Phosphoinositide 3-kinase inhibitor

A phosphoinositide 3-kinase inhibitor (PI3K inhibitor) is a class of medical drug that functions by inhibiting one or more of the phosphoinositide 3-kinase enzymes, which are part of the PI3K/AKT/mTOR pathway, an important signalling pathway for many cellular functions such as growth control, metabolism and translation initiation. Within this pathway there are many components, inhibition of which may result in tumor suppression.[1] These anti-cancer drugs are examples of targeted therapy.[2][3]

There are a number of different classes and isoforms of PI3Ks.[4] Class 1 PI3Ks have a catalytic subunit known as p110, with four types (isoforms) – p110 alpha, p110 beta, p110 gamma and p110 delta.[5] The inhibitors being studied inhibit one or more isoforms of the class I PI3Ks.[6][7]

They are being actively investigated for treatment of various cancers.[8][9] [10]

They are also being considered for inflammatory respiratory disease.[4][6]

Effects of inhibiting different isoforms

Inhibiting different p110 isoforms can have different effects.[11] e.g. PTEN-negative tumors may be more sensitive to p110β inhibitors.[11]

Notable examples

  • Wortmannin: an irreversible inhibitor of PI3K.
  • demethoxyviridin: a derivative of wortmannin.
  • LY294002:[6] a reversible inhibitor of PI3K.
  • hibiscone C: an irreversible inhibitor of PI3K.

Approvals

  • Idelalisib (PI3K Delta inhibitor) FDA approved July 2014 for leukemia and two types of lymphoma.[12]
  • Copanlisib (Inhibitor of PI3K, predominantly against PI3K-α and PI3K-δ) FDA approved in September 2017 for the treatment of adult patients with relapsed follicular lymphoma (FL) who have received at least two prior systemic therapies.[13]
  • Duvelisib (First approved oral dual inhibitor of PI3K-delta and PI3K-gamma) The U.S. Food and Drug Administration (FDA) has approved Duvelisib by the name of COPIKTRA™ on September 24, 2018. COPIKTRA™ is the first approved dual inhibitor of PI3K-delta and PI3K-gamma. COPIKTRA is approved for the treatment of adult patients with relapsed or refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) after at least two prior therapies.[14]

Clinical development

Late stage

In phase III clinical trials:

In/starting phase II clinical trials:

Early stage

With phase I results announced :

In early stage clinical trials[10]

  • RP6530, Dual PI3K delta/gamma inhibitor for lymphomas.[55]
  • INK1117, a PI3K-alpha inhibitor in phase I.[56]
  • pictilisib[57] (GDC-0941)[58][59][60] IC50 of 3nM.
  • XL147 (also known as SAR245408)[61]
  • Palomid 529[62]
  • GSK1059615 The phase I trial of this drug was terminated due to lack of sufficient exposure following single- and repeat- dosing.[63]
  • ZSTK474,[64] a potent inhibitor against p110a.
  • PWT33597, a dual PI3K-alpha/mTOR inhibitor – for advanced solid tumors.[65] IND mid 2011.[66] Phase I recruiting.[67]

Others

  • IC87114[6] a selective inhibitor of p110δ. It has an IC50 of 100 nM for inhibition of p110-δ.
  • TG100–115, inhibits all four isoforms but has a 5–10 fold better potency against p110-γ and p110-δ.
  • CAL263[68]
  • RP6503, Dual PI3K delta/gamma inhibitor for the treatment of Asthma and COPD (Late pre-clinical stage).[69][70]
  • PI-103[71] Dual PI3K-mTOR inhibitor.[72]
  • GNE-477 is PI3K-alpha and mTOR inhibitor with IC50 values of 4nM and 21nM.
  • AEZS-136, also inhibits Erk1/2.[73]

