Fragments in the clinic: verubecestat

Of all the fragment-derived drugs in the clinic, perhaps none is so closely watched as verubecestat (MK-8931), Merck’s BACE1 inhibitor in phase 3 clinical trials for Alzheimer’s disease (AD). With tens of millions of cases worldwide, few other diseases in the developed world are as simultaneously widespread, expensive, and terrifying. And despite billions of dollars thrown at the problem, failure rates are nearly 100%. A recent open-access paper by Jack Scott, Andrew Stamford, and collaborators at Merck and AMRI in J. Med. Chem. provides an excellent overview of this latest contender.

We first wrote about Merck’s BACE1 program almost exactly seven years ago, describing how an NMR screen had provided a weak hit that was optimized to nanomolar inhibitors of the enzyme. However, the molecules could fairly be called molecularly obese. This led the researchers to trim back portions of the molecule, losing affinity but gaining cell-based activity and permeability, ultimately resulting in compound 5 (below) – which is itself a fragment. The current paper describes the optimization of this molecule.

Growing compound 5 and expanding the heterocyclic ring led to compound 7, with low nanomolar biochemical and cell-based activity. The iminopyrimidinone core was becoming increasingly crowded from an intellectual-property standpoint, so the researchers replaced this with the iminothiadiazinane dioxide in compound 9, which modeling suggested should have a similar conformation – a result confirmed by crystallography. However, the alkyne moiety appeared to be metabolically unstable. More importantly, compound 9 was only 47-fold selective against the enzyme cathepsin D (CatD). An earlier Lilly BACE1 inhibitor with a similarly modest selectivity had failed due to toxicity possibly associated with CatD, and the researchers were keen to avoid a similar fate. This led them through additional rounds of optimization, ultimately resulting in verubecestat.

In addition to having low nanomolar biochemical and cell-based activity against BACE1, verubecestat is >45,000-fold selective against CatD, has good pharmacokinetics, is orally bioavailable, and is highly soluble (1.6 mM!) It does not inhibit CYP enzymes and has good brain penetration. Rule-checkers might be surprised at this later point given the high calculated polar surface area (115 Ų), a fact the researchers attribute to an intramolecular hydrogen bond between the amide and the pyridine nitrogen, effectively masking these moieties from the point of view of membranes.

A couple potential liabilities stood out. First, one metabolite is an aniline, and anilines can be mutagenic. Reassuringly, an Ames test on this particular aniline showed no mutagenicity. Also, verubecestat is a 2.2 µM hERG inhibitor, and inhibitors of this channel can cause cardiac arrhythmias. However, this concentration is significantly higher than the highest expected in humans, and studies in primates revealed no safety issues. All of which is a useful reminder that, in our business, rules are at most guidelines, and data is king.

The paper also includes some human data demonstrating that the compound is safe at doses up to 550 mg (!) and causes a dose-dependent reduction in β-amyloid levels. With the results of the first Phase 3 trial expected later this year, we could know soon whether this is a billion dollar molecule or yet another massively expensive failure. If the former, verubecestat could be one of those transformational advances in drug discovery that comes along once in a generation. But even if fails, this is the clearest test yet of the amyloid hypothesis. And fragments made it possible.

19F-NMR-guided fragment linking on BACE1

Fragment growing has been the dominant strategy of most of the recent posts involving lead optimization, consistent with our poll results. However, fragment linking can be powerful too, as illustrated by the recent approval of venetoclax, which was derived from fragment linking. A recent paper in J. Med. Chem. by Brad Jordan and colleagues at Amgen provides another nice case study.

Amgen researchers had previously used fragment growing to discover inhibitors of BACE1, an Alzheimer’s target which has been heavily tackled by fragments. However, the most potent molecules in the series also inhibited the related aspartic protease cathepsin D (CatD), which could cause serious side effects. The researchers sought to gain selectivity by building inhibitors to occupy the so-called S3subpocket of BACE1. To do so, they used ¹⁹F-NMR to find fragments that would bind to BACE1 in the presence of a “blocking compound” that filled most of the active site but not the S3subpocket. This led to the discovery of seven fragments, the most potent being compound 3. Interestingly, this fragment only bound in the presence of the blocking compound as assessed both by NMR and SPR. Also, it could be competed by a compound that binds in the S3subocket.

Having thus identified a fragment that bound in the presence of one of their inhibitors, the researchers used interligand NOE (ILOE) to determine how the two compounds bind relative to one another. This supported the idea that compound 3 binds in the S3subpocket, and also suggested how the fragment could be linked onto the existing lead series, exemplified by compound 5. Just four compounds were designed and synthesized, and all of them were more potent than either of the starting points, with compound 9 being the best. More importantly, this compound also proved to be ~2000-fold selective for BACE1 over CatD in enzymatic and cell-based assays.

