Neuropersonaltrainer-mh: A New Computerized Platform for the Cognitive Remediation in Schizophrenia and Bipolar Disorders

Schizophrenia and mood disorders -including unipolar depression and bipolar disorder-, are severe mental diseases with a highly heterogeneous symptomatology, among which cognitive dysfunction has progressively emerged as a key cornerstone. Patients suffering from these illnesses show significant deficits in different neurocognitive and social cognition domains. These deficits are evident during acute episodes, and in a high percentage of patients persist in periods of recovery, playing a decisive role on functional and clinical outcome. Nowadays, different pharmacological therapies have been tested, obtaining non-conclusive results. In this context, non-pharmacological strategies, such as neurocognitive remediation, have emerged as promising therapeutic intervention. Neurocognitive remediation comprises a program to rehabilitate cognitively impaired subjects, aiming either to restore their cognitive functioning or to compensate them in specific cognitive domains. One evolving approach, beginning to receive attention for its initial promising results, is computerized cognitive training. This technique employs tasks or games that exercise a particular brain function which target specific neural networks in order to improve cognitive functioning through neuroplasticity in a given neural circuit. In this scenario, we report our recent results with neuropersonaltrainer®-MH; a module for neurocognitive remediation consisting in a computerized telerehabilitation platform that enables cognitive remediation programs to be carried out in an intensive and personalized manner. Our group has applied NPTMH® in a pilot study treating patients with early onset psychotic disorder with positive and promising results, involving an improvement in functionality, neurocognition, and social cognition performance. Furthermore, new trials in bipolar disorder and major depressive disorder have been recently started.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Abstract 4337: Novel potent and selective orally available CDK8/19 kinase inhibitors

CDK8 and its paralog CDK19 are cyclin-dependent kinases and together with CDK7 and CDK9 belongs to the group of C-terminal domain (CTD) kinases that phosphorylate the CTD of RNA polymerase II, thus regulating transcription. CDK8 together with its partner Cyclin C, MED12 and MED13 are components of multi-protein Mediator complex which couples action of transcription factors with the molecular machinery that carries out transcription, e.g. CDK8 couple basal transcriptional machinery to sequence-specific transcription factors such as Notch, p53, β-catenin, and also repress the transcription of other genes. As Mediator independent roles, CDK8 has been shown to act as part of a separate complex behaving as a histone kinase. Moreover, CDK8 has been identified as a major kinase in the response to IFN signaling mediated STAT1-S727 phosphorylation.

Several studies indicated that high overexpression and activity of CDK8 could be a driver of malignant progression in colorectal cancer being a marker of poor prognosis. Moreover, in gastric cancer CDK8 expression and the delocalization of β-catenin expression showed a significant positive correlation with carcinogenesis and tumor progression, especially lymph node metastasis. Recently, gene amplification of CDK8, CDK19, CCNC and MED13 in breast cancers has been related with poor response to adjuvant therapy. These results suggest that CDK8 inhibitors may become a unique class of anticancer drugs that could increase the efficacy of cancer therapy by blocking chemotherapy-induced production of tumor-promoting secreted factors.

We have carried out a medium throughput screening campaign which led to the discovery of several low nanomolar hits belonging to 3 different chemical series. Later on, we have performed a Hit Generation phase, designing novel inhibitors within a patentable chemical space. Here, we have taken into account information from the chemical structures of the screening hits, X-ray structure of CDK8 protein co-crystalized with sorafenib, docking studies, chemical feasibility and intellectual property.

We have identified a novel chemical series of CDK8/19 inhibitors. After a HtL exploration we have reached lead compounds with potency in the picomolar range and high selectivity versus a panel of 468 protein kinases. The leads display cellular activity by blocking β−catenin reporter activity and STAT1 phoshorylation in the low nanomolar range. Lead compounds have been screened in a panel of tumoral cell lines, showing a defined profile in terms of sensitivity with GI50s which range from nanomolar to low micromolar values. These inhibitors induce cell death in a dose response manner. The novel chemical series show a drug-like profile in terms of solubility, permeability, CYP450 inhibition and hERG. The identified lead compounds are orally bioavailable, with good clearance, volume of distribution and exposure levels. A selected lead compound has been used in in vivo PK-PD studies showing positive results.

