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Derippe T, Fouliard S, Decleves X, Mager DE. Quantitative systems pharmacology modeling of tumor heterogeneity in response to BH3-mimetics using virtual tumors calibrated with cell viability assays. CPT Pharmacometrics Syst Pharmacol 2024; 13:1252-1263. [PMID: 38747730 PMCID: PMC11247121 DOI: 10.1002/psp4.13158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/17/2024] [Accepted: 04/24/2024] [Indexed: 07/16/2024] Open
Abstract
Both primary and acquired resistance mechanisms that involve intra-tumoral cell heterogeneity limit the use of BH3-mimetics to trigger tumor cell apoptosis. This article proposes a new quantitative systems pharmacology (QSP)-based methodology in which cell viability assays are used to calibrate virtual tumors (VTs) made of virtual cells whose fate is determined by simulations from an apoptosis QSP model. VTs representing SU-DHL-4 and KARPAS-422 cell lines were calibrated using in vitro data involving venetoclax (anti-BCL2), A-1155463 (anti-BCLXL), and/or A-1210477 (anti-MCL1). The calibrated VTs provide insights into the combination of several BH3-mimetics, such as the distinction between cells eliminated by at least one of the drugs (monotherapies) from the cells eliminated by a pharmacological combination only. Calibrated VTs can also be used as initial conditions in an agent-based model (ABM) framework, and a minimal ABM was developed to bridge in vitro SU-DHL-4 cell viability results to tumor growth inhibition experiments in mice.
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Affiliation(s)
- Thibaud Derippe
- Institut de Recherches Internationales Servier, Suresnes, France
- Inserm, UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
- Department of Pharmaceutical Sciences, University at Buffalo, SUNY, Buffalo, New York, USA
| | - Sylvain Fouliard
- Institut de Recherches Internationales Servier, Suresnes, France
| | - Xavier Decleves
- Inserm, UMRS-1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Université Paris Cité, Paris, France
| | - Donald E Mager
- Department of Pharmaceutical Sciences, University at Buffalo, SUNY, Buffalo, New York, USA
- Enhanced Pharmacodynamics, LLC, Buffalo, New York, USA
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Balachander SB, Criscione SW, Byth KF, Cidado J, Adam A, Lewis P, Macintyre T, Wen S, Lawson D, Burke K, Lubinski T, Tyner JW, Kurtz SE, McWeeney SK, Varnes J, Diebold RB, Gero T, Ioannidis S, Hennessy EJ, McCoull W, Saeh JC, Tabatabai A, Tavana O, Su N, Schuller A, Garnett MJ, Jaaks P, Coker EA, Gregory GP, Newbold A, Johnstone RW, Gangl E, Wild M, Zinda M, Secrist JP, Davies BR, Fawell SE, Gibbons FD. AZD4320, A Dual Inhibitor of Bcl-2 and Bcl-x L, Induces Tumor Regression in Hematologic Cancer Models without Dose-limiting Thrombocytopenia. Clin Cancer Res 2020; 26:6535-6549. [PMID: 32988967 DOI: 10.1158/1078-0432.ccr-20-0863] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 07/24/2020] [Accepted: 09/22/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Targeting Bcl-2 family members upregulated in multiple cancers has emerged as an important area of cancer therapeutics. While venetoclax, a Bcl-2-selective inhibitor, has had success in the clinic, another family member, Bcl-xL, has also emerged as an important target and as a mechanism of resistance. Therefore, we developed a dual Bcl-2/Bcl-xL inhibitor that broadens the therapeutic activity while minimizing Bcl-xL-mediated thrombocytopenia. EXPERIMENTAL DESIGN We used structure-based chemistry to design a small-molecule inhibitor of Bcl-2 and Bcl-xL and assessed the activity against in vitro cell lines, patient samples, and in vivo models. We applied pharmacokinetic/pharmacodynamic (PK/PD) modeling to integrate our understanding of on-target activity of the dual inhibitor in tumors and platelets across dose levels and over time. RESULTS We discovered AZD4320, which has nanomolar affinity for Bcl-2 and Bcl-xL, and mechanistically drives cell death through the mitochondrial apoptotic pathway. AZD4320 demonstrates activity in both Bcl-2- and Bcl-xL-dependent hematologic cancer cell lines and enhanced activity in acute myeloid leukemia (AML) patient samples compared with the Bcl-2-selective agent venetoclax. A single intravenous bolus dose of AZD4320 induces tumor regression with transient thrombocytopenia, which recovers in less than a week, suggesting a clinical weekly schedule would enable targeting of Bcl-2/Bcl-xL-dependent tumors without incurring dose-limiting thrombocytopenia. AZD4320 demonstrates monotherapy activity in patient-derived AML and venetoclax-resistant xenograft models. CONCLUSIONS AZD4320 is a potent molecule with manageable thrombocytopenia risk to explore the utility of a dual Bcl-2/Bcl-xL inhibitor across a broad range of tumor types with dysregulation of Bcl-2 prosurvival proteins.
