Advancing In Vivo Toxicity Prediction Beyond Modeling

 
Predicting 
in vivo 
Toxicity:
Beyond Modeling?
 
Russ Naven
November 20
th
 2015
Confidence in Ability to Predict Toxicity
Future
Time (14 years)
Confidence
 
Withdrawn owing to liver safety signals in
Phase III:
 
 
 
 
 
 
 
 
 
Recently Discontinued Drugs
 
Why No Preclinical Attrition?
 
Perhaps toxicological signals were not observed
Maybe signals were observed but…
their significance was not recognized
were considered manageable
 
Toxicological
knowledge gaps
 
Exposing Toxicological Knowledge Gaps
 
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Exposing Toxicological Knowledge Gaps
Applicability
domain
 
Example Pfizer Study:
What Features Are Predictive of 
in vivo 
Toxicity
 
207 preclinical candidates investigated
 
Compounds were annotated against the observation of any 
in vivo 
toxicity
findings at 10µM (total plasma exposure)
 
Odds of toxicity established for various physicochemical properties
 
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Training set is dominated by lipophilic basic drugs
Lipophilic basic drugs cause general toxicity, e.g. through lysosomal
dysfunction, disruption membrane integrity and inhibition of ion
channels and adrenergic GPCRs
 
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Thresholds Are Not Universally Applicable
 
pKa Class Distribution
within dataset
 
Basic
e.g. aminergenic cpds
 
Neutral
 
Thresholds Are Not Universally Applicable
 
Training set is dominated by lipophilic basic drugs
Lipophilic basic drugs cause general toxicity, e.g. through lysosomal
dysfunction, disruption membrane integrity and inhibition of ion
channels and adrenergic GPCRs
 
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AZ Study: What Features Are Predictive of
Preclinical Survival
 
Different profile to
Pfizer study:
 
Toxicity
Odds
 
Results from A Pan-Pharma Study
 
Data from AZ, Eli Lilly, GSK and Pfizer
 Focus on preclinical survival
 
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Global Computational Analyses
 
Are useful in that they identify broad physico-
chemical features associated with toxicity
Often related to exposure
These properties applicable across all chemical space
Unlikely to identify biological descriptors/mechanisms
Only applicable to certain subclasses of compounds
 
 The u
tility of computational analyses is in the
identification of toxicological knowledge gaps!
 
Understanding Liabilities in Acidic Compounds
 
Hypothesis: 
in vivo 
toxicity of acidic compounds may be masked
in 
in vitro 
assays owing to protein binding to assay serum
 
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Toxicity is Multifactorial: Nefazodone
 
Potent 5-HT
2A
 receptor antagonist and antidepressant
Withdrawn 2003 for very rare, but severe, liver toxicity
Has multiple safety liabilities
Contains structural alert (aniline)
1
Metabolic liabilities
2
Inhibitor bile-salt export pump
3
Cytotoxic
4
Mitochondrial dysfunction
4
High dose: >200mg/day
 
Refs
1. Stepan 
et al
., Chem. Res. Toxic., 2011, 24, 1345-1410.
2. Kalgutkar 
et al.
, Drug Metab. Disp., 2005, 33, 243-253
3. Kostrubsky 
et al
, Toxicol. Sci., 2006, 90, 451-459
4. 
Dykens 
et al
., Toxicol. Sci., 2008, 103, 335-345.
 
Structurally similar, yet successfully marketed drug
No
 reports of acute hepatotoxicity
Has multiple 
in vitro 
liabilities
Contains structural alert (aniline)
 1
Metabolic liabilities
2
Cytotoxic and lysosomotropic
3
Low dose: 10-20 mg/day
 
 
Can we confidently class aripiprazole as non-hepatotoxic?
 
Toxicity is Multifactorial: Aripiprazole
 
Refs
1. Stepan 
et al
., Chem. Res. Toxic., 2011, 24, 1345-1410.
2. Bauman et al., Drug Metab. Disp., 
2008, 36, 1016-1029.
3. Nadanaciva et al., Toxicol. in Vitro, 2011, 25, 715-723.
 
Toxicological Data is Very Noisy
 
….like this NMR spectra?!
 
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Tox21 Data
 
 Heat map of 110 pharmaceutical compounds tested against 801 assays
 
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Why different toxicity
profile?
ADME?
Target Potency?
Off-target pharmacology?
 
Analogues Can Drive Hypothesis Generation
 
(GSID_47281)
 
(GSID_47278)
 
CAR, RXRb, RORg
 
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Why different toxicity
profile?
ADME?
Target Potency?
Off-target pharmacology?
 