Citation Format: Carmen Blanco Aparicio, Oliver Renner, Elena Gomez-Casero, Maria Isabel Albarran, Antonio Cebria, Borja Barrera, Enara Aguirre, Maria del Carmen Rodriguez de Miguel, Manuel Urbano, Ana Isabel Hernandez, Cristina Gomez de la Oliva, Virginia Rivero, Rosario Concepcion Riesco, Sonia Martinez Gonzalez, Joaquin Pastor. Novel potent and selective orally available CDK8/19 kinase inhibitors. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4337.

Abstract B227: Discovery of 3-aryl-3H-[1,2,3]triazolo[4,5-b]pyridin-5-ylamine compounds as potent, selective and orally bioavailable inhibitors of PIM kinases

The PIM family of serine/threonine kinases (PIM-1, 2 and 3) has been originally identified as proviral integration sites involved in lymphomagenesis induced by murine leukemia virus. In almost all of the MuLV-induced lymphomas in Eμ-Pim-1 transgenic mice either c-MYC or N-MYC is activated by proviral insertion. The oncogenic properties of Pim kinases were shown to encompass their capacity to counteract the increased sensitivity to apoptosis induction that is associated with MYC-driven tumorigenesis. Pim-1, 2 and 3 are highly conserved kinases that have unique structural properties, and are characterized by a constitutive serine/threonine activity that does not depend on post-translational modifications for activation. Pim kinases activity supports in vitro and in vivo tumor cell growth and survival through modification of an increasing number of common as well as isoform-specific substrates. Pim expression is driven by oncogenes as BCR-ABL, JAK2, FLT3 and KRas. Pim kinases are overexpressed in a range of haematopoietic malignancies and solid cancers, and its overexpression is associated with drug resistance. Inhibition of PIM kinase activity may be an attractive therapeutic strategy with possible favourable toxicity profiles due to minimal phenotype of mice mutant for all Pim family members.

Based on the knowledge of complexes of ligands with PIM1 protein, previously reported, as well as known PIM1 inhibitors coming from and internal HTS campaign, we carried out a scaffold hopping strategy for hit generation. We identified triazolopyridine compounds with potent activity against PIM and FLT3 kinases. We have explored different substitution patterns to improve selectivity of PIM vs FLT3 activity. Here, we describe the exploration and biological characterization of this bicyclic series, reporting its SAR/SPR (ADME).

We identified lead compounds with potency in the low nanomolar range vs. PIM1, 2 and 3 and high selectivity versus a panel of 24 protein kinases. The compounds display cellular activity by blocking PIM signaling, S112 P-Bad in H1299 Pim1 cells, in the low nanomolar range. The combination of the PI3K inhibitor GDC-0941 with Pim inhibitors was strongly synergistic in vitro in non solid and solid tumoral cell lines.

Finally, we assessed the effect of Pim kinase inhibition on Pim signaling and tumor growth in vivo in a mouse intravenous tumor xenograft model employing tumoral cells coming from E myc mice and in an inducible transgenic KRasV12 mouse model. When delivered orally, ETP-995 inhibited phosphorylation of bad and 4EBP and reduced c-myc expression in vivo, and the compound significantly inhibited tumor growth.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2011 Nov 12-16; San Francisco, CA. Philadelphia (PA): AACR; Mol Cancer Ther 2011;10(11 Suppl):Abstract nr B227.

Abstract B228: Discovery of 6-Methyl-3-aryl-7,8-dihydro-6H-9-oxa-1,2,3a,4,6-pentaaza-cyclopenta[a]naphthalen-5-ylamine compounds as Pim kinase inhibitors with potent activity in tumoral cell lines and special binding mode

Proviral integration site for Moloney murine leukemia virus (PIM) kinases are potent oncogens. Pim-1, 2 and 3 are highly conserved kinases that have unique structural properties, and are characterized by a constitutive serine/threonine activity that does not depend on post-translational modifications for activation. Pim kinases activity supports in vitro and in vivo tumor cell growth and survival through modification of an increasing number of common as well as isoform-specific substrates including c-myc and Histone H3, which drive transcription, eukaryotic elongation factor 4E-BP-1 that regulates transcription and Bad that activates cell survival. Furthermore, cell cycle protein activation by Pim kinases is involved with proliferation, and through regulation of AMPK activity Pim kinases mediated control of energy metabolism. Pim kinases are overexpressed in a range of haematopoietic malignancies and solid cancers, and its overexpression is associated with drug resistance. Inhibition of PIM kinase activity may be an attractive therapeutic strategy with possible favourable toxicity profiles due to minimal phenotype of mice mutant for all Pim family members.