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Affiliation(s)
| | | | - Kate F Byth
- Bioscience, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - Justin Cidado
- Bioscience, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - Ammar Adam
- Bioscience, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - Paula Lewis
- Bioscience, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - Terry Macintyre
- Bioscience, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - Shenghua Wen
- Bioscience, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - Deborah Lawson
- Bioscience, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - Kathleen Burke
- Bioscience, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - Tristan Lubinski
- Translational Science, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - Jeffrey W Tyner
- Division of Hematology & Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Ashland, Oregon
| | - Stephen E Kurtz
- Division of Hematology & Medical Oncology, Knight Cancer Institute, Oregon Health and Science University, Ashland, Oregon
| | - Shannon K McWeeney
- Division of Biostatistics, Department of Public Health and Preventive Medicine, Knight Cancer Institute, Oregon Health and Science University, Ashland, Oregon
| | - Jeffrey Varnes
- Chemistry, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | | | - Thomas Gero
- Chemistry, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | | | | | - William McCoull
- Chemistry, Oncology R&D, AstraZeneca, Cambridge, United Kingdom
| | - Jamal C Saeh
- Chemistry, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - Areya Tabatabai
- Bioscience, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - Omid Tavana
- Bioscience, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - Nancy Su
- Discovery Sciences, BioPharmaceuticals R&D, AstraZeneca, Boston, Massachusetts
| | - Alwin Schuller
- Bioscience, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | | | | | | | - Gareth P Gregory
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, Australia
| | | | | | - Eric Gangl
- DMPK, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - Martin Wild
- DMPK, Oncology R&D, AstraZeneca, Cambridge, United Kingdom
| | - Michael Zinda
- Bioscience, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - J Paul Secrist
- Bioscience, Oncology R&D, AstraZeneca, Boston, Massachusetts
| | - Barry R Davies
- Projects, Oncology R&D, AstraZeneca, Cambridge, United Kingdom.
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Pierrillas PB, Henin E, Ball K, Ogier J, Amiel M, Kraus-Berthier L, Chenel M, Bouzom F, Tod M. Prediction of Human Nonlinear Pharmacokinetics of a New Bcl-2 Inhibitor Using PBPK Modeling and Interspecies Extrapolation Strategy. Drug Metab Dispos 2019; 47:648-656. [PMID: 30940629 DOI: 10.1124/dmd.118.085605] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 03/26/2019] [Indexed: 01/05/2023] Open
Abstract
S 55746 ((S)-N-(4-hydroxyphenyl)-3-(6-(3-(morpholinomethyl)-1,2,3,4-tetrahydroisoquinoline-2-carbonyl)benzo[d][1,3]dioxol-5-yl)-N-phenyl-5,6,7,8-tetrahydroindolizine-1-carboxamide) is a new selective Bcl-2 (B-cell lymphoma 2) inhibitor developed by Servier Laboratories and used to restore apoptosis functions in cancer patients. The aim of this work was to develop a translational approach using physiologically based (PB) pharmacokinetic (PK) modeling for interspecies extrapolation to anticipate the nonlinear PK behavior of this new compound in patients. A PBPK mouse model was first built using a hybrid approach, defining scaling factors (determined from in vitro data) to correct in vitro clearance parameters and predicted Kp (partition coefficient) values. The qualification of the hybrid model using these empirically determined scaling factors was satisfactorily completed with rat and dog data, allowing extrapolation of the PBPK model to humans. Human PBPK simulations were then compared with clinical trial data from a phase 1 trial in which the drug was given orally and daily to cancer patients. Human PBPK predictions were within the 95% prediction interval for the eight dose levels, taking into account both the nonlinear dose and time dependencies occurring in S 55746 kinetics. Thus, the proposed PK interspecies extrapolation strategy, based on preclinical and in vitro information and physiologic assumptions, could be a useful tool for predicting human plasma concentrations at the early stage of drug development.
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Affiliation(s)
- Philippe B Pierrillas
- Equipe mixte de recherche 3738, Ciblage Thérapeutique en Oncologie, Faculté de Médecine et de Maïeutique Lyon-Sud Charles Mérieux, Université Claude Bernard Lyon 1, Oullins, France (P.P., E.H., M.T.); Pharmacie Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France (M.T.); Centre de Pharmacocinétique et Métabolisme, Technologie Servier, Orléans, France (P.P., F.B.); Clinical Pharmacokinetics and Pharmacometrics Division, Servier, Suresnes, France (K.B., J.O., M.A., M.C.); and Institut de Recherches Internationales Servier, Oncology R&D Unit, Suresnes, France (L.K-B.)
| | - Emilie Henin
- Equipe mixte de recherche 3738, Ciblage Thérapeutique en Oncologie, Faculté de Médecine et de Maïeutique Lyon-Sud Charles Mérieux, Université Claude Bernard Lyon 1, Oullins, France (P.P., E.H., M.T.); Pharmacie Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France (M.T.); Centre de Pharmacocinétique et Métabolisme, Technologie Servier, Orléans, France (P.P., F.B.); Clinical Pharmacokinetics and Pharmacometrics Division, Servier, Suresnes, France (K.B., J.O., M.A., M.C.); and Institut de Recherches Internationales Servier, Oncology R&D Unit, Suresnes, France (L.K-B.)
