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Dually targeting the epigenetic proteins lysine specific demethylase 1 (LSD1) and histone deacetylases (HDACs) that play a key role in cancer cells by modulating gene repressor complexes including CoREST will have a profound effect in inhibiting tumour growth. Here, we evaluated JBI-097 a dual LSD1/HDAC6 inhibitor, for its in vitro and in vivo activities in various tumor models. In vitro, JBI-097 showed a strong potency in inhibiting LSD1 and HDAC6 enzymatic activities with the isoform selectivity over other HDACs. Cell-based experiments demonstrated a superior anti-proliferative profile against haematological and solid tumor cell lines. JBI-097 also showed strong modulation of HDAC6 and LSD1 specific biomarkers, alpha-tubulin, CD86, CD11b, and GFi1b. In vivo, JBI-097 showed a stronger effect in erythroleukemia, multiple myeloma xenograft models, and in CT-26 syngeneic model. JBI-097 also showed efficacy as monotherapy and additive or synergistic efficacy in combination with the standard of care or with immune checkpoint inhibitors. These and other findings suggest that JBI-097 could be a promising molecule for targeting the LSD1 and HDAC6. Further studies are warranted to elucidate the mechanism of action.

Introduction: Lysine Specific Demethylase 1 (LSD1) is a flavin adenine dinucleotide (FAD)-dependent amine oxidase that has been reported to be over-expressed in many malignant tumors. Down-regulation of LSD1 has been shown to effectively treat cancers by inducing re-expression of aberrantly silenced genes. Studies have shown that LSD1 may contribute to acute myelogenous leukemia pathogenesis by inhibiting the normal pro-differentiative function of ATRA, paving the way for new combinatorial therapies for AML. Similarly, HDAC isoform selective inhibitors are beginning to be explored as less toxic alternatives to panHDAC inhibitors in select cancers. Further, combined inhibition of LSD1 and HDAC has been shown to be more efficacious in inhibiting multiple cancers. Here, we show that JBI-295, a dual inhibitor targeting both LSD1 and HDAC6/8 shows stronger efficacy without enhancing systemic toxicity, in a subset of AML and JAK-dependent myeloproliferative cancer. Methods: Computational chemistry approaches were used to design LSD1 specific and LSD1-HDAC dual inhibitors. To assess in vitro LSD1 potency, TR-FRET assay was used. For assessing in vitro HDAC activity fluorescence based HDAC6 activity assay was performed. Western blotting was used to assess biomarkers of LSD1 and HDAC inhibition. Alamar blue cytotoxicity assay was used to assess cell proliferation. Results: Several compounds from this series show strong in vitro potency against LSD1 with more than excellent selectivity against MAOs. JBI-295 one of the lead dual molecules, showed strong LSD1 potency (IC50 of 0.07 μM) and isoform selective HDAC6/8 activity (IC50 of 0.006 and 0.08 µM on HDAC6 and HDAC8, respectively), with about 100 fold selectivity against other HDAC isoforms. JBI-295 showed strong anti-proliferative activity on leukaemia and multiple myeloma cell lines. In cell based and in vivo target engagement studies there was a concomitant increase in CD11b, CD86 and GFI1b and tubulin acetylation levels. JBI-295 was more efficacious in inhibiting the growth of leukemia HEL92.1.7 xenograft by oral administration when compared to IP administration of ACY-1215, a HDAC6 selective inhibitor. Stronger tumor growth inhibition was also observed in melanoma A375 xenograft model as compared to inhibitors with single activity. In addition, JBI-295 showed single agent activity in a syngeneic murine colon cancer model CT26 and also resulted in stronger tumor growth inhibition when combined with anti-PDL1 antibody. Conclusion: The data obtained demonstrate that dual LSD1-HDAC6/8 inhibitors could serve as novel, effective therapeutic agents for treatment of select subset of cancer. Advanced efficacy and toxicology studies with JBI-295 are in progress. Citation Format: Dhanalakshmi Sivanandhan, Sridharan Rajagopal, Sreekala Nair, Chandru Gajendran, Dimpy Ghosh, P Nagaraj, Subramanyam J. Tantry, Purushottam Dewang, Mahanandeesha S. Hallur, Kannan Murugan, Srinatha K. C, Damodara Kuntrapaku, M Dilipkumar, R Sharma, S Meghashree, Durga Prasanna Kumar, Suraj P. Ingle, Mohd Zainuddin, A B. Vinod, Sriram Rajagopal. Novel dual inhibitors of LSD1-HDAC6/8 for treatment of cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 11.

