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Characterization of atrial fibrillation adverse events reported in ibrutinib randomized controlled registration trials.
Brown JR, Moslehi J, O'Brien S, Ghia P, Hillmen P, Cymbalista F, Shanafelt TD, Fraser G, Rule S, Kipps TJ, Coutre S, Dilhuydy MS, Cramer P, Tedeschi A, Jaeger U, Dreyling M, Byrd JC, Howes A, Todd M, Vermeulen J, James DF, Clow F, Styles L, Valentino R, Wildgust M, Mahler M, Burger JA
(2017) Haematologica 102: 1796-1805
MeSH Terms: Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Atrial Fibrillation, Disease Management, Female, Follow-Up Studies, Hemorrhage, Humans, Incidence, Male, Middle Aged, Protein Kinase Inhibitors, Pyrazoles, Pyrimidines, Randomized Controlled Trials as Topic, Risk Factors, Time Factors
Show Abstract · Added December 2, 2017
The first-in-class Bruton's tyrosine kinase inhibitor ibrutinib has proven clinical benefit in B-cell malignancies; however, atrial fibrillation (AF) has been reported in 6-16% of ibrutinib patients. We pooled data from 1505 chronic lymphocytic leukemia and mantle cell lymphoma patients enrolled in four large, randomized, controlled studies to characterize AF with ibrutinib and its management. AF incidence was 6.5% [95% Confidence Interval (CI): 4.8, 8.5] for ibrutinib at 16.6-months 1.6% (95%CI: 0.8, 2.8) for comparator and 10.4% (95%CI: 8.4, 12.9) at the 36-month follow up; estimated cumulative incidence: 13.8% (95%CI: 11.2, 16.8). Ibrutinib treatment, prior history of AF and age 65 years or over were independent risk factors for AF. Multiple AF events were more common with ibrutinib (44.9%; comparator, 16.7%) among patients with AF. Most (85.7%) patients with AF did not discontinue ibrutinib, and more than half received common anticoagulant/antiplatelet medications on study. Low-grade bleeds were more frequent with ibrutinib, but serious bleeds were uncommon (ibrutinib, 2.9%; comparator, 2.0%). Although the AF rate among older non-trial patients with comorbidities is likely underestimated by this dataset, these results suggest that AF among clinical trial patients is generally manageable without ibrutinib discontinuation ().
Copyright© 2017 Ferrata Storti Foundation.
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19 MeSH Terms
Synthesis and evaluation of 4,6-disubstituted pyrimidines as CNS penetrant pan-muscarinic antagonists with a novel chemotype.
Bender AM, Weiner RL, Luscombe VB, Cho HP, Niswender CM, Engers DW, Bridges TM, Conn PJ, Lindsley CW
(2017) Bioorg Med Chem Lett 27: 2479-2483
MeSH Terms: Animals, Brain, Humans, Inhibitory Concentration 50, Muscarinic Antagonists, Protein Binding, Pyrimidines, Rats, Receptor, Muscarinic M4, Receptors, Muscarinic, Recombinant Proteins, Structure-Activity Relationship
Show Abstract · Added March 3, 2020
This letter describes the synthesis and structure activity relationship (SAR) studies of structurally novel M antagonists, based on a 4,6-disubstituted core, identified from a high-throughput screening campaign. A multi-dimensional optimization effort enhanced potency at both human and rat M (ICs<300nM), with no substantial species differences noted. Moreover, CNS penetration proved attractive for this series (brain:plasma K=0.87), while other DMPK attributes were addressed in the course of the optimization effort, providing low in vivo clearance in rat (CL=5.37mL/min/kg). Surprisingly, this series displayed pan-muscarinic antagonist activity across M, despite the absence of the prototypical basic or quaternary amine moiety, thus offering a new chemotype from which to develop a next generation of pan-muscarinic antagonist agents.
Copyright © 2017 Elsevier Ltd. All rights reserved.
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Myc enhances B-cell receptor signaling in precancerous B cells and confers resistance to Btk inhibition.
