The importance of specific reactivity for covalent drugs

As we noted in our thousandth post, covalent drugs are becoming increasingly popular, particularly for tackling tough targets. But finding and optimizing covalent ligands entails unique challenges, as discussed in a new paper by Bharath Srinivasan at Cancer Research UK. (Derek Lowe also recently blogged about this.)

 

Interactions between noncovalent drugs and their targets are characterized by dissociation or inhibition constants K_D or K_{I ,} where lower numbers mean stronger binding. In contrast, irreversible covalent drugs are characterized by a ratio we discussed last year, k_inact/K_I, where the rate constant k_inact represents the covalent modification step. (Side note: although the term k_inact is commonly used, covalent modulators can also be activators; my company Frontier Medicines recently announced a covalent activator of p53^Y220C. Perhaps k_cov would be more general?)

 

To explain k_inact/K_I, Srinivasan draws a useful analogy to enzymes, which are mechanistically described by the specificity constant k_cat/K_m in Michaelis-Menten kinetics. In both cases, higher numbers mean more rapid modification or greater catalytic efficiency. A study of several thousand enzymes found the median k_cat/K_m to be around 100,000 M^-1s^-1, with 60% between 1,000 and 1,000,000 M^-1s^-1. Enzymes operate by stabilizing the transition state of the reaction, which means that the affinities for the substrates do not necessarily have to be high, particularly if the structures of the substrates differ from the transition states.

 

Just as catalytic efficiency for enzymes can be increased either by increasing k_cat or lowering K_m, the inactivation efficiency of covalent drugs can be optimized either by increasing k_inact or by decreasing K_I. Historically, drug hunters have focused on the latter; we previously described the discovery of TAK-020 in which the affinity of a fragment for the kinase BTK was first optimized and then a covalent warhead was appended.

 

However, focusing on k_inact can also be productive, and Srinivasan argues this is particularly true for challenging targets with shallow pockets where noncovalent affinity is difficult to obtain. As a case in point he discusses covalent KRAS^G12C inhibitors such as sotorasib, which I wrote about here. Just as residues within enzyme active sites stabilize the transition state of a reaction, a lysine residue in KRAS forms a hydrogen bond to the carbonyl of the acrylamide electrophile, thereby increasing its reactivity for the protein.

 

Srinivasan emphasizes that k_inact is specific for each particular protein-ligand pair as well as distinct from intrinsic or chemical reactivity. This is a critical point. Newcomers to the field often worry that a high k_inact value means a molecule is generically reactive and thus likely to react with many proteins, but this is not necessarily true. For example, sotorasib’s favorable k_inact/K_I is driven by a high k_inact for KRAS^G12C but it is still quite specific. Indeed, Srinivasan points out that even a chemically reactive molecule may not react with a protein if the geometry isn’t right.

 

A nice way of assessing specific reactivity (which unfortunately is not cited) is the reactivity enhancement factor, or REF, as defined by Alan Armstrong, David Mann, and colleagues at Imperial College London in an (open-access) 2020 ChemBioChem paper. Akin to the k_cat/k_uncat ratio used to assess rate enhancement for enzymes, REF is defined as the rate of reaction for a specific protein divided by the rate of reaction for glutathione, an abundant cellular thiol. The higher the REF score, the higher the specific reactivity for the protein of interest.

 

Srinivasan also considers tradeoffs between k_inact and K_I as k_inact/K_I approaches the rate of diffusion, suggesting that above 1,000,000 M^-1s^-1 or so any further improvement in affinity will come at the cost of specific reactivity. While this is theoretically interesting, from a practical perspective you can have a perfectly fine drug with a k_inact/K_I of just 10,000 M^-1s^-1.

 

Covalent drugs will only become more important as we pursue increasingly hard targets that have resisted previous efforts. For these targets in particular, focusing on specific reactivity will be rewarding.