Despite the excellent (high picomolar) affinity of compound 9 for BACE1, this is actually about 25-fold worse than would be predicted by a simplistic additivity of binding energies – a not uncommon occurrence when linking molecules. Still, with its combined used of multiple NMR techniques and structure-based design to solve a specificity challenge, this paper is worth perusing.

Fragments in Texas

The meeting Development of Novel Therapies through Fragment Based Drug Discovery was held last week in Houston, Texas, organized by the Gulf Coast Consortium for Quantitative Biomedical Sciences. Although it was only a single day, it was packed, with thirteen speakers, a couple vendor lunch talks, and some two dozen posters. Below is just a flavor – please add your own impressions if you were there.

I kicked off the first session by giving an overview of FBDD, highlighting both pitfalls and successes. Beth Knapp-Reed (GlaxoSmithKline) then discussed efforts against LDHA, a target previously tackled successfully using fragment linking (see here and here). In this case, an HTS screen of 1.9 million compounds produced only a single hit that resulted in a crystal structure, while fragment screens yielded 16 structures at three binding sites. An NMR-based functional screen (using ¹³C-labeled substrate) was key to obtaining robust SAR, and using information from both the HTS hit and the fragments ultimately led to nanomolar inhibitors. Next, Tom Davies provided an overview of Astex’s discovery platform, focusing on a success with KEAP1. We recently highlighted research suggesting that crystallography should be used as a primary screen, which Astex does for some targets. Tom noted that doing so currently takes about a month, though only after spending somewhere between 3 and 12 months establishing a robust protein construct as well as crystallization and soaking conditions.

Jane Withka opened the next session by discussing the continuing evolution and use of the Pfizer fragment library. Out of 32 targets screened, only one produced no hits, and this was a particularly flexible protein. Interestingly, despite being relatively balanced among basic, acidic, and neutral members, hits were strong enriched in neutral compounds and strongly depleted in basic fragments. Neutral fragments were exactly what was sought by Daniel Cheney (Bristol-Meyers Squibb), who discussed successful efforts to replace a basic amidine moiety in Factor VIIa inhibitors. And Brad Jordan (Amgen) discussed the successful application of ¹⁹F NMR screening to find fragments that could be linked to previously discovered inhibitors to obtain selective picomolar inhibitors of BACE1.

Alex Waterson (Vanderbilt) started the first afternoon session by discussing how fragments had been successfully applied to RPA, RAS, and MCL-1. In the last case, the best compounds now have dissociation constants in the picomolar range, are active in cells, and show activity in xenograft models. IND-enabling studies are slated to begin as early as this year, with the hope of developing a cousin of venetoclax. Inna Krieger (Texas A&M) described how fragments could be used to understand the mechanism of M. tuberculosis malate synthase, while Dawn George (AbbVie) described selective (but inexplicably toxic) PKCθ inhibitors, which are now being made available to researchers to probe the biology. Finally, Damian Young (Baylor) gave an update on his sp³-carbon enriched fragments. Jane had mentioned that following up on hits with multiple stereocenters was not always easy, but Damian’s DOS approach efficiently and systematically yields each possibility. Whether these will meet the Safran-Zunft challenge remains to be seen.

The last session was focused on success stories. Michael Mesleh (Broad Institute) discussed Cubist’s bacterial DNA gyrase inhibitors. Marion Lanier (Takeda) described how fragment screening and careful medicinal chemistry led to a low nanomolar, selective inhibitor of BTK. With a molecular weight of just 318, the molecule is scarcely larger than a Texas fragment, and has good pharmacokinetics and activity in a rat arthritis model. And Yi Liu (Kura) discussed the optimization of covalent KRAS inhibitors originally discovered using Tethering.

This was my first visit to Houston, and I was struck by the number of researchers who had relocated from around the world, particularly from (previously) large(r) pharma companies. Whenever scientists meet the talk often turns to funding shortages, but not here: everyone seemed to have plenty of money and resources, and one of the organizers announced that he was trying to fill several positions. This was the first major fragment meeting in Texas but likely not the last – there is talk of turning it into a recurring event. And there are still several good upcoming events this year; early registration for FBLD 2016 closes in just a few weeks.

Review of 2014 reviews

The year is spinning to an end, and as we did in 2013 and 2012, Practical Fragments is looking back on notable events as well as reviews we didn’t cover previously.

