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At the forefront of cancer research

We look at FLIP, STING and other potentially groundbreaking areas of oncology therapeutics R&D
Written byJeffrey Bouley
| 18 min read

Focus Feature: Cancer Research News

At the forefront of cancer research

Researchers look to ‘FLIP’ the script on cancer care, analysts say not to fear so much getting stung by STING—and more

Because cancer has for some time now been one of the most prolific and best-funded areas of life-sciences and pharma/biotech research, we have seen quite a lot of interesting approaches, new breakthroughs and fascinating insight into how tumors work and how they might be stopped.

With researchers balancing on that sharp cutting edge of oncology research, we thought we would share a few bits of news from some of the newer and less-publicized areas of study recently: a first-in-class FLIP inhibitor, insights about whether the STING pathway is a boom or bust, a potential therapeutic target for one of the deadliest cancers, drug-induced xenogenization findings and a previously unknown protein variant with therapeutic implications.

Head over heels for FLIP?

BELFAST & SAFFRON WALDEN, U.K.—In late march, Queen’s University Belfast and Domainex announced that their joint project team had successfully identified novel first-in-class small-molecule inhibitors of the anti-apoptotic protein FLIP and are now seeking a commercial partner for further development of the novel inhibitors. Moreover, the team generated data suggesting multiple therapeutic opportunities for a FLIP inhibitor for both single-agent and combination therapeutic approaches.

This FLIP program has been funded by the Wellcome Trust and has focused on the identification and optimization of novel first-in-class small-molecule FLIP-FADD protein-protein interaction inhibitors. FLIP is a non-redundant inhibitor of the caspase 8 protein, and functional FLIP is believed to allow tumor cells to evade cell death, as well as promoting tumor growth and therapy resistance. The novel FLIP inhibitors activate caspase 8 and are said to have shown efficacy in a number of preclinical models including clinically challenging KRAS and EGFR mutant non-small cell lung cancer.

“Our medicinal chemists have been delighted to work on this exciting target and enable Prof. Dan Longley and his team to identify and optimize the FLIP inhibitors,” said Trevor Perrior, CEO of Domainex. “There were several challenges that we had to solve in order to identify hits and develop a series of potential drug compounds that are potent and selective. We look forward to at least one of these compounds progressing towards the clinic for the benefit of patients. The funding secured from the Wellcome Trust is a clear endorsement of the strength of the integrated drug discovery platform of Domainex to deliver molecules with disease-modifying potential and we remain deeply committed to supporting academic translational research.”

In a poster presentation at the American Association for Cancer Research (AACR) annual meeting this year, the researchers highlighted the on-target effects of the inhibitors and their drug-like properties; their potency against B cell lymphomas, triple-negative breast cancer and KRAS and EGFR mutant non-small cell lung cancer; and their potential for combination with chemotherapy, immune oncology agents and EGFR-targeted therapeutics.

The next phase of the program will involve selection of a preclinical development candidate and completion of preclinical activities.

“Resistance to cancer therapeutics such as chemotherapy is a major clinical problem that limits the effectiveness of many current cancer treatments. Very often, this is caused by the failure of anticancer therapies to kill the cancer cells. FLIP is a cellular protein that cancer cells frequently express at high levels, and this increases their resistance to chemotherapy and other types of therapy used to treat cancer, such as radiotherapy,” explained Longley, who is at the Centre for Cancer Research and Cell Biology at Queen’s University Belfast. “The agents that we are developing target FLIP and prevent it from causing therapy resistance. In addition, some tumor-promoting immune cells also need FLIP, so our FLIP inhibitors may also have beneficial effects in the tumor microenvironment by reactivating immune cells to attack cancer cells.”

Some feel hurt by STING, but pathway has potential

BOSTON—News out of 2018 put a damper on the enthusiasm that some had for investigational immuno-oncology therapeutics targeting STING (stimulator of interferon genes), but analysts at SVB Leerink LLC urge pharma and life-sciences market-watchers not to give up on the pathway just yet.

Many investors are down on STING following reports of zero percent to 5 percent objective responses with single-agent agonists in 2018 from candidates being explored by Merck & Co. (known as MSD outside the United States and Canada) and Aduro Biotech.

“We remain enthusiastic about STING for several reasons,” wrote Dr. Daina M. Graybosch of Leerink, though, adding that “...we know from murine experiments that establishing durable immunity with STING requires combination with checkpoints ... Multiple clinical trials of TLR9 plus checkpoints had promising results, building evidence for the type I interferon approach, a target shared by STING ... Without more extensive preclinical data, we are hesitant to assume [Merck’s] STING agonist is representative of the class, given wide variation in molecule selectivity and potency.”

In addition to those three points, Graybosch noted that “STING agonism is fully complementary to checkpoint inhibition, positively impacting four steps in the adaptive immunity cycle as well as stimulating innate immunity [natural killer cells]” and that the “scientific community remains optimistic,” pointing out that half of the MEDACorp key opinions leaders that Leerink surveyed in 2018 picked STING as “top 10” potential mechanism.

In other STING news, Kirkland, Wash.-based Mavupharma early this year announced that it had selected its first immuno-oncology clinical development candidate, MAVU-104, a small-molecule inhibitor of ENPP1 (a phosphodiesterase that negatively regulates the STING pathway). Inhibiting ENPP1 activity with MAVU-104 reportedly allows for highly-controlled enhancement of STING signaling in all tumors and lymph nodes without any injections.

“With our approach, which focuses on blocking a key negative regulator of the STING pathway, as opposed to directly stimulating STING itself, the degree and duration of innate immune activation are tunable, which avoids both overstimulation of the pathway and high levels of cytokine release,” said Dr. Mike Gallatin, Mavupharma’s president and co-founder. “Having selected our first immuno-oncology drug candidate, we are now focused on the path to IND for MAVU-104, which we expect to file in the second half of 2019.”

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Volume 15 - Issue 5 | May 2019

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