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Brad Pamnani
NYU Medical Center
Abstract
   Philadelphia chromosome or Philadelphia translocation,
    a chromosomal abnormality associated with Chronic
    Myelogenous Leukemia (CML) by a reciprocal translocation
    between chromosome 9 and 22, results in abnormal protein
    translation by newly formed oncogene Abl-Bcr.
   Drug Imatinib (Gleevec) has helped in inhibiting BCR-ABL
    expression and has dampened tumorogensis in many
    patients with CML.
   But resistance attributed to kinase domain mutations can
    lead to relapse, for which second-line therapy with nilotinib or
    dasatinib has been applied.
   Inspite of the three approved therapeutic options, the cross-
    resistant BCR-ABLT315I mutation and compound mutants
    selected on sequential inhibitor therapy still remain major
    clinical challenges.
Protein Background
   For the above reasons, an artificial inhibitor protein,
    AP24534 (Ponatinib) was designed and first reported by
    Ariad Scientists, Oregon Health and Science University,
    Knight Cancer Institute and Howard Hughes Medical
    Institute.
   AP24534, an orally available multi-targeted kinase
    inhibitor was clinically active against T315I and other
    BCR-ABL mutants.
   AP24534 also inhibited all tested BCR-ABL mutants in
    cellular and biochemical assays.
Protein AP24534, a pan-BCR-ABL inhibitor
  for treatment of CML
Treatment of CML Primary Cells with
AP24534 Inhibits Cellular Proliferation
Mononuclear cells derived from blood or
bone marrow of CML patients with BCR-
ABL-driven leukemia were exposed to
graded concentrations of AP24534 and
assayed viable cells after 72 hr.
Patients with myeloid blast crisis
harboring native BCR-ABL or BCR-
ABLT315I and
Cells from healthy individuals to were
also exposed to similar conditions.

Results: AP24534 induced a selective
reduction of viable cell numbers in
primary CML cells, with IC50 values
approximately 500-fold lower
than those observed with normal cells
(Figure A).
AP24534 Inhibits the Catalytic Activity of
ABLT315I
Chemical structure of
                  AP24534.




   The structure of AP24534 in complex with ABLT315I was
    determined by molecular replacement by AMoRe (Navaza, 1994)
    using the structure of native ABL bound with imatinib (PDB code:
    1IEP). There were two ABLT315I molecules in the asymmetric unit.
PDB Code for AP24534: 3IK3
                         Batch Precipitation, Batch
                         Dialysis, Vapor Diffusion by
Extraction Methodology
                         Hanging Drop and Sitting
                         Drop
pH                       8.5
Temperature              277.0
                         0.1 M Tris-HCl (pH 8.5),
                         30% w/v polyethylene glycol
                         4000, and 0.2 M sodium
Details
                         acetate, VAPOR
                         DIFFUSION, HANGING
                         DROP, temperature 277K
Extraction Procedure:
•Kinase domain of murine ABLT315I (residues 229–515) were co-expressed with YopH
          protein tyrosine phosphatase in E. coli (Zhou et al., 2007) and purified in the
          presence of AP24534 to near homogeneity (> 95%) using metal affinity, Mono
          Q, and size exclusion chromatography (O’Hare et al. 2009).
•The typical yield of purified ABLT315I bound with AP24534 was about 1 mg/L.
•Co-crystals of ABLT315I and AP24534 were grown by the hanging drop vapor diffusion
          method at 4oC by mixing equal volumes of the AP24534:ABLT315I complex
          (25 mg/mL) and well solution (30% w/v polyethylene 4000, 0.2 M sodium
          acetate, 0.1 M Tris, pH 8.5).
•After 1–2 days, crystals reached a typical size of 50 × 50 × 300 μm3 and were
          harvested in mother liquor and supplemented with 30% v/v glycerol as
          cyroprotectant.
•X-ray diffraction data were collected at 100K at beamline 19 BM (Advanced Photon
          Service, Argonne, IL). The data were indexed and scaled in space group P21
          by using the HKL2000 package (Otwinowski and Minor,1997).
•The structure of AP24534 in complex with ABLT315I was determined by molecular
          replacement by AMoRe (Navaza, 1994) using the structure of native ABL boun
          with imatinib (PDB code: 1IEP). There were two ABLT315I molecules in the
          asymmetric unit.
Crystallographic Analysis of AP24534:
                  ABLT315I
   Crystal structure of AP24534 in
    complex with the ABL T315I mutant
    kinase. And AP24534 (green). The
    side chain of the mutated
    gatekeeper residue Ile315 (red).
    The side chains of Y253 and E255
    and locations of point mutations
    appearing in the resistant outgrowth
    screen of AP24534 are shown in
    grey along with the C-helix (αC).


