to 700 mg twice daily were administered as a monotherapy to 52 subjects with advanced solid tumors. The EPA plasma concentration-time profiles were adequately described by a population PK model comprised of the first-order kinetics of oral absorption with 2-compartment distribution and constant clearance from the central compartment. Body weight was the only significant covariant to influence EPA PK. Determination of EPA's on-target potency, ie, its half-maximal inhibitory concentration (IC50 ) against IDO1, is important for dose selection but complicated by the bioconversion of tryptophan (TRP) to kynurenine (KYN) catalyzed by both IDO1 and TRP 2,3-dioxygenase (TDO). In vitro and ex vivo, the IC50 was estimated following the selective induction of IDO1, rendering the TDO activity relatively insignificant; however, it was desirable to determine the in vivo IC50 without inducing an IDO1 abundance. A mechanistic population PD model was developed based on time-matched EPA, TRP, and KYN plasma concentrations in 44 oncology patients, and EPA in vivo IC50 was estimated to be ∼70 nM, consistent with the ex vivo value independently determined. The model suggests that ∼60% and 40% of TRP→KYN bioconversion was mediated by IDO1 and TDO, respectively, in the cancer patients at baseline. For this study population of limited numbers of subjects, neither age nor sex was a significant covariate for EPA PK or PD.
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Boer J, Young-Sciame R, Lee F, Bowman KJ, Yang X, Shi JG, Nedza FM, Frietze W, Galya L, Combs AP, Yeleswaram S, Diamond S. Roles of UGT, P450, and Gut Microbiota in the Metabolism of Epacadostat in Humans. Drug Metab Dispos 2016; 44:1668-74. [DOI: 10.1124/dmd.116.070680] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/20/2016] [Indexed: 12/21/2022] Open
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Forero-Torres A, Wertheim MS, Phillips TJ, Gutierrez ME, Edenfield WJ, Yeleswaram S, Bleam M, Zhou L, Pulini JH, Faivre T, Miao H, Spear M, Ramchandren R. Abstract CT056: Preliminary safety, efficacy, and pharmacodynamics of a highly selective PI3Kδ inhibitor, INCB050465, in patients with previously treated B-cell malignancies. Clin Trials 2016. [DOI: 10.1158/1538-7445.am2016-ct056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bissonnette R, Luchi M, Fidelus-Gort R, Jackson S, Zhang H, Flores R, Newton R, Scherle P, Yeleswaram S, Chen X, Menter A. A randomized, double-blind, placebo-controlled, dose-escalation study of the safety and efficacy of INCB039110, an oral janus kinase 1 inhibitor, in patients with stable, chronic plaque psoriasis. J DERMATOL TREAT 2016; 27:332-8. [PMID: 26769332 DOI: 10.3109/09546634.2015.1115819] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Chronic plaque psoriasis is partially mediated by elevation of proinflammatory cytokines, including several within the Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway. OBJECTIVE To evaluate the safety and efficacy of the oral selective JAK1 inhibitor INCB039110 in stable, chronic plaque psoriasis. METHODS This was a phase 2, randomized, double-blind, placebo-controlled, dose-escalation study of INCB039110 (100 mg once daily, 200 mg once daily, 200 mg twice daily and 600 mg once daily) for 28 days. The primary endpoint was mean percent change from baseline in the static Physician Global Assessment (sPGA) at day 28. The protocol was institutional review board approved. RESULTS Of 50 patients, 48 completed the study. At day 28, mean percent reduction from baseline in sPGA was 22.2% for INCB039110 100 mg once daily (p = 0.270 vs. placebo), 29.4% for 200 mg once daily (p = 0.118), 35.2% for 200 mg twice daily (p = 0.053), 42.4% for 600 mg once daily (p = 0.003) and 12.5% for placebo. Across groups, 11.1% to 45.5% achieved an sPGA score of 1 versus 0% for placebo. INCB039110 was generally well tolerated; the most common treatment-emergent adverse event was nasopharyngitis (18.4%). CONCLUSION INCB039110 produced significant improvements in sPGA, demonstrating proof of concept in chronic plaque psoriasis.
