Optimal cancer chronotherapeutics schedules using a Systems Biology approach Chronotherapeutics of Seliciclib. Dr. Christophe Chassagnole, COO

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Optimal cancer chronotherapeutics schedules using a Systems Biology approach Chronotherapeutics of Seliciclib Dr. Christophe Chassagnole, COO Copyright Physiomics plc 2008

About Physiomics plc Business Founded 2001, Oxford (UK) based, listed on the LSE (AIM) 2004 We use computer modelling to understand and predict optimal cancer therapy. We accelerate the discovery process and reduce development risk. Focus Cancer Models to simulate drug mechanism of action. Combination therapy and cell populations (SystemCell Technology). Collaborations: Eli Lilly Cyclacel Pharmaceuticals ValiRx - Cronos Therapeutics Bayer Technology Services TEMPO (FP6 EU LifeSciHealth project) Institute of Life Science, Swansea University (HPC) 2

Chronotherapy for cancer drugs Chronotherapy consists of coordinating the timing of a medical treatment with patient s biological rhythms in order to optimise a drug s beneficial effects and reduce the undesired ones Tolerability varies in mice and rats by as much as 10-fold for >35 anticancer drugs (e.g. Oxaliplatin, 5-FU, Docetaxel,..) [1] ;2000 patients in Phase I, II & III trials Oxaliplatin was rescued using adjusted chronotherapeutic regimes [1] Phase III: Oxaliplatin-5FU combination chronotherapy with gender effect ( 2-Year survival male increase by 25%, but female decrease by 38%) [2] Much evidence for circadian regulation of the cell cycle in a variety of cell types [3] and this synchronisation may be lost in tumours [4]. [1] Levi F. & Schibler U., Ann Rev Pharm Tox (2007); 47:593-528 [2] Giacchetti et al. J Clin Oncol 2006, 24:3562-3569 [3] Levi F., IEEE Eng Med Biol Mag. (2008); 27(1):17-9. [4] Iurisci I. et al., Cancer Res (2006); 10720-8. 3

Circadian rhythms Source: http://en.wikipedia.org/wiki/image:biological_clock_human.png 4

Altered molecular clock in experimental tumors Healthy liver mrev-erbα Relative abundance of mrna (% 24-h mean) 200 Dividing cells: targets for cancer therapeutics 150 mbmal1 100 50 (no specificity for cancer cells) Cell cycle mper2 0 0 6 12 18 24 6 Tumor (advanced stage GOS) 200 150 mper2 mrev-erbα mbmal1 100 50 0 0 6 12 18 24 6 Circadian Time (hours) Iurisci I. et al., Cancer Res (2006); 10720-8. 5 deregulated in cancer cells controlled by circadian timing system in normal cells

TEMPO project This research is supported by European Commission FP6 Specific Targeted Project TEMPO LSHG-CT-2006-037543 Copyright Physiomics plc 2008

Tempo (EU project, 8 partners) General Objectives Design 3 to 5 chronotherapeutic schedules based on patient profiling, identified by: Set of 20 to 30 marker genes Cell cycle, drug activity & pattern tolerability & efficacy Addressing gene expression, proteins, signaling pathways, biochemistry Mathematical models WP1 Functional chronopharmacoge nomics F. Delaunay CNRS, INSERM Application: patient-tailored cancer chronotherapeutics: WP2 Integration and Modelling J. Clairambault INRIA, INSERM, Helios, Physiomics WP3 Dynamic drug delivery F. Levi CNRS, CINBO, HS Seliciclib Irinotecan Validation during the project: Optimal schedules in cell cultures, animal models and development of micro-pumps for drug delivery Human prerequisites and theoretical schedules 7 WP4 Human prerequisites / tailored chronotherapeutics M. Pirovano HS, INSERM, INRIA, CNRS CINBO, Helios, Physiomics

TEMPO (EU project) Chronotherapy Modelling Circadian timing system Supra Chiasmatic Nucleus PK-Sim Cell division cycle Repair or apoptosis M G2 Circadian physiology G1 S Corresponding optimal delivery schedule of Irinotecan and Seliciclib Molecular clocks Repair or apoptosis Therapeutic implications of the interactions between the circadian timing system, the cell division cycle and the pharmacology determinants 8

Snapshot of the Mammalian Cell Cycle Model The diagram shows cell cycle phases & components within a fragment of the mitosis module. Two wild-type mammalian cell cycles starting from G0 arrest: DNA replication (top) and time courses of cyclins E, D, A & B in complex with cdks (bottom) are shown. 9

Circadian Clock Model (molecular clock) 16 equations model Bmal mrna Per mrna Cry mrna Leloup et Goldbeter, PNAS 2003 10

