Reetta Riikonen

Discovery of ODM-201, a new-generation androgen receptor inhibitor targeting resistance mechanisms to androgen signaling-directed prostate cancer therapies.

Activation of androgen receptor (AR) is crucial for prostate cancer growth. Remarkably, also castration-resistant prostate cancer (CRPC) is dependent on functional AR, and several mechanisms have been proposed to explain the addiction. Known causes of CRPC include gene amplification and overexpression as well as point mutations of AR. We report here the pharmacological profile of ODM-201, a novel AR inhibitor that showed significant antitumor activity and a favorable safety profile in phase 1/2 studies in men with CRPC. ODM-201 is a full and high-affinity AR antagonist that, similar to second-generation antiandrogens enzalutamide and ARN-509, inhibits testosterone-induced nuclear translocation of AR. Importantly, ODM-201 also blocks the activity of the tested mutant ARs arising in response to antiandrogen therapies, including the F876L mutation that confers resistance to enzalutamide and ARN-509. In addition, ODM-201 reduces the growth of AR-overexpressing VCaP prostate cancer cells both in vitro and in a castration-resistant VCaP xenograft model. In contrast to other antiandrogens, ODM-201 shows negligible brain penetrance and does not increase serum testosterone levels in mice. In conclusion, ODM-201 is a potent AR inhibitor that overcomes resistance to AR-targeted therapies by antagonizing both overexpressed and mutated ARs. ODM-201 is currently in a phase 3 trial in CRPC.

Discovery and development of ODM-204: A Novel nonsteroidal compound for the treatment of castration-resistant prostate cancer by blocking the androgen receptor and inhibiting CYP17A1

We report the discovery of a novel nonsteroidal dual-action compound, ODM-204, that holds promise for treating patients with castration-resistant prostate cancer (CRPC), an advanced form of prostate cancer characterised by high androgen receptor (AR) expression and persistent activation of the AR signaling axis by residual tissue androgens. For ODM-204, has a dual mechanism of action. The compound is anticipated to efficiently dampen androgenic stimuli in the body by inhibiting CYP17A1, the prerequisite enzyme for the formation of dihydrotestosterone (DHT) and testosterone (T), and by blocking AR with high affinity and specificity. In our study, ODM-204 inhibited the proliferation of androgen-dependent VCaP and LNCaP cells in vitro and reduced significantly tumour growth in a murine VCaP xenograft model in vivo. Intriguingly, after a single oral dose of 10-30 mg/kg, ODM-204 dose-dependently inhibited adrenal and testicular steroid production in sexually mature male cynomolgus monkeys. Similar results were obtained in human chorionic gonadotropin-treated male rats. In rats, leuprolide acetate-mediated (LHRH agonist) suppression of the circulating testosterone levels and decrease in weights of androgen-sensitive organs was significantly and dose-dependently potentiated by the co-administration of ODM-204. ODM-204 was well tolerated in both rodents and primates. Based on our data, ODM-204 could provide an effective therapeutic option for men with CRPC.

Abstract 4649: ODM-207, a novel BET-bromodomain inhibitor as a therapeutic approach for the treatment of prostate and breast cancer

Introduction: BET (bromodomain and extraterminal) family proteins (BRD2, BRD3, BRD4, and BRDT) are epigenetic readers that bind to acetylated-lysine residues in histones and recruit protein complexes to promote transcription elongation. In many cancers, BET proteins have been shown to regulate expression of MYC and other oncogenic drivers that are important for cell proliferation and survival. Pharmacologic inhibition of the BET-histone interaction has been shown to result in transcriptional downregulation of a number of oncogenes and inhibition of tumor growth providing a novel strategy for treatment of cancer. Therefore, in this study, we evaluated the in vitro and in vivo antitumor activity of ODM-207, a novel, potent and highly selective BET bromodomain inhibitor using cell lines derived from prostate and breast cancer as well as patient-derived tumor cell cultures of breast cancer. Methods and Results: ODM-207 has antiproliferative effects on several hematological and solid tumor cell lines. In a panel of prostate cancer cell lines, ODM-207 attenuates cell growth of androgen receptor (AR)-positive cell lines such as VCaP and 22Rv1. RNA-sequencing and Western blot studies revealed that the exposure of sensitive prostate cancer cells to ODM-207 is associated with rapid down-regulation c-Myc expression levels while wtAR was not affected. In 22Rv1 prostate cancer xenograft, which expresses both the full-length androgen receptor and androgen receptor splice variant V7, oral administration of ODM-207 was very efficacious in suppressing tumor growth at well tolerated doses whereas enzalutamide had only a modest effect. Contrary to our findings in prostate cancer cells, BET-inhibitor treatment of estrogen-dependent MCF-7 breast cancer cell line inhibits tumor growth in cell proliferation assays but is associated with down-regulation of ERα while the c-Myc levels are very low, highlighting the context-dependent functional effects of BET inhibition. Interestingly, ODM-207 produces potent antiproliferative effects associated with cell-cycle arrest and cellular senescence in patient-derived breast cancer cells. Conclusions: In summary, ODM-207 is a new generation BET inhibitor found to possess excellent pharmacological properties and antitumor activity both in vitro and in vivo. Our data suggest the potential utilization of ODM-207 for the treatment of prostate and breast cancer. Citation Format: Mari Bjorkman, Elina Mattila, Reetta Riikonen, Chandra Sekhar, Mahaboobi Jaleel, Sivapriya Marappan, Tarja Ikonen, Daniel Nicorici Nicorici, Juha Rantala, Susanta Samajdar, Murali Ramachandra, Pekka Kallio, Anu-Maarit Moilanen. ODM-207, a novel BET-bromodomain inhibitor as a therapeutic approach for the treatment of prostate and breast cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4649.

Abstract 674: ODM-201 - New generation androgen receptor inhibitor targeting resistance mechanisms to androgen signalling-directed prostate cancer therapies

Proceedings: AACR Annual Meeting 2014; April 5-9, 2014; San Diego, CA Androgen receptor (AR) mutations have been described to emerge in response to prostate cancer treatment with first generation AR antagonists, resulting in broadened ligand specificity and AR antagonist-to-agonist switch. Second-generation AR antagonists enzalutamide and ARN-509 function as antagonists in the presence of AR overexpression. They express high clinical efficacy in castration resistant prostate cancer (CRPC) but eventually resistance will emerge. Recently, a F876L missense mutation in the ligand-binding domain of AR has been described that confers resistance to enzalutamide and ARN-509 in preclinical models of prostate cancer. AR F876L mutation has also been identified in plasma DNA from ARN-509-treated CRPC patients with rising PSA. ODM-201 is a new generation AR inhibitor with high anticancer activity in patients with CRPC and has unique properties compared to first and second generation antiandrogens. ODM-201 and its major metabolite bind to wt AR with excellent affinity (Ki 8 and 9 nM, respectively) and selectivity. In functional cell-based assays, ODM-201 functions as antagonist in highly AR overexpressing cells and does not induce AR T877A or W741L transcriptional activity. In contrast to enzalutamide and ARN-509, ODM-201 and its metabolite have been found to potently inhibit the activity of AR F876L while enzalutamide and ARN-509 were agonistic. ODM-201 is a promising new generation AR inhibitor for the treatment of advanced prostate cancer with superior antiandrogenic activity in preclinical models of AR function. Citation Format: Anu-Maarit Moilanen, Reetta Riikonen, Pekka J. Kallio. ODM-201 - New generation androgen receptor inhibitor targeting resistance mechanisms to androgen signalling-directed prostate cancer therapies. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 674. doi:10.1158/1538-7445.AM2014-674