Moyo TK, Wilson CS, Moore DJ, Eischen CM
(2017) Oncogene 36: 4653-4661
MeSH Terms: Agammaglobulinaemia Tyrosine Kinase, Animals, B-Lymphocytes, CD79 Antigens, Cell Proliferation, Flow Cytometry, Humans, Lymphoma, Non-Hodgkin, Male, Mice, Mice, Inbred C57BL, Mitogen-Activated Protein Kinase 3, Phosphatidylinositol 3-Kinases, Phospholipase C gamma, Phosphorylation, Precancerous Conditions, Protein-Tyrosine Kinases, Proto-Oncogene Proteins c-myc, Pyrazoles, Pyrimidines, Receptors, Antigen, B-Cell, Splenic Neoplasms, Syk Kinase
Show Abstract · Added April 6, 2017
Dysregulation of the oncogenic transcription factor MYC induces B-cell transformation and is a driver for B-cell non-Hodgkin lymphoma (B-NHL). MYC overexpression in B-NHL is associated with more aggressive phenotypes and poor prognosis. Although genomic studies suggest a link between MYC overexpression and B-cell receptor (BCR) signaling molecules in B-NHL, signaling pathways essential to Myc-mediated B-cell transformation have not been fully elucidated. We utilized intracellular phospho-flow cytometry to investigate the relationship between Myc and BCR signaling in pre-malignant B cells. Utilizing the Eμ-myc mouse model, where Myc is overexpressed specifically in B cells, both basal and stimulated BCR signaling were increased in precancerous B lymphocytes from Eμ-myc mice compared with wild-type littermates. B cells overexpressing Myc displayed constitutively higher levels of activated CD79α, Btk, Plcγ2 and Erk1/2. Notably, Myc-overexpressing B cells maintained elevated BCR signaling despite treatment with ibrutinib, a Bruton's tyrosine kinase inhibitor. Furthermore, PI3K/Akt pathway signaling was also increased in Eμ-myc B cells, and this increase was partially suppressed with ibrutinib. In addition, experiments with Btk-null B cells revealed off-target effects of ibrutinib on BCR signaling. Our data show that in pre-malignant B cells, Myc overexpression is sufficient to activate BCR and PI3K/Akt signaling pathways and further enhances signaling following BCR ligation. Therefore, our results indicate that precancerous B cells have already acquired enhanced survival and growth capabilities before transformation, and that elevated MYC levels confer resistance to pharmacologic inhibitors of BCR signaling, which has significant implications for B-NHL treatment.
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23 MeSH Terms
Ventricular arrhythmias and sudden death in patients taking ibrutinib.
Lampson BL, Yu L, Glynn RJ, Barrientos JC, Jacobsen ED, Banerji V, Jones JA, Walewska R, Savage KJ, Michaud GF, Moslehi JJ, Brown JR
(2017) Blood 129: 2581-2584
MeSH Terms: Arrhythmias, Cardiac, Death, Sudden, Cardiac, Humans, Leukemia, Lymphocytic, Chronic, B-Cell, Male, Middle Aged, Pyrazoles, Pyrimidines
Added March 26, 2017
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Discovery of a Novel Series of Orally Bioavailable and CNS Penetrant Glucagon-like Peptide-1 Receptor (GLP-1R) Noncompetitive Antagonists Based on a 1,3-Disubstituted-7-aryl-5,5-bis(trifluoromethyl)-5,8-dihydropyrimido[4,5-d]pyrimidine-2,4(1H,3H)-dione Core.
Nance KD, Days EL, Weaver CD, Coldren A, Farmer TD, Cho HP, Niswender CM, Blobaum AL, Niswender KD, Lindsley CW
(2017) J Med Chem 60: 1611-1616
MeSH Terms: Administration, Oral, Animals, Blood Glucose, Cells, Cultured, Central Nervous System, Glucagon-Like Peptide-1 Receptor, Halogenation, Humans, Insulin, Islets of Langerhans, Male, Pyrimidines, Rats, Sprague-Dawley
Show Abstract · Added April 6, 2017
A duplexed, functional multiaddition high throughput screen and subsequent optimization effort identified the first orally bioavailable and CNS penetrant glucagon-like peptide-1 receptor (GLP-1R) noncompetitive antagonist. Antagonist 5d not only blocked exendin-4-stimulated insulin release in islets but also lowered insulin levels while increasing blood glucose in vivo.
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13 MeSH Terms
Development of a Series of (1-Benzyl-3-(6-methoxypyrimidin-3-yl)-5-(trifluoromethoxy)-1H-indol-2-yl)methanols as Selective Protease Activated Receptor 4 (PAR4) Antagonists with in Vivo Utility and Activity Against γ-Thrombin.