Analogues Can Drive Hypothesis Generation
 
(GSID_47281)
 
(GSID_47278)
 
CAR, RXRb, RORg
 
TX006173
(GSID_47282)
 
PDE10, PPARa
 
Different Chemotypes for the Same Target
Have Different Profiles
 
Reducing Drug Attrition
 
Developing Early Screening Paradigms
 
22
 
Cell health and disruption of homeostasis
 Cytotoxicity
 Mitochondrial Dysfunction
 ROS/NOX induction
 Promiscuity measure
 
Targets/
phenotypic
 assays linked to toxicity
 ion channels, hERG (cardiotox)
 GPCRs (5HT2b agonism)
 Specific cellular assays (iPS cells)
 Cytokine storm
 Disruption of Cellular Differentiation?
 
Recent Marketed Example
 
Tolvaptan
Competitive vasopressin
receptor 2 antagonist by Otsuka
Pharm
Approved by the FDA 2009
2012: FDA “Limits Duration and
Usage Due To Possible Liver
Injury Leading to Organ
Transplant or Death”
 
 
23
 
Dose  = 60mg/day
Cmax 
 1µM (total)
 
Tolvaptan Has HepG2 Cytotoxic Liabilities
 
Viability in Hepg2 cells:
 
 
 
 
 
 
Impact can be seen in other screening assays:
 
24
 
52.2 uM
 
33.0 uM
 
ROS
  
                             
Comet assay
 
                                                     
DNA oxidation
 
 
 Why would a vasopressin receptor 2
antagonist cause cytotoxicity?
 
 Likely due to inherent properties of
the compound?
 
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Tolvaptan May Disrupt Bile Acid Transport
 
 
25
 
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Summary
 
Toxicology is exceptionally complex
Recognize limitations of global computational analyses
Improving toxicity prediction means deeper understanding
of our tox data
Understand the applicability of assays and models
Identify knowledge gaps and drive investigative towards
addressing them
Chemical/computational toxicology is inseparable from
investigative toxicology
 
26
 
Acknowledgements
 
Yvonne Dragan
Nigel Greene
 
Jodi Maglich Goodwin
Shirley Louise-May
 
Satoko Kiyota
     
Thank you for listening!
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Explore the challenges and opportunities in predicting in vivo toxicity beyond traditional models. Learn about confidence in toxicity prediction, recently discontinued drugs due to safety concerns, and the importance of recognizing toxicological signals in preclinical stages. Discover how computational toxicology and predictive models are bridging knowledge gaps in investigative toxicology.

  • Toxicity Prediction
  • In Vivo
  • Computational Toxicology
  • Safety Signals
  • Investigative Toxicology

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  1. Predicting in vivo Toxicity: Beyond Modeling? Russ Naven November 20th2015 Creating a Safer and Healthier World by Advancing the Science and Increasing the Impact of Toxicology

  2. Confidence in Ability to Predict Toxicity Modeling repeat dose toxicity Aromatic amine mutagenicity model Non-genotoxic carcinogencity External validation Future Confidence Toxicology = chaos deterministic Retrain model Herg Time (14 years)

  3. Recently Discontinued Drugs Withdrawn owing to liver safety signals in Phase III:

  4. Why No Preclinical Attrition? Perhaps toxicological signals were not observed Maybe signals were observed but their significance was not recognized were considered manageable Toxicological knowledge gaps

  5. Exposing Toxicological Knowledge Gaps Computational Toxicology Predictive in vitro/ in silico models in vivo toxicology data Investigative Toxicology

  6. Exposing Toxicological Knowledge Gaps Model Applicability domain

  7. Example Pfizer Study: What Features Are Predictive of in vivo Toxicity 207 preclinical candidates investigated Compounds were annotated against the observation of any in vivo toxicity findings at 10 M (total plasma exposure) Odds of toxicity established for various physicochemical properties TPSA and ClogP are calculated measures of lipophilicity Hughes et al, Bioorg&Med Chem Lett, 2008,18, 4872 4875

  8. Thresholds Are Not Universally Applicable pKa Class Distribution within dataset Data from Hughes et al, Bioorg&Med Chem Lett, 2008,18, 4872 4875 Basic e.g. aminergenic cpds Training set is dominated by lipophilic basic drugs Lipophilic basic drugs cause general toxicity, e.g. through lysosomal dysfunction, disruption membrane integrity and inhibition of ion channels and adrenergic GPCRs

  9. Thresholds Are Not Universally Applicable Neutral Training set is dominated by lipophilic basic drugs Lipophilic basic drugs cause general toxicity, e.g. through lysosomal dysfunction, disruption membrane integrity and inhibition of ion channels and adrenergic GPCRs

  10. AZ Study: What Features Are Predictive of Preclinical Survival Different profile to Pfizer study: Toxicity Odds D. Muthas et al, Med. Chem. Commun., 2013, 4, 1058

  11. Results from A Pan-Pharma Study Data from AZ, Eli Lilly, GSK and Pfizer Focus on preclinical survival Waring et al, Nature Reviews Drug Discovery 14, 475, 2015

  12. Global Computational Analyses Are useful in that they identify broad physico- chemical features associated with toxicity Often related to exposure These properties applicable across all chemical space Unlikely to identify biological descriptors/mechanisms Only applicable to certain subclasses of compounds The utility of computational analyses is in the identification of toxicological knowledge gaps!