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Affiliation(s)
| | - Monica Luchi
- b Incyte Corporation , Wilmington , DE , USA , and
| | | | | | | | | | | | | | | | - Xuejun Chen
- b Incyte Corporation , Wilmington , DE , USA , and
| | - Alan Menter
- c Division of Dermatology , Baylor University Medical Center , Dallas , TX , USA
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50
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Punwani N, Burn T, Scherle P, Flores R, Shi J, Collier P, Hertel D, Haley P, Lo Y, Waeltz P, Rodgers J, Shepard S, Vaddi K, Yeleswaram S, Levy R, Williams W, Gottlieb AB. Downmodulation of key inflammatory cell markers with a topical Janus kinase 1/2 inhibitor. Br J Dermatol 2015; 173:989-97. [PMID: 26123031 DOI: 10.1111/bjd.13994] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2015] [Indexed: 12/30/2022]
Abstract
BACKGROUND INCB018424 is a novel, potent Janus kinase (JAK)1/JAK2 inhibitor that blocks signal transduction of multiple proinflammatory cytokines. OBJECTIVES To evaluate the safety, tolerability, pharmacokinetics, pharmacodynamics and preliminary efficacy of topical INCB018424 phosphate cream in patients with plaque psoriasis. METHODS Topical INCB018424 phosphate 1·0% or 1·5% cream was applied once daily (QD) or twice daily (BID) for 4 weeks to 2-20% body surface area in five sequential cohorts of five patients aged 18-65 years. Target lesions were scored on a scale of 0-4 for erythema, scaling and thickness. Additionally, the overall disease activity in each patient was measured using Physician's Global Assessment. INCB018424 concentrations were measured in plasma, and cytokine stimulated phosphorylated signal transducer and activator of transcription 3 phosphorylation (pSTAT3) levels in peripheral blood cells were evaluated. Pretreatment and post-treatment skin biopsies were compared with healthy skin, including evaluation of histopathology, immunohistochemistry and mRNA expression. RESULTS Treatment with INCB018424 phosphate cream either 1·0% QD or 1·5% BID resulted in improvements in lesion scores. No significant inhibition of pSTAT3 in peripheral blood cells was observed following topical application, consistent with the generally low steady-state plasma concentrations of INCB018424 measured. Transcriptional markers of immune cell lineage/activation in lesional skin were reduced by topical INCB018424, with correlations observed between clinical improvement and decreases in markers of T helper 17 lymphocyte activation, dendritic-cell activation and epidermal hyperplasia. INCB018424 treatment reduced epidermal hyperplasia and dermal inflammation in most patient samples, with reductions in CD3, CD11c, Ki67 and keratin 16 observed by immunohistochemical analysis. CONCLUSIONS Topical INCB018424 dosed for 28 days QD or BID is pharmacologically active in patients with active psoriasis and modulates proinflammatory cytokines in the pathogenesis of psoriatic lesions.
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Affiliation(s)
- N Punwani
- Drug Development, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - T Burn
- Drug Discovery, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - P Scherle
- Drug Discovery, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - R Flores
- Drug Development, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - J Shi
- Drug Discovery, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - P Collier
- Drug Discovery, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - D Hertel
- Drug Discovery, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - P Haley
- Drug Discovery, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - Y Lo
- Drug Discovery, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - P Waeltz
- Drug Discovery, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - J Rodgers
- Drug Discovery, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - S Shepard
- Drug Discovery, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - K Vaddi
- Drug Discovery, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - S Yeleswaram
- Drug Discovery, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - R Levy
- Drug Development, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - W Williams
- Drug Development, Incyte Corporation, Rt. 141 and Henry Clay Road, Wilmington, DE, 19880, U.S.A
| | - A B Gottlieb
- Department of Dermatology, Tufts Medical Center, Boston, MA, U.S.A
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