2014 was full of conferences, starting with the CHI meeting in San Diego (here and here), moving to the Zing conference in the Dominican Republic, on to the Fall ACS meeting in beautiful San Francisco, and ending with FBLD 2014 in Basel.

In terms of reviews relevant to the fragment community, John Christopher and colleagues at Heptares published an extensive analysis of “Structure-based and fragment-based GPCR drug discovery” in ChemMedChem early in 2014. The last few years have seen an efflorescence of new structural information on G protein-coupled receptors, and this paper provides a thorough compilation of crystal structures and small molecule ligands. The review also discusses methods that have been used to discover fragments that bind to GPCRs, including TINS, SPR, CEfrag, radioligand binding, and fluorescence assays, and ends with case studies on A_2A antagonists and β₁AR ligands.

In contrast to GPCRs, kinases represent a well-established target class for fragment-based drug discovery, as exemplified by the first approved drug, vemurafenib. Structural biology has played a major role in this success; more than 200 of the 518 human kinases have had their X-ray crystal structures determined, and more than 3000 protein kinase structures have been deposited in the protein data bank. Astex has put several kinase inhibitors into the clinic, and in Methods in Enzymology Paul Mortenson and colleagues from the company discuss the state of the art. This is a clear and concise review of fragment-based drug discovery in general and as specifically applied to kinases. It serves as an excellent introduction to the topic.

Any chemist who has worked on kinases will be familiar with azaindoles, and in Molecules, Sylvain Routier and colleagues at Université d’Orléans discuss “the azaindole framework in the design of kinase inhibitors.” This provides a thorough compilation of azaindole inhibitors against ALK, Aurora, Cdc7, CHK1, C-Met, DYRK1A, FAK, IKK2, JAK2, KIT/FMS, PAK1, p38α, PIM1, B-Raf, ROCK, m-TOR, and TrkA, replete with synthetic methods. The paper also includes a nice analysis of binding modes. Of the 58 crystal structures of azaindoles bound to kinases in the protein data bank, the majority (48) are with 7-azaindole rather than the three other positional isomers. This isomer (found in vemurafenib) is also over-represented in the patent literature and among commercial compounds.

Another target that has yielded to FBLD is BACE1, a hot but still controversial target for Alzheimer’s disease, and in Bioorg. Med. Chem. Lett. Daniel Oehlrich and colleagues at Janssen review “the evolution of amidine-based brain penetrant BACE1 inhibitors”. This is very much a medicinal chemist’s review, with over 100 chemical structures, including a nice summary of the various chemotypes used by different companies. The authors do an excellent job synthesizing a tremendous amount of data, much of it reported only in the patent literature, and engage in some intriguing chemical sleuthing to guess at the identity of clinical candidates whose structures have not been publicly disclosed, such as MK-8931.

Jia Zhou and collaborators at the University of Texas Galveston and Fuzhou University discuss “Evolutions in fragment-based drug design: the deconstruction-reconstruction approach” in Drug Discovery Today. After briefly describing fragment-finding methods and library design, the review focuses on deconstruction of known ligands to generate “privileged” fragments that are then reassembled into new molecules. Although this approach can be productive, if one doesn’t exclude PAINS the result can be garbage-in, garbage-out.

Finally, in Methods in Enzymology, Katherine Warner (National Heart, Lung and Blood Institute) and Adrian Ferré-D’Amaré (University of Cambridge) review the crystallographic analysis of fragments binding to the TPP riboswitch. This is a concise how-to guide, and the methodology could be applicable to other RNA targets.

And with that, Practical Fragments says farewell to 2014. Thanks for reading, and may the New Year bring wonderful new discoveries!

Fragments vs BACE1: again, and sometimes unintentionally

If I had to pick one target as a poster child for fragment-based lead discovery, it would probably be BACE1, a hot but controversial enzyme implicated in Alzheimer’s disease. Indeed, several inhibitors that have entered the clinic trace their origins to fragments (though unfortunately LY2886721 was just dropped due to liver problems). Four recent papers give a good flavor for where things stand.

The first paper, published in Bioorg. Med. Chem. Lett. by Thomas J. Woltering and colleagues at Roche, is not really a fragment story. Rather, it describes how a high-throughput screen against BACE1 identified a fragment-sized hit that had first been synthesized at Roche in the 1970s as part of an analgesic program. Despite relatively low affinity, compound 1 had good ligand efficiency, and its similarity to other reported BACE1 inhibitors suggested how to grow into the so-called S3 pocket of the enzyme. At the same time, the cyclic amidine “head group” was modified to try to modulate the pKa of the molecule and thus improve the pharmaceutical properties, leading ultimately to compound 12, with good biochemical and cell potency and marginal activity in a mouse model.