  13. Understanding Liabilities in Acidic Compounds Hypothesis: in vivo toxicity of acidic compounds may be masked in in vitro assays owing to protein binding to assay serum Satoko Kakiuchi-Kiyota, The Toxicologist (SOT) 2015

  14. Toxicity is Multifactorial: Nefazodone Potent 5-HT2A receptor antagonist and antidepressant Withdrawn 2003 for very rare, but severe, liver toxicity Has multiple safety liabilities Contains structural alert (aniline)1 Metabolic liabilities2 Inhibitor bile-salt export pump3 Cytotoxic4 Mitochondrial dysfunction4 High dose: >200mg/day Refs 1. Stepan et al., Chem. Res. Toxic., 2011, 24, 1345-1410. 2. Kalgutkar et al., Drug Metab. Disp., 2005, 33, 243-253 3. Kostrubsky et al, Toxicol. Sci., 2006, 90, 451-459 4. Dykens et al., Toxicol. Sci., 2008, 103, 335-345.

  15. Toxicity is Multifactorial: Aripiprazole Structurally similar, yet successfully marketed drug No reports of acute hepatotoxicity Has multiple in vitro liabilities Contains structural alert (aniline) 1 Metabolic liabilities2 Cytotoxic and lysosomotropic3 Low dose: 10-20 mg/day Can we confidently class aripiprazole as non-hepatotoxic? Refs 1. Stepan et al., Chem. Res. Toxic., 2011, 24, 1345-1410. 2. Bauman et al., Drug Metab. Disp., 2008, 36, 1016-1029. 3. Nadanaciva et al., Toxicol. in Vitro, 2011, 25, 715-723.

  16. Toxicological Data is Very Noisy .like this NMR spectra?! Wiki: Loteralle Wiki: T.vanschaik

  17. Tox21 Data Heat map of 110 pharmaceutical compounds tested against 801 assays Shah and Greene, Chem Res &Tox, 2014, 27, 86-98

  18. Analogues Can Drive Hypothesis Generation Why different toxicity profile? ADME? Target Potency? Off-target pharmacology? (GSID_47281) (GSID_47278) CAR, RXRb, RORg Shah and Greene, Chem Res &Tox, 2014, 27, 86-98

  19. Analogues Can Drive Hypothesis Generation Why different toxicity profile? ADME? Target Potency? Off-target pharmacology? (GSID_47281) TX006173 (GSID_47282) (GSID_47278) PDE10, PPARa CAR, RXRb, RORg Shah and Greene, Chem Res &Tox, 2014, 27, 86-98

  20. Different Chemotypes for the Same Target Have Different Profiles

  21. Reducing Drug Attrition

  22. Developing Early Screening Paradigms Cell health and disruption of homeostasis Cytotoxicity Mitochondrial Dysfunction ROS/NOX induction Promiscuity measure Targets/phenotypic assays linked to toxicity ion channels, hERG (cardiotox) GPCRs (5HT2b agonism) Specific cellular assays (iPS cells) Cytokine storm Disruption of Cellular Differentiation? 22

  23. Recent Marketed Example Tolvaptan Competitive vasopressin receptor 2 antagonist by Otsuka Pharm Approved by the FDA 2009 2012: FDA Limits Duration and Usage Due To Possible Liver Injury Leading to Organ Transplant or Death Dose = 60mg/day Cmax 1 M (total) 23

  24. Tolvaptan Has HepG2 Cytotoxic Liabilities Viability in Hepg2 cells: Why would a vasopressin receptor 2 antagonist cause cytotoxicity? 52.2 uM 33.0 uM Likely due to inherent properties of the compound? ROS Comet assay DNA oxidation Impact can be seen in other screening assays: Wu et al. Biochemical Pharmacology 95 (2015) 324 336 24

  25. Tolvaptan May Disrupt Bile Acid Transport Slizgi et al. Tox Sci Advance Access published October 26, 2015 25

  26. Summary Toxicology is exceptionally complex Recognize limitations of global computational analyses Improving toxicity prediction means deeper understanding of our tox data Understand the applicability of assays and models Identify knowledge gaps and drive investigative towards addressing them Chemical/computational toxicology is inseparable from investigative toxicology 26

  27. Acknowledgements Yvonne Dragan Nigel Greene Jodi Maglich Goodwin Shirley Louise-May Satoko Kiyota Thank you for listening!

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