        Imatinib, nilotinib and dasatinib each form a hydrogen bond with the
         side chain of T315 in native ABL, ligands were designed to devoid
         this interaction by introducing vinyl and ethyl linkages into a purine-
         based inhibitor scaffold.
Crystallographic Analysis of the Bcr-Abl
                inhibitors




AP24534 in complex with the murine ABL T315I kinase
domain confirmed that AP24534 binds in the DFG-out mode
(Figure C) and maintains a network of protein contacts similar
to imatinib (Figure D and E).
UniProt Analysis:
3IK3 Chain Representation




   Description of Proto-oncogene tyrosine-protein kinase ABL1
    Identical chains
   Chain Type polypeptide(L): Length 288 residues
   Dssp secondary structure: 44% helical (15 helices; 128 residues)
    15% beta sheet (12 strands; 45 residues)
Blastp of AP24534:




   Obtain protein sequences to see similarity in different species
    http://blast.ncbi.nlm.nih.gov/Blast.cgi
   Identify conserved regions indicating evolutionary relatedness
    http://www.ebi.ac.uk/Tools/clustalw2/index.html
Blastp Results for AP24534
ClustalW Analysis
ClustalW Analysis
   The “*” refers to identical amino acids
   The “:” refers to highly conserved areas
   The “.” refers to somewhat similar areas
   The gap refers to dissimilar areas
   Therefore, the first 16 amino acids have the most conserved
    domain
ClustalW Analysis




   The Cladogram shows that AP24534 is closely related to the
    Tyrosine-protein kinase ABL1 polypeptide(L) protein
    (3KFA) and not so much to the muscle specific tyrosine
    kinase (1LUF).
Structural Similarity to 3KFA.A




3KFA.A: Results from a kinase mutation in
purine templates of DFG-in and DFG-out
and is also a dual Src-Abl inhibitors.
Structural Similarity to 3KFA.A
Future Scope
ARIAD Pharmaceuticals, Inc. Announces
Initiation of Ponatinib (AP24534) Pivotal
Trial in Drug-Resistant or Intolerant
Chronic Myeloid Leukemia
Ponatinib (previously known as AP24534), in
patients with resistant or intolerant chronic
myeloid leukemia (CML) and Philadelphia
positive acute lymphoblastic leukemia (Ph+
ALL). The PACE (Ponatinib Ph+ ALL
and CML Evaluation) trial is designed to
provide definitive clinical data for regulatory    “The start of the pivotal PACE trial
approval of ponatinib in this setting. Ponatinib   represents an important step in the
has been granted orphan drug status in both        development of our second molecularly
the United States and Europe for the               targeted cancer therapy,” stated
treatment of CML and Ph+ ALL.                      Harvey J. Berger, M.D., chairman and
                                                   chief executive officer at ARIAD.
Future Scope
Phase I trial indicates ponatinib may
thwart most resistant CML

Drug also acts against chronic myeloid
leukemia with untreatable T135I
mutation
                                         "Ponatinib seems to be filling the gap
                                         we had for patients who right now have
                                         no good treatments left," said Jorge
                                         Cortes, M.D.
References:
   Amor, J., Harrison, D., Kahn, R., & Ringe, D. (1994). Structure of
    the human ADP-ribosylatioin factor 1 complexed with GDP. Letters
    to Nature, 372, 704-708.
   Navaza J. A MoRe. Acta Crystallogr A 1994;A50:157–163.
   Otwinowski Z, Minor W. Processing of X-ray Diffraction Data
    Collected in Oscillation Mode. Methods
   Zhou T, Parillon L, Li F, Wang Y, Keats J, Lamore S, Xu Q,
    Shakespeare W, Dalgarno D, Zhu X. Crystal structure of the T315I
    mutant of Abl kinase. Chem Biol Drug Des 2007;70:171–181.
    [PubMed:17718712]