In a related J. Med.Chem. paper by Hans Hilpert and colleagues, the Roche researchers further optimized this series of molecules, most notably by introducing electron-withdrawing fluorine substituents around the cyclic amidine ring to further tweak its basicity. Compound 89 was potent, exhibited good pharmacokinetics, and showed impressive target modulation in both mice and rats. The authors state that “a compound from this chemical class is currently undergoing clinical evaluation.” Thus, even though this program did not start explicitly from fragment screening, an initial fragment hit ultimately led to a clinical candidate.

The third paper, in Curr. Opin. Chem. Biol., is much more fragment-centric. In this brief but lucid review, Merck researchers Andrew Stamford and Corey Strickland describe how FBLD has played an integral role in developing BACE1 inhibitors and highlight several successful examples; given that MK-8931 is the most advanced clinical candidate for BACE1, they know of what they write. They note that:

Key elements of successful fragment based drug discovery (FBDD) approaches targeting BACE1 have been the use of X-ray co-crystal structures to design optimal starting points for subsequent optimization and an emphasis on ligand efficiency (LE) rather than affinity to drive the discovery of drug-like, brain penetrant inhibitors.

And if this just whets your appetite, check out the 25 page review in a recent issue of J. Med. Chem. by Suresh Singh and colleagues at Vitae Pharmaceuticals, which contains more than 100 chemical structures of BACE1 inhibitors. The review is certainly not limited to fragment-derived molecules, but it does note that these are superior to the peptidic inhibitors discovered using more traditional approaches.

MK-8931, BACE1 inhibitor, enters Phase 2/3 for Alzehimer’s

Perhaps no other single target so successfully demonstrates the potential of fragment-based approaches as BACE1, a challenging aspartyl protease implicated in Alzheimer’s Disease. Practical Fragments has previously written about efforts from Merck, Lilly, Pfizer, Evotec, and Amgen (there’s also the Astex-AstraZeneca collaboration).

Today Merck announced that their MK-8931 has entered a Phase 2/3 clinical trial, a randomized placebo-controlled study which will run for 78 weeks and enroll up to 1700 patients in the phase 3 portion.

There have been concerns lately as to whether or not BACE1 is a viable target for Alzheimers; it will take large studies like this to answer that question. Practical Fragments wishes them luck.

Fragments vs BACE1: Amgen’s story

Some targets that have proven recalcitrant to standard screening approaches seem to be particularly amenable to fragment-based approaches. Beta-site amyloid precursor protein cleaving enzyme 1 (BACE1) is one such example: Practical Fragments has previously discussed programs from both Evotec and Schering/Merck, the latter of which has resulted in more than one clinical candidate. In a recent issue of J. Med. Chem., researchers at Amgen describe their adventures with this Alzheimer’s disease target.

The researchers started by using SPR to screen a library of about 4000 fragments (which had MW < 300, polar surface area < 30 Ų, and ≤ 2 hydrogen bond donors). This led to 106 hits with 10 mM or better potency, of which 8 confirmed in an orthogonal assay with potency better than 1 mM. Among these was fragment 1, which was also discovered as a BACE1 binder by researchers at Astex using crystallographic screening.

Astex’s crystallographic structure showed compound 1 packed pretty tightly into BACE1, but surprisingly, the Amgen team found that walking a bromine atom around the phenyl ring produced gains in potency at all four positions. In fact, adding an aromatic group off the 6-position, as in compound 34, led to a dramatic increase in potency, and crystallography revealed that the protein undergoes a conformational change to accommodate the extra bulk and form an edge-face interaction between a phenylalanine side chain and the added aromatic group.

Putting substituents off the 3-position, as in compound 44, led to molecules that could access either the P1 pocket or the P2’ pocket of the enzyme, but adding the ortho-tolyl group from compound 34 to give compound 43 locked the binding mode down to the P2’ pocket and gave a satisfying boost in potency such that standard enzymatic assays could be used instead of SPR. Further medicinal chemistry led to picomolar binders such as compound 57 as well as compounds less active in the biochemical assay but with better permeability and lower efflux, such as compound 59. This compound also showed in vivo activity in a rat model, though it is rapidly metabolized.

Although crystallography was clearly enabling throughout the process, this paper is a warning not to be too slavish in adherence to structure, as the initial break (compound 1 to compound 34) would not have been predicted to be active based on the co-crystal structure of compound 1 with BACE1.

This is also another nice example of starting with a rather generic fragment (heck, one published by another group!) and advancing it to a potent, proprietary series.