Roche (China)

The orally available toll-like receptor 7 (TLR7) agonist prodrug RO7119929 is converted to active drug predominantly in the liver, where it is hypothesized to reprogram the local immune microenvironment. We aimed to explore the safety, pharmacokinetics (PK), and preliminary antitumor activity and obtain the proof-of-mechanism for RO7119929 in patients with liver cancer. RO7119929 was investigated in mouse tumors and liver tissue from cynomolgus monkeys. In the first-in-human, open-label, dose-escalation and expansion study, patients with histologically confirmed advanced or metastatic primary liver cancers or solid tumors with predominant liver involvement received RO7119929 weekly in 3-week cycles either on a flat-dose (FD) or step-up dose (SUD) schedule. Preclinical results demonstrated antitumor activity and the proinflammatory proof-of-mechanism in mouse liver tumors and cynomolgus monkey liver tissue. The subsequent first-in-human study enrolled 27 patients in five FD dose-escalation cohorts, 18 patients in a FD dose-expansion cohort, and 9 patients in two SUD dose-escalation cohorts. The most common primary tumor type at study entry was hepatocellular carcinoma (HCC) (31%). PK data showed fast conversion of RO7119929 to the active TLR7 agonist. Treatment-related adverse events (TRAEs) were observed in 50 (91%) patients across all treated patients; the most commonly reported TRAE was cytokine release syndrome (CRS) in 48 (81%) patients. CRS was also identified as a dose-limiting safety risk and had a dose-dependent incidence and severity. Grade 3 CRS occurred in six (13%) patients receiving FD RO7119929, while no grade 3 CRS was reported in SUD patients at comparable target dose levels. TLR7-related transient, dose-dependent gene expression and cytokine induction was observed both with FD and SUD treatment and corresponded with treatment-induced local inflammation of the tumor microenvironment induced by reprogramming of the myeloid cells. Among 17 patients with HCC, one durable complete response was observed, and 10 (59%) patients had stable disease. SUD appears to reduce the risk of CRS while maintaining mode-of-action-relevant pharmacodynamic effects. The clinical activity of RO7119929 as a single agent was limited, suggesting that combination therapy with a checkpoint inhibitor may be needed to leverage the proinflammatory potential of RO7119929 and further increase antitumor activity. NCT04338685.

Accurately measuring compound binding affinities is key to driving the pharmaceutical development process. Rigorous physics-based in silico approaches, particularly alchemical free energy methods, have become a gold standard tool for estimating compound affinity changes. Here we present the results of a large-scale pre-competitive collaborative assessment of relative binding free energy (RBFE) calculations generated by 15 pharmaceutical companies. We evaluate an open-source and MIT licensed RBFE Protocol from the Open Free Energy (OpenFE) ecosystem across both public and blinded private datasets, encompassing over 1,700 ligands in total. For the public dataset, the weighted RMSE across the 58 systems was 1.73 [1.53, 1.96] kcal/mol, with 10 of the systems reaching sub-kcal/mol accuracy. For the private dataset, the weighted RMSE across the 37 systems was 2.44 [1.94, 3.06] kcal/mol, with only 2 of the systems reaching sub-kcal/mol accuracy, reflecting the increased complexity of real-world drug discovery. The protocols performance was system-dependent, with no single dominant error source, indicating that accuracy is primarily influenced by input quality and transformation type. Overall, these benchmark results are encouraging and indicate that OpenFE is ready for large-scale industrial applications, with an "out-of-the-box" accuracy that approaches that of commercial solutions. While comparison against published FEP+ results, which were obtained after manual parameter optimization, shows comparable ranking statistics, a gap remains in error statistics, for which we outline possible paths toward improvement. The protocol meets key criteria required for production use in an industrial setting: it shows robust performance, generates reproducible results, and achieves both sufficient throughput and rapid convergence.

New drug modalities (NDMs) have gained significant popularity and attention in recent years due to their ability to target previously undruggable pathways and offer new strategies for tackling complex diseases. This trend is reflected in our review, which encompasses 17 publications, an increase from 11 last year and includes a growing number of contributors across industry and academia. We have focused on five categories of NDMs: (1) Peptides with an emphasis on macrocyclic structures; (2) Bivalent protein degraders, also known as proteolysis-targeting chimeras (PROTACs); (3) Conjugated drugs, including peptide-drug and antibody-drug conjugates; (4) Antisense oligonucleotides and N-acetylgalactosamine (GalNAc) conjugated oligonucleotides; and (5) Covalent inhibitors.

Polθ is recruited via RAD51 ubiquitylation to resolve clustered ICLs that generate HR-refractory replication fork collapse.

After the global approval of atezolizumab plus bevacizumab and chemotherapy as first-line metastatic nonsquamous non-small-cell lung cancer (nsqNSCLC) treatment, the IMpower151 ( NCT04194203 ) trial was conducted in China to address regional differences. Chemotherapy-naive patients with metastatic nsqNSCLC (N = 305) were randomized 1:1 to receive either atezolizumab, bevacizumab, carboplatin and paclitaxel or pemetrexed (ABCPem/Pac; n = 152) or placebo plus bevacizumab, carboplatin and pemetrexed or paclitaxel (BCPem/Pac; n = 153). The primary endpoint was investigator-assessed progression-free survival (INV-PFS); secondary endpoints included subgroup analyses of INV-PFS, independent review facility-assessed PFS, overall survival, and investigator-assessed objective response rate and duration of response per RECIST v.1.1. Most patients (97%) received pemetrexed, and 53% had EGFR+ tumors. Median INV-PFS for ABCPem/Pac versus BCPem/Pac was 9.5 versus 7.1 months (stratified hazard ratio: 0.84; 95% confidence interval: 0.65, 1.09; P = 0.184). INV-PFS across subgroups and independent review facility-assessed PFS were consistent with INV-PFS in the intention-to-treat population. Median overall survival was 20.7 versus 18.7 months in the ABCPem/Pac versus BCPem/Pac arms, respectively (stratified hazard ratio: 0.93; 95% confidence interval: 0.67, 1.28). Confirmed objective response rate with ABCPem/Pac versus BCPem/Pac was 48% versus 50%, respectively; median duration of response was 11.3 versus 8.3 months. Adverse events of special interest for atezolizumab were observed in 68% (grades 3 and 4: 11%) and 71% (grades 3 and 4: 7%) of patients receiving ABCPem/Pac and BCPem/Pac, respectively. The most common adverse events of special interest for atezolizumab in the ABCPem/Pac and BCPem/Pac arms were hepatitis (driven by laboratory abnormalities; mostly low grade), hypothyroidism and rash. Overall, IMpower151 did not meet its primary endpoint (INV-PFS) in metastatic nsqNSCLC. ABCPem/Pac was generally well tolerated, with no new safety signals. Trial registration number: ClinicalTrials.gov, NCT02366143.