Biomarkers in drug discovery and development. Margit Wissenbach, PhD Dir Business Development Scandinavia

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Brenda George
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1 Biomarkers in drug discovery and development Margit Wissenbach, PhD Dir Business Development Scandinavia

2 Aptuit: A Truly Integrated R&D Offering Integrated Discovery Integrated Development IND Candidate To specification 2

Biomarkers Biomarkers are used in pre-clinical and clinical drug development as indicators of

and also as warning signs of potential TOXICITY cells Efficacy biomarkers rapid confirmation

measurable indicators of toxicological and adverse side effects of drug activity genes proteins

3 Biomarkers Biomarkers are used in pre-clinical and clinical drug development as indicators of likely response to drug: therefore, they enjoy utility both as predictors of possible EFFICACY and also as warning signs of potential TOXICITY cells Efficacy biomarkers rapid confirmation that the drug has hit its target Indicator of pharmacological activity + Safety biomarkers measurable indicators of toxicological and adverse side effects of drug activity genes proteins Quality assessment of biological drug activity Translational approach to clinic development Reduced attrition

4 4 Applications for biomarkers

5 Use of biomarkers in support of disease hypothesis Single biomarker approach (ELISA, EIA, RIA, IRMA); Disease-driven biomarker panels (Luminex and Meso Scale Discovery platforms): acute stress markers: corticosterone and ACTH - potential indicators of specific compound activity or side effects; metabolic markers/adipokines: prolactin, insulin, amylin, glucagon, GLP-1, glucose, leptin, resistin, adiponectin, MCP-1, ghrelin - to assess metabolic liability displayed by some compounds; inflammatory markers: Cytokines/Chemokines (e.g. IL-1α, IL-1β, IL-2, IL-4, IL- 6, IL-10, GRO-KC, MIP-1α, GM-CSF, IFN-γ & TNF-α) to test for pro- or antiinflammatory activity; hypothalamic neuroendocrine markers: prolactin, TSH, LH, GH, FSH; neuroplasticity panel: serum BDNF, VEGF, camp; sex hormones: testosterone, progesterone, estradiol. Quantification in complex biological samples (e.g. serum, plasma, urine, saliva, brain tissue) from preclinical species and in clinical samples 5

Regulatory requirements for biomarker validation Little regulatory guidance on biomarker assay validation is available: In 2003 the American Association of Pharmaceutical Scientists participated in a

6 Regulatory requirements for biomarker validation Little regulatory guidance on biomarker assay validation is available: In 2003 the American Association of Pharmaceutical Scientists participated in a Biomarker Method Validation Workshop to address the validation challenges of biomarker assays in support of drug development Biomarker method development and validation is based on a fit-forpurpose approach. 6

7 Cardiac Troponin I (ctni): courtesy by jolisfukyu.tokai-sc.jaea.go.jp represents a biomarker of cardiac toxicity in the clinic can be used as reverse translational biomarker since animal studies have demonstrated that it s a marker of the same diseases that occur in humans has been successfully applied as marker of cardiac injury in different preclinical animal species is measured in preclinical by automated chemiluminescent immunoassay on the Siemens ADVIA Centaur CP 7

Aminoterminal pro-brain natriuretic peptide (NT-proBNP): courtesy by Roche Diagnostics is primarily secreted from the cardiac ventricular myocytes in response to cardiac stress

8 Aminoterminal pro-brain natriuretic peptide (NT-proBNP): courtesy by Roche Diagnostics is primarily secreted from the cardiac ventricular myocytes in response to cardiac stress used in the clinic for the diagnosis of left ventricular systolic and diastolic dysfunction has been evaluated in preclinical studies in the dog is measured in preclinical by ELISA 8

9 Biomarkers in a 26-week dog study ctni and NT-proBNP are reliable, sensitive and non-invasive markers of drug-induced cardiac changes in the dog CTnI was essential in the characterization of the onset of the lesions and its slow evolution; excellent correlation between ctni and developing pathology was observed with ctni elevations detectable long before light microscopy changes; transmission electron microscopy analysis was capable to detect ultrastructural changes in the heart which were concomitant to ctni elevations NT-proBNP determination in conjunction with echocardiography and morphometry acted as an early marker of heart hypertrophy anticipating echocardiography changes as well morphometry 9

