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Szychowski J, Papp R, Dietrich E, Liu B, Vallée F, Leclaire MÈ, Fourtounis J, Martino G, Perryman AL, Pau V, Yun Yin S, Mader P, Roulston A, Truchon JF, Marshall CG, Diallo M, Duffy NM, Stocco R, Godbout C, Bonneau-Fortin A, Kryczka R, Bhaskaran V, Mao D, Orlicky S, Beaulieu P, Turcotte P, Kurinov I, Sicheri F, Mamane Y, Gallant M, Black WC. Discovery of an Orally Bioavailable and Selective PKMYT1 Inhibitor, RP-6306. J Med Chem 2022; 65:10251-10284. [PMID: 35880755 PMCID: PMC9837800 DOI: 10.1021/acs.jmedchem.2c00552] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PKMYT1 is a regulator of CDK1 phosphorylation and is a compelling therapeutic target for the treatment of certain types of DNA damage response cancers due to its established synthetic lethal relationship with CCNE1 amplification. To date, no selective inhibitors have been reported for this kinase that would allow for investigation of the pharmacological role of PKMYT1. To address this need compound 1 was identified as a weak PKMYT1 inhibitor. Introduction of a dimethylphenol increased potency on PKMYT1. These dimethylphenol analogs were found to exist as atropisomers that could be separated and profiled as single enantiomers. Structure-based drug design enabled optimization of cell-based potency. Parallel optimization of ADME properties led to the identification of potent and selective inhibitors of PKMYT1. RP-6306 inhibits CCNE1-amplified tumor cell growth in several preclinical xenograft models. The first-in-class clinical candidate RP-6306 is currently being evaluated in Phase 1 clinical trials for treatment of various solid tumors.
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Affiliation(s)
- Janek Szychowski
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Robert Papp
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Evelyne Dietrich
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Bingcan Liu
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Frédéric Vallée
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Marie-Ève Leclaire
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Jimmy Fourtounis
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Giovanni Martino
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Alexander L. Perryman
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Victor Pau
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, M5G 1X5, Canada
| | - Shou Yun Yin
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Pavel Mader
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, M5G 1X5, Canada
| | - Anne Roulston
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Jean-Francois Truchon
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - C. Gary Marshall
- Repare Therapeutics, 1 Broadway, 15th Floor, Cambridge, MA 02142, USA
| | - Mohamed Diallo
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Nicole M. Duffy
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Rino Stocco
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Claude Godbout
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | | | - Rosie Kryczka
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Vivek Bhaskaran
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Daniel Mao
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, M5G 1X5, Canada
| | - Stephen Orlicky
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, M5G 1X5, Canada
| | - Patrick Beaulieu
- OmegaChem Inc., 480 Rue Perreault, Saint-Romuald, QC, G6W 7V6, Canada
| | - Pascal Turcotte
- AdMare BioInnovations, 7171 Frederick-Banting, Montréal, QC, H4S 1Z9, Canada
| | - Igor Kurinov
- Department of Chemistry and Chemical Biology, Cornell University, NE-CAT, Argonne, Il 60439, USA
| | - Frank Sicheri
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, M5G 1X5, Canada
- Departments of Biochemistry and Molecular Genetics, University of Toronto, Ontario M5S 1A8, Canada
| | - Yael Mamane
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - Michel Gallant
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
| | - W. Cameron Black
- Repare Therapeutics, Inc., 7210 Frederick-Banting, Ville St-Laurent, QC, H4S 2A1, Canada
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Chennou F, Bonneau-Fortin A, Portolese O, Belmesk L, Jean-Pierre M, Côté G, Dirks MH, Jantchou P. Oral Lorazepam is not Superior to Placebo for Lowering Stress in Children Before Digestive Endoscopy: A Double-Blind, Randomized, Controlled Trial. Paediatr Drugs 2019; 21:379-387. [PMID: 31418168 DOI: 10.1007/s40272-019-00351-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Digestive endoscopies must be performed within a safe and comfortable environment. We have previously shown that the quality of intravenous sedation is influenced by preoperative stress. AIM Our primary objective was to compare the effects of oral lorazepam and placebo on the salivary cortisol response of children undergoing a digestive endoscopy. Secondary objectives were the assessment of procedural pain and comfort as well as the occurrence of adverse events. METHODS Participants were randomized and received either lorazepam, placebo, or no premedication. Saliva was collected upon arrival at the hospital and 1 h following randomization. The sedation protocol included midazolam and fentanyl ± ketamine. Procedural pain was evaluated with the Nurse Assessed Patient Comfort Score (NAPCOMS). Patients completed a postoperative questionnaire. The primary outcome was defined as the proportion of children having a cortisol decrease ≥ 15 nmol/L. RESULTS 101 participants (54 females) were included. The rate of children having a cortisol decrease ≥ 15 nmol/L was 27.3%, 35.3%, and 19.4% for lorazepam, placebo, and no premedication, respectively (p = 0.356). The median (IQR) NAPCOMS pain score was 3.0 (0-6) for lorazepam, 4.4 (0-6) for placebo, and 3.4 (3-4) for no premedication (p = 0.428). With lorazepam, 75.9% of children reported experiencing a comfortable procedure, compared with 41.9% taking placebo and 34.5% with no premedication (p = 0.013). Transient tachycardia was the most frequent intraoperative adverse event, particularly with lorazepam (62.5%, p = 0.029). CONCLUSIONS Oral lorazepam had no effect on patients' preoperative stress, as measured by salivary cortisol, but was associated with a higher rate of comfortable procedures. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov, Identifier NCT03180632.
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Affiliation(s)
- Fella Chennou
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
| | | | | | - Lina Belmesk
- CHU Sainte-Justine Research Center, Montreal, QC, Canada
| | - Mélissa Jean-Pierre
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, CHU Sainte-Justine University Hospital, 3175, ch. côte Sainte-Catherine, Montreal, QC, Canada
| | - Geneviève Côté
- Division of Anesthesiology, Department of Pediatrics, CHU Sainte-Justine University Hospital, Montreal, QC, Canada
| | - Martha H Dirks
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, CHU Sainte-Justine University Hospital, 3175, ch. côte Sainte-Catherine, Montreal, QC, Canada
| | - Prévost Jantchou
- CHU Sainte-Justine Research Center, Montreal, QC, Canada. .,Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, CHU Sainte-Justine University Hospital, 3175, ch. côte Sainte-Catherine, Montreal, QC, Canada.
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