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DEVELOPMENT AND CHARACTERIZATION OF NEXTGENERATION
CORRECTORS AS PART OF A TRIPLE
CF THERAPY
Balut, C.1; Akkari, R.3; Alani, S.1; Bock, X.3; Claes, P.2;
Cowart, M.1; Desroy, N.3; De Wilde, G.2; Fan, Y.1; Gao, W.1;
Gees, M.2; Jia, Y.1; Liu, B.1; Manelli, A.1; Musch, S.2;
Pizzonero, M.2; Scanio, M.1; Searle, X.1; Singh, A.K.1;
Swensen, A.1; Van Der Plas, S.2; Vortherms, T.1; Wang, X.1;
Tse, C.1; Conrath, K.2 1. Abbvie Inc, North Chicago, IL, USA;
2. Galapagos, Mechelen, Belgium; 3. Galapagos, Romainville,
France
Cystic fibrosis (CF) is a life-threatening, genetic disease caused by
mutations in the gene encoding the cystic fibrosis transmembrane conductance
regulator (CFTR) protein. This results in abnormal transport of
chloride across epithelial cells, leading to dehydration of airway surface
liquid and impaired mucociliary clearance. The F508 deletion in CFTR
is the most prevalent mutation present on at least one allele in 85% of CF
patients. Maximal restoration of F508delCFTR is expected to require at
least two corrector molecules with complementary mechanisms, type 1
(C1) and type 2 (C2), to increase CFTR at cell surface, in combination
with a potentiator (P) to increase channel activity. To this end, AbbVie and
Galapagos have been developing multiple CFTR modulators to develop a
triple combination therapy.
Our lead C1 corrector, ABBV/GLPG-2222 exhibits significant
improvements over existing type 1 correctors, lumacaftor and tezacaftor
and is continuing progression in clinical studies. Multiple novel potentiators
(P) are also in clinical studies.
To complete the triple combination, herein we report the identification
and in vitro characterization of type 2 correctors. Two lead C2 compounds
from different chemical series, ABBV/GLPG-2737 and ABBV/GLPG-
3221 exhibit desirable pharmacologic properties and are currently in late
preclinical development to early clinical trials. Our C2 leads have consistently
shown a substantial increase in cellular protein processing and in
combination with the other assets in our portfolio have shown a significant
increase in CFTR function in human bronchial epithelial (HBE) cells with
the homozygous and heterozygous F508del CFTR mutations.
CMB, SA, MDC, YF, WG, YJ, BL, AM, MS, XS, AKS, AS, TAV, XW
and CT are employees of AbbVie. The design, study conduct, and financial
support for the research conducted by AbbVie were provided by AbbVie.
AbbVie participated in the interpretation of data, review, and approval of
the publication.
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EFFICACY OF NEXT GENERATION CFTRMODULATORS
OF GALAPAGOS-ABBVIE IN RECTAL
ORGANOIDS
de Poel, E.2,1; van Mourik, P.2; Vonk, A.M.2,1; Oppelaar, H.2,1;
Hagemeijer, M.C.2,1; Berkers, G.2; Heida-Michel, S.2;
Geerdink, M.2; van der Ent, C.K.2; Musch, S.3; Conrath, K.3;
Beekman, J.M.2,1 1. Regenerative Medicine Center, University
Medical Centre, Utrecht, Utrecht, Netherlands; 2. Pediatric
Pulmonology, University Medical Center Utrecht, Utrecht,
Utrecht, Netherlands; 3. Galapagos, Mechelen, Belgium
The primary drug target for novel CFTR modulators is the most dominant
F508del (p.Phe508del) CFTR mutation that is carried by ~85% of
people with CF on at least one allele. Treatment of F508del CFTR by the
first generation CFTR modulators (ivacaftor (VX-770) and Lumacaftor
(VX-809)) have yielded significant clinical improvements. However,
VX-809/VX-770 (Orkambi) treatment is suboptimal, highlighting the need
for a more effective F508del therapy that enables treatment of the majority
(>85%) of people with CF. Galapagos (GLPG) and AbbVie (ABBV) have
developed two distinct sets of correctors (ABBV/GLPG C1: ’2222, C2:
‘2737 and ’3221) with complementary mechanisms and different potentiators
(ABBV/GLPG P: ’1837, ’2451) that can synergistically restore CFTR
function in primary human bronchial epithelial cells. Here, we assessed the
CFTR restoring capacity of these compounds using a forskolin-induced
swelling (FIS) assay in patient-derived rectal F508del/F508delCFTR organoids.
Various compound combinations (C1 or C2 + P and C1 + C2 + P)
were assessed using three different forskolin concentrations to study maximal
restoration and potential synergy of compound combinations. Combination
therapy (C1 or C2 + P) resulted in a significant increase of organoid
swelling indicating restoration of CFTR function. The C1+P combination
also showed a higher efficacy than the first generation CFTR modulating
compounds (VX-809/VX-770). Synergy was observed when additional
correctors of the second set (C2) were added to the combination treatment
containing a corrector of the first set (C1 + P). This synergistic effect was
present, but limited as compared to the synergistic effects of these compounds
in Ussing chamber settings using the identical rectal cells. Future
experiments will include the setup of additional swelling phenotypes in
organoids to optimally assess synergistic CFTR repair, as well as studies
focusing on the mode of action of these CFTR modulators on F508delCFTR
and other non-F508delCFTR mutations.