10 CARDIAC MARKERS NT-proBrain Natriuretic Peptide Serum ELISA Atrial Natriuretic Peptide Serum ELISA Cardiac Troponine I Serum MSD or Centaur CP Cardiac Troponin T Serum MSD Fatty acid binding protein 3 Serum MSD Myosin light chain 3 Serum MSD CK-MB Serum ELISA AST, myoglobin, aldolase, CK and LDH isoemzymes Serum Clinical Chemistry Analyzer HORMONES Prolactin Serum Immulite 2000 Growth hormone Serum Immulite 2000 Insulin Serum Immulite 2000 IGF-1 (Insulin-like growth factor 1) Serum ELISA INFLAMMATION/IMMUNITY IL-1beta, TNF-alpha, IFN-gamma, IL-2, IL-6, IL-12/23 Plasma Luminex (p40) IFN-gamma Splenocytes ELISpot Intracellular cytokines Whole Flow Cytometry blood/tissues Histamine Serum ELISA T cell activation markers (CD25,CD69, HLA-DR) Whole blood, Flow cytometry PBMC T/B/NK cells Immunophenotyping Whole blood Flow cytometry LIVER INJURY MARKERS Arginase 1 Arginase 1 Arginase 1 αgst αgst αgst

11 ONCOLOGY AlPhafetoprotein (AFP) Serum ELISA Caspase3 Tumor section Immunohistochemistry Carbohydrate antigen-19-9 (CA-19-9) Serum ELISA Carbohydrate antigen-15-3 (CA-15-3) Serum ELISA Carbohydrate antigen-125 (CA-125) Serum ELISA Carcinogenic Embryonic Antigen (CEA) Serum Chemiluminescent CD31 Tumor section Immunohistochemistry CYFRA 21-1 (Cytokeratin) Serum Monoclonal based assay Galectin-3 Serum ELISA HER2 Expression Serum ELISA Ki67 Tumor section Immunohistochemistry PCNA Tumor section Immunohistochemistry p-histone-3 Tumor section Immunohistochemistry Prostate Specific Antigen (PSA) Blood/plasma Chemiluminescent Putresceine TPA (Cytokeratin) Serum Monoclonal based assay TPS (Cytokeratin) Serum Monoclonal based assay TRAIL/TRAIL Rs Blood/plasma TUNEL Tumor section Immunohistochemistry VEGF, VEGF-C, VEGF-D, Tie-2, Flt-1, PIGF and bfgf Serum MSD P53 Serum MSD OXIDATIVE STRESS MARKERS GSH-GSSG ratio Muscle and liver Fluorimetric Assay Nitrotyrosine Muscleand liver ELISA Reactive Oxygen Species (ROS) Plasma, muscle and liver Fluorimetric Assay

12 RENAL MARKERS Albumine Serum and urine MSD Lipocalin -2 Serum and urine MSD KIM-! Serum and urine MSD Osteopontin Serum and urine MSD SEX HORMONES Progesterone Serum ELISA Testosterone Serum ELISA Dihydrotestosterone Serum ELISA STRESS MARKERS Corticosterone Serum/plasma RIA THYROID MARKERS Triiodothyronine (T3) Serum Centaur CP or ELISA Thyroxine (T4) Serum Centaur CP or ELISA Thyroid stimulating hormone (TSH) Serum Centaur CP or ELISA or Immulite 2000

13 Instrumentation TECHNOLOGIES MATRIX Rodents blood and derivatives Primate blood and derivatives Human blood and derivatives Primary cells Luminex ELISA ECL ELIspot Flow Cytometry Gene expression

AVAILABLE BIOMARKER ASSAYS

AVAILABLE BIOMARKER ASSAYS AAILABLE BIOMARKER ASSAYS alidation Alpha-2-microglobulin ELISA Anti-CD71/anti-platelet/propidium iodide Anti-KLH IgG ELISA,, Dog, Minipig, Apoptotic, necrotic and dead cells (bone marrow) B (activated