| | - Kathryn Ball
- Equipe mixte de recherche 3738, Ciblage Thérapeutique en Oncologie, Faculté de Médecine et de Maïeutique Lyon-Sud Charles Mérieux, Université Claude Bernard Lyon 1, Oullins, France (P.P., E.H., M.T.); Pharmacie Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France (M.T.); Centre de Pharmacocinétique et Métabolisme, Technologie Servier, Orléans, France (P.P., F.B.); Clinical Pharmacokinetics and Pharmacometrics Division, Servier, Suresnes, France (K.B., J.O., M.A., M.C.); and Institut de Recherches Internationales Servier, Oncology R&D Unit, Suresnes, France (L.K-B.)
| | - Julien Ogier
- Equipe mixte de recherche 3738, Ciblage Thérapeutique en Oncologie, Faculté de Médecine et de Maïeutique Lyon-Sud Charles Mérieux, Université Claude Bernard Lyon 1, Oullins, France (P.P., E.H., M.T.); Pharmacie Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France (M.T.); Centre de Pharmacocinétique et Métabolisme, Technologie Servier, Orléans, France (P.P., F.B.); Clinical Pharmacokinetics and Pharmacometrics Division, Servier, Suresnes, France (K.B., J.O., M.A., M.C.); and Institut de Recherches Internationales Servier, Oncology R&D Unit, Suresnes, France (L.K-B.)
| | - Magali Amiel
- Equipe mixte de recherche 3738, Ciblage Thérapeutique en Oncologie, Faculté de Médecine et de Maïeutique Lyon-Sud Charles Mérieux, Université Claude Bernard Lyon 1, Oullins, France (P.P., E.H., M.T.); Pharmacie Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France (M.T.); Centre de Pharmacocinétique et Métabolisme, Technologie Servier, Orléans, France (P.P., F.B.); Clinical Pharmacokinetics and Pharmacometrics Division, Servier, Suresnes, France (K.B., J.O., M.A., M.C.); and Institut de Recherches Internationales Servier, Oncology R&D Unit, Suresnes, France (L.K-B.)
| | - Laurence Kraus-Berthier
- Equipe mixte de recherche 3738, Ciblage Thérapeutique en Oncologie, Faculté de Médecine et de Maïeutique Lyon-Sud Charles Mérieux, Université Claude Bernard Lyon 1, Oullins, France (P.P., E.H., M.T.); Pharmacie Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France (M.T.); Centre de Pharmacocinétique et Métabolisme, Technologie Servier, Orléans, France (P.P., F.B.); Clinical Pharmacokinetics and Pharmacometrics Division, Servier, Suresnes, France (K.B., J.O., M.A., M.C.); and Institut de Recherches Internationales Servier, Oncology R&D Unit, Suresnes, France (L.K-B.)
| | - Marylore Chenel
- Equipe mixte de recherche 3738, Ciblage Thérapeutique en Oncologie, Faculté de Médecine et de Maïeutique Lyon-Sud Charles Mérieux, Université Claude Bernard Lyon 1, Oullins, France (P.P., E.H., M.T.); Pharmacie Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France (M.T.); Centre de Pharmacocinétique et Métabolisme, Technologie Servier, Orléans, France (P.P., F.B.); Clinical Pharmacokinetics and Pharmacometrics Division, Servier, Suresnes, France (K.B., J.O., M.A., M.C.); and Institut de Recherches Internationales Servier, Oncology R&D Unit, Suresnes, France (L.K-B.)
| | - François Bouzom
- Equipe mixte de recherche 3738, Ciblage Thérapeutique en Oncologie, Faculté de Médecine et de Maïeutique Lyon-Sud Charles Mérieux, Université Claude Bernard Lyon 1, Oullins, France (P.P., E.H., M.T.); Pharmacie Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France (M.T.); Centre de Pharmacocinétique et Métabolisme, Technologie Servier, Orléans, France (P.P., F.B.); Clinical Pharmacokinetics and Pharmacometrics Division, Servier, Suresnes, France (K.B., J.O., M.A., M.C.); and Institut de Recherches Internationales Servier, Oncology R&D Unit, Suresnes, France (L.K-B.)
| | - Michel Tod
- Equipe mixte de recherche 3738, Ciblage Thérapeutique en Oncologie, Faculté de Médecine et de Maïeutique Lyon-Sud Charles Mérieux, Université Claude Bernard Lyon 1, Oullins, France (P.P., E.H., M.T.); Pharmacie Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France (M.T.); Centre de Pharmacocinétique et Métabolisme, Technologie Servier, Orléans, France (P.P., F.B.); Clinical Pharmacokinetics and Pharmacometrics Division, Servier, Suresnes, France (K.B., J.O., M.A., M.C.); and Institut de Recherches Internationales Servier, Oncology R&D Unit, Suresnes, France (L.K-B.)
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