See also

References

  1. ↑ Kurtz, J.E.; Ray-Coquard, I. (2012). "PI3 kinase inhibitors in the clinic: an update. [Review]". Anticancer Research. 32 (7): 2463–70.
  2. ↑ "PI3K inhibitors: Targeting multiple tumor progression pathways". 2003. Archived from the original on February 28, 2009.
  3. ↑ Neri, LM; Borgatti, P; Tazzari, PL; Bortul, R; Cappellini, A; Tabellini, G; Bellacosa, A; Capitani, S; Martelli, AM (2003). "The phosphoinositide 3-kinase/AKT1 pathway involvement in drug and all-trans-retinoic acid resistance of leukemia cells". Molecular Cancer Research. 1 (3): 234–46. PMID 12556562.
  4. 1 2 Ito, K; Caramori, G; Adcock, IM (2007). "Therapeutic potential of phosphatidylinositol 3-kinase inhibitors in inflammatory respiratory disease". The Journal of Pharmacology and Experimental Therapeutics. 321 (1): 1–8. doi:10.1124/jpet.106.111674. PMID 17021257.
  5. ↑ Study results provide rationale for use of PI3K inhibitors in therapeutic settings. News-medical.net. Retrieved on 2010-11-05.
  6. 1 2 3 4 Crabbe, T (2007). "Exploring the potential of PI3K inhibitors for inflammation and cancer". Biochemical Society Transactions. 35 (Pt 2): 253–6. doi:10.1042/BST0350253. PMID 17371252.
  7. ↑ Stein, R. (2001). "Prospects for phosphoinositide 3-kinase inhibition as a cancer treatment". Endocrine Related Cancer. Bioscientifica. 8 (3): 237–48. doi:10.1677/erc.0.0080237. PMID 11566615.
  8. ↑ Flanagan (Dec 2008). "Zeroing in on PI3K Pathway".
  9. ↑ Wu, P; Liu, T; Hu, Y (2009). "PI3K inhibitors for cancer therapy: what has been achieved so far?". Current Medicinal Chemistry. 16 (8): 916–30. doi:10.2174/092986709787581905. PMID 19275602.
  10. 1 2 Maira, Sauveur-Michel; Stauffer, Frédéric; Schnell, Christian; García-Echeverría, Carlos (2009). "PI3K inhibitors for cancer treatment: where do we stand?". Biochemical Society Transactions. 37 (Pt 1): 265–72. doi:10.1042/BST0370265. PMID 19143644.
  11. 1 2 Isoform-Specific Phosphoinositide 3-Kinase Inhibitors Exert Distinct Effects in Solid Tumors. 2010
  12. ↑ "FDA approves Zydelig for three types of blood cancers". US Food and Drug Administration. July 23, 2014.
  13. ↑ "FDA approves new treatment for adults with relapsed follicular lymphoma". US Food and Drug Administration. September 14, 2017.
  14. ↑ "FDA Approval for duvelisib (COPIKTRA, Verastem, Inc.) for adult patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL)". US Food and Drug Administration. September 24, 2018.
  15. ↑ "Search of: CAL101 – List Results – ClinicalTrials.gov". clinicaltrials.gov.
  16. ↑ Wu, M.; Akinleye, A.; Zhu, X. (2013). "Novel agents for chronic lymphocytic leukemia". Journal of Hematology & Oncology. 6: 36. doi:10.1186/1756-8722-6-36. PMC 3659027. PMID 23680477.
  17. ↑ Clinical trial number NCT02536300 at ClinicalTrials.gov
  18. ↑ Clinical trial number NCT01068483 at ClinicalTrials.gov
  19. ↑ Clinical trial number NCT01132664 at ClinicalTrials.gov
  20. ↑ PI3K Inhibitor Penetrates Endocrine-Resistant Breast Cancer. Dec 2015
  21. ↑ "Infinity Initiates Two Phase 1 Trials of IPI-145, a Potent Inhibitor of PI3K Delta and Gamma". finanznachrichten.de. 31 October 2011.
  22. ↑ "Infinity commences two IPI-145 Phase 1 clinical trials for hematologic malignancies". Retrieved November 28, 2011.
  23. ↑ Novel Agents Show Promise Against Endocrine-resistant Breast Cancer. July 2016
  24. ↑ Alpelisib Combo Promising in PIK3CA-Altered, Heavily Pretreated Breast Cancer. March 2016
  25. ↑ Study Assessing the Efficacy and Safety of Alpelisib Plus Fulvestrant in Men and Postmenopausal Women With Advanced Breast Cancer Which Progressed on or After Aromatase Inhibitor Treatment. (SOLAR-1)
  26. ↑ "Evaluate the Safety and Efficacy of TGR 1202 in Patients With Relapsed or Refractory Hematologic Malignancies". clinicaltrials.gov.