Coupled Cell Cycle Circadian Clock model Bmal Wee1 CyclinBCDK1 Left: the circadian clock model (dotted orange rectangle) was coupled to the cell cycle model through the CyclinB-cdk1 mitotic switch (red dotted square) via its regulator Wee1. Top: Simulation showing the entrainment of some cell cycle species by the circadian clock. Fernandez E. et al.aacr 2008 Poster #801 11

Virtual FACS - SystemCell Technology SAMPLED CELL CYCLE 2N / G1 DRUG ADDITION S-phase 2N / G1 S-phase 4N / G2 4N / G2 M-phase M-phase 8N TUNEL 4N S-phase END OF EXPERIMENT 8N 12

HPC - SystemCell Technology 2N / G1 min 120 DRUG ADDITION S-phase 2N / G1 100 S-phase 4N / G2 80 4N / G2 M-phase M-phase 60 8N TUNEL 40 4N S-phase 20 0 8N 1CPU - Dual Core2 HPC - serial 13 HPC - 32CPUsEND OF EXPERIMENT

PK Modelling Approach Chosen to use a mechanistic (PBPK) model i.v. provided by PK-Sim : WALL PxSA Transp 1 Transp 2 WALL LARGE INTESTINE WALL PANCREAS SPLEEN GALL BLADDER PORTAL VEIN LIVER KIDNEY Vmax, Km Vmax, Km TESTES HEART BRAIN FAT BONE SKIN MUSCLE Meta 1 Meta 2 LUNG Vmax, Km Vmax, Km 14 ARTERIAL BLOOD POOL Qorg Crbc SMALL INTESTINE VENOUS BLOOD POOL compartments for different tissues (useful for simulations of toxicity) Extrapolation from mouse to human is based on physiological mechanisms so may be more accurate. Cpl STOMACH p.o. The model is preconstructed to include DOSE

Pharmacokinetic Modelling First Sketch We are currently using literature-derived and experimentally determined values for physicochemical properties of roscovitine No calibration has been performed for distribution (active transport) and organspecific metabolism (actually experimentally determined) Put PK-Sim screenshot Therefore, only the plasma concentration-time courses are used as an input to the pharmacodynamic model 15

Pharmacokinetic Modelling PK-Sim vs Nutley et al. (2005) Plasma [CYC202] (nm) 1000000 Simulated Results Observed Results 100000 10000 1000 100 10 1 0 5 10 15 20 25 Time after 100mg/kg IV dose (hr) 100mg/kg IV dose published by: Nutley et al.; Mol Cancer Ther 2 5;4(1), 125-139 16

Combined PK-PD Modelling PK profile Cell population Concentration [µmol/ l] 1.00E+02 1.00E+01 Sim ulation: Se liciclib (-c le ara nce s ) Spe cie s : M ous e Com poun d: Se liciclib 1.00E+00 Ve nous Blood -Plas m a 1.00E-01 1.00E-02 0 1 2 3 Time [day] Conversion and rescaling SystemCell for HPC drug Example single cell #time um 0 0 0.060526316 0.121052632 0.181578947 0.242105263 0.302631579 0.363157895 0.423684211 0.484210526 0.544736842 1.2 2.4 3.6 4.8 6 5.612872 5.237883 4.875008 4.524247 128 unsync cells DNA content (virtualfacs) phh3 (IVTI) Mitotic index Dose scheduling 17

Single Cell Combined PK-PD Modelling DNA drug cyclina_cdk2 cyclind_cdk4 cycline_cdk2 cyclinb_cdk1_inact cyclinb_cdk1_act When administered at early G1 double Seliciclib dosing barely effects cell cycle length. When administered at late G1-G2, Seliciclib leads to sustained G2 arrest Fernandez, E. et al, Abstract No 801, AACR Annual Meeting 2008,San Diego, CA 18

Multi-cell Combined PK-PD Modelling Dose given at ZT3 Synchronised cell population Dose given at ZT19 Arrested Proliferating 1 Arrested Time (hour) Time (hour) Unsynchronised cell population 1 Arrested Arrested Proliferating Proliferating Time (hour) 19 1 Time (hour)

Experimental Data Experimental data in mice (Iurisci et al. Cancer Res (2006) 10720-8) is broadly in line with our initial simulations. 20

Perspectives Future work Simulate effects of Seliciclib on apoptosis Add regulation of apoptosis by circadian clock (balance cell division/cell death) Models for each organ calibrated with experimental data Adapting model for Human (clinical trial design) New dosing regimen and delivery protocols for cancer drugs 21

Thank You cchassagnole@physiomics-plc.com www.physiomics-plc.com Copyright Physiomics plc 2008