Knowledge of the three-dimensional structure of Pim1 is especially important for understanding the design of potent and selective Pim1 inhibitors as novel therapeutic agents. Using a rational strategy we have generated a novel chemical series, by introduction of a morpholine cycle in the C-7, C-8 position of the triazolopyridazine ring. Morpholine ring can be accommodated in the catalytic site due to a change in the conformation of the P-loop on the crystal structure to afford very potent and selective tricyclic compounds against PIM kinases. Depending on the amine C-6 substitution fragment we have observed different isoforms profiles. Here, we describe the exploration and biological characterization of C-6 tricyclic series, reporting its SAR/SPR (ADME).

We identified lead compounds with potency in the low nanomolar range vs. PIM1, 2 and 3 and high selectivity versus a panel of 24 protein kinases. The compounds display cellular activity by blocking PIM signaling, S112 P-Bad in H1299 Pim1 cells, in the low nanomolar range. The combination of the PI3K inhibitor GDC-0941 with Pim inhibitors was strongly synergistic in vitro in non solid and solid tumoral cell lines.

Finally, we assessed the effect of Pim kinase inhibition on Pim signaling in vivo in a mouse subcutaeneous tumor xenograft model employing a human mantle cell lymphoma cell line, Jeko-1. Results demonstrated that ETP-652 inhibited phosphorylation of S112 P-Bad in vivo.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2011 Nov 12-16; San Francisco, CA. Philadelphia (PA): AACR; Mol Cancer Ther 2011;10(11 Suppl):Abstract nr B228.

Abstract 627: Etp-47187 a novel potent and efficacious dual inhibitor of phosphoinositide-3-kinases and mTOR

The phosphoinositide-3-kinase (PI3K) signaling pathway is activated in a variety of solid and non-solid tumors. In many instances this is due to either activating mutations in the catalytic subunit of PI3Kα, p110α, or inactivating mutations or deletions of the tumor suppressor PTEN. In addition, the PI3K pathway is activated by mutations in certain receptor tyrosine kinases as well as by mutation of the oncogene KRAS. All of these lesions lead to enhanced activity of both PI3K and mTOR. Hence there is great interest to discover inhibitors of PI3K and mTOR for the treatment for cancer. Following a rational design strategy, we identified the fused thiadiazole derivative ETP-47187 as a potent dual inhibitor of PI3Kα and mTOR Kis = 0.18 nM and 1.2 nM, respectively. ETP-47187 also inhibits three oncogenc mutants of p110α: p110α E542K Ki = 0.38 nM, p110α E545K Ki = 0.2 nM and p110α H1047R Ki = 0.29 nM as well as PI3Kβ, PI3KΔ and PI3Kγ Kis 2.7, 0.26 and 1.5 nM, respectively. The compound inhibits PI3K signaling in treated tumor cell lines; the EC50 for inhibition of the phosphorylation of Akt was 5 nM. ETP-47187 has a pharmacokinetic profile suitable for oral dosing in mice (%F = 73%, Cl = 0.11 L/hr/kg; Vds = 0.38 L/h/kg). Treatment of tumor bearing mice with the compound causes a dose dependent reduction in P-Akt levels in the tumor. Once a day treatment of mice bearing human tumor xenografts with ETP-47187 results in significant tumor growth delay and is well tolerated. In a mouse model of lung cancer induced by expression of an oncogenic mutant KRAS, treatment with ETP-47187 blocked tumor growth and lead to a significant PET response. These and combination data will be discussed. We believe ETP-47187 and compounds like it are suitable to propose for clinical development in cancer patients with activated PI3K signaling.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 627. doi:10.1158/1538-7445.AM2011-627