  27. 1 2 Novel BTK, PI3K Inhibitors on Horizon for Relapsed CLL. March 2016
  28. ↑ Therapy Focus – TG Could Benefit From Zydelig Setback. March 2016
  29. ↑ TG Therapeutics Inc.: TG Therapeutics, Inc. Announces First Patient Enrolled in the Registration-Directed UNITY-DLBCL Phase 2b Trial. June 2016
  30. ↑ Follow-Up Data for Combination of TGR-1202 (umbralisib) plus Ibrutinib in Patients with Relapsed or Refractory CLL and MCL. 2017
  31. ↑ Bayer to Present New Data on Growing Oncology Pipeline. April 2013 Archived 2013-04-14 at the Wayback Machine.
  32. ↑ Howes, AL; Chiang, GG; Lang, ES; Ho, CB; Powis, G; Vuori, K; Abraham, RT (2007). "The phosphatidylinositol 3-kinase inhibitor, PX-866, is a potent inhibitor of cancer cell motility and growth in three-dimensional cultures". Molecular Cancer Therapeutics. 6 (9): 2505–14. doi:10.1158/1535-7163.MCT-06-0698. PMID 17766839.
  33. ↑ PX-866 June 2010
  34. ↑ Clinical trial number NCT00726583 for "Phase I Trial of Oral PX-866" at ClinicalTrials.gov
  35. ↑ "ONTY Starts Four-Phase II Trial Program With Its Oral PI3K Inhibitor". 4 Nov 2010.
  36. ↑ Liu, TJ; Koul, D; Lafortune, T; Tiao, N; Shen, RJ; Maira, SM; Garcia-Echevrria, C; Yung, WK (2009). "NVP-BEZ235, a novel dual phosphatidylinositol 3-kinase/mammalian target of rapamycin inhibitor, elicits multifaceted antitumor activities in human gliomas". Molecular Cancer Therapeutics. 8 (8): 2204–10. doi:10.1158/1535-7163.MCT-09-0160. PMC 2752877. PMID 19671762.
  37. ↑ Clinical trial number NCT00620594 for "A Phase I/II Study of BEZ235 in Patients With Advanced Solid Malignancies Enriched by Patients With Advanced Breast Cancer" at ClinicalTrials.gov
  38. ↑ Serra, V; Markman, B; Scaltriti, M; Eichhorn, PJA; Valero, V; Guzman, M; Botero, ML; Llonch, E (2008). "NVP-BEZ235, a Dual PI3K/mTOR Inhibitor, Prevents PI3K Signaling and Inhibits the Growth of Cancer Cells with Activating PI3K Mutations". Cancer Research. 68 (19): 8022–30. doi:10.1158/0008-5472.CAN-08-1385. PMID 18829560.
  39. 1 2 CUDC-907 Treatment in People With Metastatic and Locally Advanced Thyroid Cancer
  40. ↑ Voxtalisib for CLL and B-Cell Lymphomas March 2018
  41. ↑ A Study of Investigational SAR245409 in Patients With Certain Lymphoma or Leukemia
  42. ↑ Business Wire. "Curis Presents Data On PI3K And HDAC Inhibitor CUDC-907 At The 2011 AACR-NCI-EORTC Symposium". TheStreet.
  43. ↑ Novel Dual HDAC/PI3K Inhibitor Assessed in Lymphoma, Myeloma. April 2016
  44. ↑ Dual HDAC, PI3K Inhibitor Active in Lymphoma, Myeloma. April 2016
  45. ↑ New PI3K Delta Inhibitor to Treat Blood Cancers Shows Promise in Early Clinical Study May 2, 2016. Ines Martins Archived May 6, 2016, at the Wayback Machine.
  46. ↑ Infinity Provides Company Update... May 2016
  47. ↑ IPI-549 early clinical. Sept 2016
  48. ↑ Definition of pan-PI3K/mTOR inhibitor SF1126 – National Cancer Institute Drug Dictionary. Cancer.gov. Retrieved on 2010-11-05.
  49. ↑ "Semafore's PI3 Kinase Inhibitor SF1126 Is A Vascular Targeted Conjugate In Phase I Clinical Trials In Solid Tumors And Multiple Myeloma" (Press release). Semafore Pharmaceuticals. April 15, 2008. Retrieved November 3, 2010.
  50. ↑ Clinical trial number NCT00907205 for "A Dose Escalation Study of SF1126, a PI3 Kinase (PI3K) Inhibitor, Given By Intravenous (IV) Infusion in Patients With Solid Tumors (SF112600106)" at ClinicalTrials.gov
  51. ↑ Semafore's SF1126 peptidic prodrug demonstrates clinical activity in chronic lymphocytic leukemia. News-medical.net. Retrieved on 2010-11-05.
  52. ↑ Update on the Novel Prodrug Dual mTOR‐PI3K Inhibitor SF1126 Archived 2011-07-16 at the Wayback Machine.