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Tumor proteins

  • 2. Abstract  Philadelphia chromosome or Philadelphia translocation, a chromosomal abnormality associated with Chronic Myelogenous Leukemia (CML) by a reciprocal translocation between chromosome 9 and 22, results in abnormal protein translation by newly formed oncogene Abl-Bcr.  Drug Imatinib (Gleevec) has helped in inhibiting BCR-ABL expression and has dampened tumorogensis in many patients with CML.  But resistance attributed to kinase domain mutations can lead to relapse, for which second-line therapy with nilotinib or dasatinib has been applied.  Inspite of the three approved therapeutic options, the cross- resistant BCR-ABLT315I mutation and compound mutants selected on sequential inhibitor therapy still remain major clinical challenges.
  • 3. Protein Background  For the above reasons, an artificial inhibitor protein, AP24534 (Ponatinib) was designed and first reported by Ariad Scientists, Oregon Health and Science University, Knight Cancer Institute and Howard Hughes Medical Institute.  AP24534, an orally available multi-targeted kinase inhibitor was clinically active against T315I and other BCR-ABL mutants.  AP24534 also inhibited all tested BCR-ABL mutants in cellular and biochemical assays.
  • 4. Protein AP24534, a pan-BCR-ABL inhibitor for treatment of CML
  • 5. Treatment of CML Primary Cells with AP24534 Inhibits Cellular Proliferation Mononuclear cells derived from blood or bone marrow of CML patients with BCR- ABL-driven leukemia were exposed to graded concentrations of AP24534 and assayed viable cells after 72 hr. Patients with myeloid blast crisis harboring native BCR-ABL or BCR- ABLT315I and Cells from healthy individuals to were also exposed to similar conditions. Results: AP24534 induced a selective reduction of viable cell numbers in primary CML cells, with IC50 values approximately 500-fold lower than those observed with normal cells (Figure A).
  • 6. AP24534 Inhibits the Catalytic Activity of ABLT315I
  • 7. Chemical structure of AP24534.  The structure of AP24534 in complex with ABLT315I was determined by molecular replacement by AMoRe (Navaza, 1994) using the structure of native ABL bound with imatinib (PDB code: 1IEP). There were two ABLT315I molecules in the asymmetric unit.
  • 8. PDB Code for AP24534: 3IK3 Batch Precipitation, Batch Dialysis, Vapor Diffusion by Extraction Methodology Hanging Drop and Sitting Drop pH 8.5 Temperature 277.0 0.1 M Tris-HCl (pH 8.5), 30% w/v polyethylene glycol 4000, and 0.2 M sodium Details acetate, VAPOR DIFFUSION, HANGING DROP, temperature 277K
  • 9. Extraction Procedure: •Kinase domain of murine ABLT315I (residues 229–515) were co-expressed with YopH protein tyrosine phosphatase in E. coli (Zhou et al., 2007) and purified in the presence of AP24534 to near homogeneity (> 95%) using metal affinity, Mono Q, and size exclusion chromatography (O’Hare et al. 2009). •The typical yield of purified ABLT315I bound with AP24534 was about 1 mg/L. •Co-crystals of ABLT315I and AP24534 were grown by the hanging drop vapor diffusion method at 4oC by mixing equal volumes of the AP24534:ABLT315I complex (25 mg/mL) and well solution (30% w/v polyethylene 4000, 0.2 M sodium acetate, 0.1 M Tris, pH 8.5). •After 1–2 days, crystals reached a typical size of 50 × 50 × 300 μm3 and were harvested in mother liquor and supplemented with 30% v/v glycerol as cyroprotectant. •X-ray diffraction data were collected at 100K at beamline 19 BM (Advanced Photon Service, Argonne, IL). The data were indexed and scaled in space group P21 by using the HKL2000 package (Otwinowski and Minor,1997). •The structure of AP24534 in complex with ABLT315I was determined by molecular replacement by AMoRe (Navaza, 1994) using the structure of native ABL boun with imatinib (PDB code: 1IEP). There were two ABLT315I molecules in the asymmetric unit.
