ciap using fragment based drug discovery

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Discovery of a potent dual antagonist of both XIAP and ciap using fragment based drug discovery Gianni Chessari, PhD TAT Congress 2012

Disclosures I am an employee of Astex Pharmaceuticals I will present pre-clinical data from the IAP program

Inflammation and Tumor Progression Strong clinical unmet need for inflammatory tumour types Melanoma, Breast, Colorectal, Mesothelioma, Ovarian Inflammatory mediators (e.g. TNFα) can initiate tumorigenesis and subsequent tumour progression TNFα released by the macrophage activates Nuclear Factor-Kappa B (NF-κB) pathway. NF-κB activates production of pro-survival proteins that promote cell proliferation and inflammation http://www.breakthroughresearch.org.uk/the_research_centre/research_teams/apoptosis/index.html

TNFα Signaling and IAP Antagonism Canonical NF κb pathway ciap ciap antagonists promote ciap auto ubiquitylation and proteosomal degradation TNF signalling in absence of ciap XcIAP XIAP antagonists promote activation of Caspase 3, 7, 9 Inflammation XXIAP Apoptosis The full pro apoptotic action of ciap1 loss cannot be achieved without sustained XIAP inhibition Darding, M. & Meier, P. Cell Death Differ, (2012), pp.58 66 4

Astex Target Product Profile Molecular Profile Dual XIAP and ciap inhibitors Switch TNFα signalling from inflammation to apoptosis Strong apoptotic signal: activation of Caspase-3, -7, -8, -9 Non peptidomimetics and non alanine as the warhead Well tolerated at therapeutic dose No overproduction of cytokines (side effect due to ciap1 inhibition) No liver toxicity Once daily oral Disease Area Clinical unmet need in inflammatory tumor types (single agent) Melanoma (also breast, colorectal, l mesothelioma, ovarian)

IAP Protein Family Human IAPs Caspase-3 Caspase-7 Caspase-9 SMAC HtrA2 GSPT CLPX 3HB A N P R A N P R A T P F A V P I A V P S A K P F A SKD A S K T P3' First generation of IAP antagonists Based on SMAC peptide sequence AVPI Ala-like warhead Tendency for ciap1 selectivity P1' P2' XIAP BIR3 SMAC complex P4'

Fragment to Candidate Progression Pyramid TM fragment screening identifies a non alanine hit Hit optimisation via structure based drug design Candidate (ASTX) True dual XIAP and ciap inhibitor XIAP BIR3 IC50 > 5 mm XIAP BIR3 IC50 = 0.64 μm XIAP BIR3 IC50 < 0.04 μm ciap1 BIR3 IC50 > 5 mm ciap1 BIR3 IC50 = 0.32 μm ciap1 BIR3 IC50 < 0.01 μm ASTX is well tolerated in mouse at efficacious dose (50 mg/kg g p.o.) No liver toxicity (levels of ALT and AST in plasma were normal and comparable to control). No weight loss ASTX is orally available in mouse and rat and it shows low/moderate clearance in both species

Astex Candidate Shows Potent Pan-Inhibition in Cell Cell based assays give more accurate reflection of XIAP and ciap1 potency In vitro binding assays not sensitive enough to differentiate potent compounds 10 9 ciap1 degradation XIAP Casp9 inhibition Compound Chemistry Status LBW 242 Novartis Peptidomimetic Ala like warhead Preclinical Selectivity ciap/xiap > 150 fold pec 50 8 7 LCL 161 Novartis AT 406 Ascenta ASTX Peptidomimetic Ala like warhead Peptidomimetic Ala like like warhead FBDD Non Ala warhead Phase I/II Phase I/II Preclinical > 100 fold > 30 fold < 10 fold 6 LBW 242 AT 406 LCL 161 ASTX ASTX is a potent dual inhibitor of XIAP and ciap1 Alanine-based compounds tend to be ciap1 selective ciap1 degradation measured in MDA MB 231 cell line XIAP Casp9 inhibition measured in HEK293 engineered cell line

In Vivo XIAP Inhibition HEK293-X-C9 HEK293 X C9 xenograft mouse model ASTX 50 mg/kg P.O. Ala based dcompetitor (ciap1 selective) 50 mg/kg P.O. Caspase 9 levels (measured by immunoprecipitation assay) Veh. Ctr. 6 h 24 h 48 h blanks Mouse No: C1 C2 C3 1 2 3 4 5 6 7 8 9 BI BI MSD electrochemiluminescence detection BI Ca aspase 9 levels (% Veh. Ctr.) Tumour Conc c. (μm) ASTX Ala based Competitor ASTX strongly binds to XIAP inhibiting the formation of XIAP/Caspase-9 complex over 48 h ASTX PK/PD profile in the HEK293-X-C9 xenograft mouse model is superior to Alaninebased SMAC mimetics competitors

In Vivo Efficacy in MDA-MB-231 mouse model PK/PD ASTX 50 mg/kg P.O. Efficacy Study 120 1500 Levles h. Ctr.) ciap1 (% Veh 100 80 60 40 20 0 Veh. 6h 24h 1200 900 600 300 0 Tumou r Conc. (fold ov ver EC 50 ) ASTX achieves high h concentration ti in tumor and plasma over 24 h Excellent inhibition ciap1 and XIAP Induction of apoptosis markers (cleaved PARP, cleaved Caspase-3) Strong inhibition of tumour growth.

Cell Lines Panel of Inflammatory Tumours 15 31 inflammatory tumour cell lines where tested with ASTX + 1ng/ml of TNFα Sk Mel2 12 Single agent activity 4 ciap1 lines n cell 9 6 Non Sensitive Sensitive ciap2 tot. PARP cleaved PARP 3 79% 54% 45% 44% 40% tot. Casp. 3 0 Melanoma Colon Breast Ovary cleaved Casp.3 Inflammatory tumours cell lines shows good sensitivity iii to ASTX when TNF is present (>50% overall sensitivity) Sensitivity is driven by the ability of ASTX to switch the TNFα signalling frompro survivalto pro apoptotic P NF kb, p65 tot NF kb,p65 β Actin 6 h 11

Summary Potent dual XIAP and ciap1/2 candidate Novel non-alanine and non-peptidic chemotype identified by Pyramid TM fragment screening Structure based drug design approach led to candidate molecule: Good physico-chemical properties and in vivo profile Well tolerated (no liver tox nor elevation of cytokines levels) No P450 or herg liabilities Structurally distinct from any known IAP inhibitors Oral pharmacodynamic activity and tumour growth inhibition demonstrated Targeting inflammatory tumour types

Acknowledgements IAP Team Based in Cambridge (UK) & Dublin (US) www.astx.com 13

Thank you! www.astx.com 14