  53. ↑ Semafore Pharmaceuticals. "Semafore Pharmaceuticals Announces Presentation Highlighting Activity of Multi-Kinase, PI3K/mTOR Inhibitor SF1126 at 2011 AACR Annual Meeting". GlobeNewswire News Room.
  54. ↑ "Semafore Pharmaceuticals Receives FDA Orphan Drug Designation for SF1126 in the Treatment of Chronic Lymphocytic Leukemia". 9 Nov 2010.
  55. ↑ Rhizen Pharmaceuticals SA. "Rhizen Pharmaceuticals S.A. announces initiation of a "First in Human" Phase-1 trial of RP6530, a dual PI3K delta/gamma inhibitor, in patients with hematological malignancies". GlobeNewswire News Room.
  56. ↑ "Intellikine commences INK1117 Phase I dose escalation study in cancer". 12 Oct 2011.
  57. ↑ Sarker, D; Ang, JE; Baird, R; Kristeleit, R; Shah, K; Moreno, V; Clarke, PA; Raynaud, FI; Levy, G; Ware, JA; Mazina, K; Lin, R; Wu, J; Fredrickson, J; Spoerke, JM; Lackner, MR; Yan, Y; Friedman, LS; Kaye, SB; Derynck, MK; Workman, P; de Bono, JS. "First-in-human phase I study of pictilisib (GDC-0941), a potent pan-class I phosphatidylinositol-3-kinase (PI3K) inhibitor, in patients with advanced solid tumors". Clin Cancer Res. 21: 77–86. doi:10.1158/1078-0432.CCR-14-0947. PMC 4287394. PMID 25370471.
  58. ↑ Clinical trial number NCT00974584 for "A Study of the Safety and Pharmacology of PI3-Kinase Inhibitor GDC-0941 in Combination With Paclitaxel and Carboplatin With or Without Bevacizumab in Patients With Advanced Non-Small Cell Lung Cancer" at ClinicalTrials.gov
  59. ↑ Clinical trial number NCT00876109 at ClinicalTrials.gov
  60. ↑ Clinical trial number NCT00876122 for "A Study of GDC-0941 in Patients With Locally Advanced or Metastatic Solid Tumors or Non-Hodgkin's Lymphoma for Which Standard Therapy Either Does Not Exist or Has Proven Ineffective or Intolerable" at ClinicalTrials.gov
  61. ↑ Clinical trial number NCT01042925 at ClinicalTrials.gov
  62. ↑ Clinical trial number NCT01033721 at ClinicalTrials.gov
  63. ↑ "GSK Clinical Register: PIK111051". Archived from the original on 2012-07-12.
  64. ↑ A Safety Study of Oral ZSTK474 in Patients With Cancer
  65. ↑ Pathway Receives $7.5M Boost to Take Lead PI3K/mTOR Inhibitor into Clinical Development. 25 May 2011
  66. ↑ http://gamutnews.com/20110525/8934/fda-approves-trial-of-pathway-therapeutics-inc-cancer-drug-7-5-million-financing-in-place-to-advance-novel-pi3kmtor-inhibitor-portfolio.html
  67. ↑ "Pathway Therapeutics Announces Appointment of Mark Perry and Dr. Paul Goddard to its Board of Directors – Business Wire". businesswire.com. 15 August 2011.
  68. ↑ Study to Investigate Effects of CAL-263 in Subjects With Allergic Rhinitis Exposed to Allergen in an Environmental Chamber
  69. ↑ http://rhizen.com/News%20&%20PR/Rhizen_Press%20Release_ATS_May'13.pdf%5Bpermanent+dead+link%5D
  70. ↑ http://www.atsjournals.org/doi/abs/10.1164/ajrccm-conference.2013.187.1_MeetingAbstracts.A3880
  71. ↑ Werzowa, J; Koehrer, S; Strommer, S; et al. (4 November 2010). "Vertical Inhibition of the mTORC1/mTORC2/PI3K Pathway Shows Synergistic Effects against Melanoma In Vitro and In Vivo". Journal of Investigative Dermatology. 131 (2): 495–503. doi:10.1038/jid.2010.327. PMID 21048785.
  72. ↑ Fan (Nov 2010). "Akt and Autophagy Cooperate to Promote Survival of Drug-Resistant Glioma". Science Signaling. 3 (147): ra81. doi:10.1126/scisignal.2001017. PMC 3001107. PMID 21062993.
  73. ↑ http://www.marketwatch.com/story/aeterna-zentaris-presents-preclinical-data-for-its-anti-cancer-pi3k-erk-12-inhibitor-aezs-136-at-aacr-meeting-2012-04-03-73000

Further reading

  • Williams, Roger; Berndt, Alex; Miller, Simon; Hon, Wai-Ching; Zhang, Xuxiao (2009). "Form and flexibility in phosphoinositide 3-kinases". Biochemical Society Transactions. 37 (Pt 4): 615–626. doi:10.1042/BST0370615. PMID 19614567.
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