  • 10. Crystallographic Analysis of AP24534: ABLT315I  Crystal structure of AP24534 in complex with the ABL T315I mutant kinase. And AP24534 (green). The side chain of the mutated gatekeeper residue Ile315 (red). The side chains of Y253 and E255 and locations of point mutations appearing in the resistant outgrowth screen of AP24534 are shown in grey along with the C-helix (αC).  Imatinib, nilotinib and dasatinib each form a hydrogen bond with the side chain of T315 in native ABL, ligands were designed to devoid this interaction by introducing vinyl and ethyl linkages into a purine- based inhibitor scaffold.
  • 11. Crystallographic Analysis of the Bcr-Abl inhibitors AP24534 in complex with the murine ABL T315I kinase domain confirmed that AP24534 binds in the DFG-out mode (Figure C) and maintains a network of protein contacts similar to imatinib (Figure D and E).
  • 12.
  • 14. 3IK3 Chain Representation  Description of Proto-oncogene tyrosine-protein kinase ABL1 Identical chains  Chain Type polypeptide(L): Length 288 residues  Dssp secondary structure: 44% helical (15 helices; 128 residues) 15% beta sheet (12 strands; 45 residues)
  • 15. Blastp of AP24534:  Obtain protein sequences to see similarity in different species http://blast.ncbi.nlm.nih.gov/Blast.cgi  Identify conserved regions indicating evolutionary relatedness http://www.ebi.ac.uk/Tools/clustalw2/index.html
  • 18. ClustalW Analysis  The “*” refers to identical amino acids  The “:” refers to highly conserved areas  The “.” refers to somewhat similar areas  The gap refers to dissimilar areas  Therefore, the first 16 amino acids have the most conserved domain
  • 19. ClustalW Analysis  The Cladogram shows that AP24534 is closely related to the Tyrosine-protein kinase ABL1 polypeptide(L) protein (3KFA) and not so much to the muscle specific tyrosine kinase (1LUF).
  • 20. Structural Similarity to 3KFA.A 3KFA.A: Results from a kinase mutation in purine templates of DFG-in and DFG-out and is also a dual Src-Abl inhibitors.
  • 22. Future Scope ARIAD Pharmaceuticals, Inc. Announces Initiation of Ponatinib (AP24534) Pivotal Trial in Drug-Resistant or Intolerant Chronic Myeloid Leukemia Ponatinib (previously known as AP24534), in patients with resistant or intolerant chronic myeloid leukemia (CML) and Philadelphia positive acute lymphoblastic leukemia (Ph+ ALL). The PACE (Ponatinib Ph+ ALL and CML Evaluation) trial is designed to provide definitive clinical data for regulatory “The start of the pivotal PACE trial approval of ponatinib in this setting. Ponatinib represents an important step in the has been granted orphan drug status in both development of our second molecularly the United States and Europe for the targeted cancer therapy,” stated treatment of CML and Ph+ ALL. Harvey J. Berger, M.D., chairman and chief executive officer at ARIAD.
  • 23. Future Scope Phase I trial indicates ponatinib may thwart most resistant CML Drug also acts against chronic myeloid leukemia with untreatable T135I mutation "Ponatinib seems to be filling the gap we had for patients who right now have no good treatments left," said Jorge Cortes, M.D.
  • 24. References:  Amor, J., Harrison, D., Kahn, R., & Ringe, D. (1994). Structure of the human ADP-ribosylatioin factor 1 complexed with GDP. Letters to Nature, 372, 704-708.  Navaza J. A MoRe. Acta Crystallogr A 1994;A50:157–163.  Otwinowski Z, Minor W. Processing of X-ray Diffraction Data Collected in Oscillation Mode. Methods  Zhou T, Parillon L, Li F, Wang Y, Keats J, Lamore S, Xu Q, Shakespeare W, Dalgarno D, Zhu X. Crystal structure of the T315I mutant of Abl kinase. Chem Biol Drug Des 2007;70:171–181. [PubMed:17718712]