Temple KJ, Duvernay MT, Young SE, Wen W, Wu W, Maeng JG, Blobaum AL, Stauffer SR, Hamm HE, Lindsley CW
(2016) J Med Chem 59: 7690-5
MeSH Terms: Dose-Response Relationship, Drug, Enzyme Inhibitors, Humans, Indoles, Molecular Structure, Pyrimidines, Receptors, Thrombin, Structure-Activity Relationship, Thrombin
Show Abstract · Added March 24, 2020
Here, we describe the development of a series of highly selective PAR4 antagonists with nanomolar potency and selectivity versus PAR1, derived from the indole-based 3. Of these, 9j (PAR4 IC50 = 445 nM, PAR1 response IC50 > 30 μM) and 10h (PAR4 IC50 = 179 nM, PAR1 response IC50 > 30 μM) maintained an overall favorable in vitro DMPK profile, encouraging rat/mouse in vivo pharmacokinetics (PK) and activity against γ-thrombin.
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New structure-activity relationships of N-acetamide substituted pyrazolopyrimidines as pharmacological ligands of TSPO.
Li J, Schulte ML, Nickels ML, Manning HC
(2016) Bioorg Med Chem Lett 26: 3472-7
MeSH Terms: Acetamides, Dose-Response Relationship, Drug, Humans, Ligands, Molecular Structure, Pyrazoles, Pyrimidines, Receptors, GABA, Structure-Activity Relationship
Show Abstract · Added April 6, 2017
Translocator protein (TSPO) represents an attractive target for molecular imaging and therapy due to its prevalence and critical roles played in oncology and other pathologies. Based upon our previously optimized pyrazolopyrimidine scaffold, we elucidated new structure activity relationships related to N,N-disubstitutions of the terminal acetamide on pyrazolopyrimidines and further explored the impacts of these substituents on lipophilicity and plasma protein binding. Several novel chemical probes reported here exhibited significantly increased binding affinity, suitable lipophilicity and protein binding compared with contemporary TSPO ligands. We illustrate that N,N-acetamide disubstitution affords opportunities to introduce diverse chemical moieties distal to the central pyrazolopyrimidine core, without sacrificing TSPO affinity. We anticipate that further exploration of N-acetamide substitutions may yield additional TSPO ligands capable of furthering the field of precision medicine.
Copyright © 2016 Elsevier Ltd. All rights reserved.
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9 MeSH Terms
Heterogeneous Mechanisms of Primary and Acquired Resistance to Third-Generation EGFR Inhibitors.
Ortiz-Cuaran S, Scheffler M, Plenker D, Dahmen L, Scheel AH, Fernandez-Cuesta L, Meder L, Lovly CM, Persigehl T, Merkelbach-Bruse S, Bos M, Michels S, Fischer R, Albus K, König K, Schildhaus HU, Fassunke J, Ihle MA, Pasternack H, Heydt C, Becker C, Altmüller J, Ji H, Müller C, Florin A, Heuckmann JM, Nuernberg P, Ansén S, Heukamp LC, Berg J, Pao W, Peifer M, Buettner R, Wolf J, Thomas RK, Sos ML
(2016) Clin Cancer Res 22: 4837-4847
MeSH Terms: Acrylamides, Adenocarcinoma, Adenocarcinoma of Lung, Aged, Aniline Compounds, Antineoplastic Agents, Drug Resistance, Neoplasm, ErbB Receptors, Female, Humans, Lung Neoplasms, Male, Middle Aged, Pyrimidines
Show Abstract · Added September 10, 2020
PURPOSE - To identify novel mechanisms of resistance to third-generation EGFR inhibitors in patients with lung adenocarcinoma that progressed under therapy with either AZD9291 or rociletinib (CO-1686).
EXPERIMENTAL DESIGN - We analyzed tumor biopsies from seven patients obtained before, during, and/or after treatment with AZD9291 or rociletinib (CO-1686). Targeted sequencing and FISH analyses were performed, and the relevance of candidate genes was functionally assessed in in vitro models.