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Introduction: The PD-1/PD-L1 molecular pathway is one of the primary mechanisms of immune evasion deployed by cancer cells. Induction of PD-L1 expression on cancer cells is associated with inhibition of immune responses against cancer, thus favouring cancer progression and metastasis. Activation of PD-1/PD-L1 pathway induces T-cell anergy and exhaustion and enhances the function of regulatory T-cells (Tregs) thereby leading to an immune suppressive environment. Therefore, blocking this pathway restores the proliferation and cytotoxicity of T- lymphocytes, inhibits the function of Tregs and results in decreased T-cell apoptosis. A number of monoclonal antibodies agents targeting PD-1/PD-L1 have approved for a number of malignancies. These approved therapies require bolus intravenous injections, are administered in high dose and have a long half-life. The long residence time of these mAbs could contribute to the well-documented drug-related adverse effects. Therefore, there is still a need for potent, selective small molecule inhibitors of the PD-1/PD-L1 pathway. Such small molecule inhibitors, can provide increased oral bioavailability, and shorter half-life activity for a more controllable treatment, and flexibility for combination strategies. Methods: Rational design approaches were used to design novel small molecule PD-1/PD-L1 pathway inhibitors; potency of these inhibitors was assessed in an in-vitro TR-FRET assay. Checkpoints signaling reporter assays as well as ex-vivo co-culture assays were used to assess the ability of the compounds to restore T-cell proliferation and function. In vivo efficacy was assessed by syngeneic and humanized models in mice. Results: Our lead molecule JTi showed strong in vitro IC50 of 0.8 nM in TR-FRET assay that measures interaction between PD-1 and PD-L1. This molecule also augmented T-cell response as measured by IFN-gamma activation in a cancer cell-PBMC based co-culture assay. This molecule induced dimerization of PD-L1 in U2OS cell based assay with an EC50 of ~300 nM. Competition study between anti-PD-L1 blocking antibody and this small molecule inhibitor clearly suggested that it binds at the same site as the antibody. In a cell based assay, measuring PD-1/PD-L1 interaction, JTi clearly demonstrated inhibition of PD-1 and PD-L1 binding in a dose-dependent manner. JTi showed comparable efficacy to the anti-PD-L1 antibody in syngeneic (4T1, CT-26) and humanized models (MC-38/hPD-L1) by oral administration. Conclusion: Advanced studies to further characterize and progress the molecule into pre-clinical development are in progress. The oral administration route of these small molecule PD-1/PD-L1 inhibitors would provide an attractive option to be used as a maintenance therapy followed by mAb based treatment to enhance patient compliance. The lead compound will be entering IND enabling studies in the 1st half of 2021. Citation Format: Dhanalakshmi Sivanandhan, Sridharan Rajagopal, Naveen Sadhu M, Chandru Gajendran, Chandregowda venkateshappa, Muralidhar Reddy, Pendyala Satya Kishore, Pratima Deshpande, Sundarajan kannan, Tabassum Sahareen, Santhosh Viswakarma, Amir Siddiqui, Mohammed Zainuddin, Rudresh G, Prashanthi Daram, Ramchandraiah Gosu, Rashmi Rekha Devi. Novel, small molecule inhibitors of PD-L1/PD-1 interaction [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1630.