RESULTS - We found recurrent amplification of either MET or ERBB2 in tumors that were resistant or developed resistance to third-generation EGFR inhibitors and show that ERBB2 and MET activation can confer resistance to these compounds. Furthermore, we identified a KRAS mutation in a patient with acquired resistance to AZD9291 as a potential driver of acquired resistance. Finally, we show that dual inhibition of EGFR/MEK might be a viable strategy to overcome resistance in EGFR-mutant cells expressing mutant KRAS CONCLUSIONS: Our data suggest that heterogeneous mechanisms of resistance can drive primary and acquired resistance to third-generation EGFR inhibitors and provide a rationale for potential combination strategies. Clin Cancer Res; 22(19); 4837-47. ©2016 AACR.
©2016 American Association for Cancer Research.
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Discovery and optimization of a novel series of highly CNS penetrant M4 PAMs based on a 5,6-dimethyl-4-(piperidin-1-yl)thieno[2,3-d]pyrimidine core.
Wood MR, Noetzel MJ, Engers JL, Bollinger KA, Melancon BJ, Tarr JC, Han C, West M, Gregro AR, Lamsal A, Chang S, Ajmera S, Smith E, Chase P, Hodder PS, Bubser M, Jones CK, Hopkins CR, Emmitte KA, Niswender CM, Wood MW, Duggan ME, Conn PJ, Bridges TM, Lindsley CW
(2016) Bioorg Med Chem Lett 26: 3029-3033
MeSH Terms: Allosteric Regulation, Animals, Brain, Humans, Microsomes, Liver, Piperidines, Pyrimidines, Quinazolines, Rats, Receptor, Muscarinic M4, Structure-Activity Relationship, Thiophenes
Show Abstract · Added April 6, 2017
This Letter describes the chemical optimization of a novel series of M4 positive allosteric modulators (PAMs) based on a 5,6-dimethyl-4-(piperidin-1-yl)thieno[2,3-d]pyrimidine core, identified from an MLPCN functional high-throughput screen. The HTS hit was potent and selective, but not CNS penetrant. Potency was maintained, while CNS penetration was improved (rat brain:plasma Kp=0.74), within the original core after several rounds of optimization; however, the thieno[2,3-d]pyrimidine core was subject to extensive oxidative metabolism. Ultimately, we identified a 6-fluoroquinazoline core replacement that afforded good M4 PAM potency, muscarinic receptor subtype selectivity and CNS penetration (rat brain:plasma Kp>10). Moreover, this campaign provided fundamentally distinct M4 PAM chemotypes, greatly expanding the available structural diversity for this exciting CNS target.
Copyright © 2016 Elsevier Ltd. All rights reserved.
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12 MeSH Terms
N-Alkylpyrido[1',2':1,5]pyrazolo-[4,3-d]pyrimidin-4-amines: A new series of negative allosteric modulators of mGlu1/5 with CNS exposure in rodents.
Felts AS, Rodriguez AL, Morrison RD, Venable DF, Blobaum AL, Byers FW, Daniels JS, Niswender CM, Jones CK, Conn PJ, Lindsley CW, Emmitte KA
(2016) Bioorg Med Chem Lett 26: 1894-900
MeSH Terms: Allosteric Regulation, Animals, Central Nervous System, Dose-Response Relationship, Drug, Male, Mice, Molecular Structure, Pyrazoles, Pyrimidines, Rats, Rats, Sprague-Dawley, Receptors, Metabotropic Glutamate, Structure-Activity Relationship
Show Abstract · Added April 6, 2017
Selective negative allosteric modulators (NAMs) of each of the group I metabotropic glutamate receptors (mGlu1 and mGlu5) have been well characterized in the literature and offer potential as therapeutics in several disorders of the central nervous system (CNS). Still, compounds that are potent mGlu1/5 NAMs with selectivity versus the other six members of the mGlu family as well as the balance of properties required for use in vivo are lacking. A medicinal chemistry effort centered on the identification of a lead series with the potential of delivering such compounds is described in this Letter. Specifically, a new class of pyrido[1',2':1,5]pyrazolo[4,3-d]pyrimidin-4-amines was designed as a novel isosteric replacement for 4-aminoquinazolines, and compounds from within this chemotype exhibited dual NAM activity at both group I mGlus. One compound, VU0467558 (29), demonstrated near equipotent activity at both receptors, selectivity versus other mGlus, a favorable ancillary pharmacology profile, and CNS exposure in rodents.
Copyright © 2016 Elsevier Ltd. All rights reserved.
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13 MeSH Terms