Drug development

药物开发
  • 文章类型: Journal Article
    抗体-药物缀合物(ADC)代表实体瘤和血液肿瘤的系统治疗中的革命性方法。由抗体构成,细胞毒性有效载荷,和一个链接器,ADC旨在选择性地将细胞毒性剂递送至肿瘤,同时保留正常组织。到目前为止,已经测试并批准了多种ADC用于多种实体瘤,但是如果有一个对临床实践有重大影响,这就是曲妥珠单抗-deruxtecan(T-DXd).值得注意的是,T-DXd被批准用于HER2阳性和HER2低转移性乳腺癌(MBC),HER2阳性胃癌(GC),HER2突变型非小细胞肺癌(NSCLC)和HER23+实体瘤。此外,它接受了HER2阳性结直肠癌(CRC)的突破性治疗.
    我们回顾了T-DXd的临床前和临床数据,重点是正在进行的早期试验,探索联合疗法以增强表达HER2的实体瘤中T-DXd的活性。
    T-DXd的临床使用仍然引起患者选择的问题,治疗持续时间,优先于其他批准的ADC,和管理抵抗。对T-DXd毒性的担忧仍然存在,特别是涉及潜在毒性药物的组合。生物标志物识别和联合疗法的进步为提高疗效和克服对T-DXd的耐药性提供了有希望的途径。最终改善癌症患者的预后。
    UNASSIGNED: Antibody-drug conjugates (ADCs) represent a revolutionary approach in the systemic treatment for both solid and hematologic tumors. Constituted by an antibody, a cytotoxic payload, and a linker, ADCs aim to selectively deliver cytotoxic agents to tumors while sparing normal tissues. Various ADCs have been tested and approved for multiple solid tumors so far, but if there is one that had a major impact on clinical practice, this is Trastuzumab-deruxtecan (T-DXd). Notably, T-DXd was approved for HER2-positive and HER2-low metastatic breast cancer (MBC), HER2-positive gastric cancer (GC), HER2-mutant non-small cell lung cancer (NSCLC) and HER2 3+ solid tumors. Moreover, it received Breakthrough Therapy Designation for HER2-positive colorectal cancer (CRC).
    UNASSIGNED: We review preclinical and clinical data of T-DXd, focusing on early-phase ongoing trials exploring combination therapies to enhance the activity of T-DXd in HER2-expressing solid tumors.
    UNASSIGNED: The clinical use of T-DXd still raises questions about selection of patients, treatment duration, prioritization over other approved ADCs, and management of resistance. Concerns regarding the toxicity of T-DXd remain, particularly with combinations involving potentially toxic drugs. Advancements in biomarker identification and combination therapies offer promising avenues to enhance efficacy and overcome resistance to T-DXd, ultimately improving outcomes for patients with cancer.
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  • 文章类型: Journal Article
    恰加斯病是一种热带被忽视的疾病,影响着全世界数百万人,仍然需要更有效和更安全的治疗,尤其是在慢性阶段,缺乏促进实质性寄生虫治疗的治疗方法。Romanha及其合作者于2010年发表的技术说明旨在为开发克氏锥虫新药建立一个指南,其中包括一套最低标准和决策门,重点是开发新的抗锥虫药物。在这个意义上,本次审查旨在更新本技术说明,带来了近年来关于这一主题的最新技术和新进展。
    Chagas disease is a tropical neglected disease that affects millions of people worldwide, still demanding a more effective and safer therapy, especially in its chronic phase which lacks a treatment that promotes substantial parasitological cure. The technical note of Romanha and collaborators published in 2010 aimed establish a guideline with the set of minimum criteria and decision gates for the development of new agents against Trypanosoma cruzi with the focus on developing new antichagasic drugs. In this sense, the present review aims to update this technical note, bringing the state of the art and new advances on this topic in recent years.
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  • 文章类型: Journal Article
    G蛋白偶联受体(GPCRs)广泛存在于体内,参与多种生理过程,从而成为药物开发的重要靶点。大约30%的食品和药物管理局(FDA)批准的药物靶向GPCRs。迄今为止,一种疾病,一个目标,一种分子策略不再满足药物开发的需求。同时,小分子药物占FDA批准药物的60%。中医以其独特的理论体系和治疗方法引起了广泛的关注。TCM涉及多个组件,目标和途径。以GPCRs和TCM为中心,本文从中医证候的角度探讨了中医与GPCRs的异同,中药多组分和多靶点方法的一致性以及GPCRs和中药在新药开发中的潜力。一种新颖的策略,“同时筛选药物和目标”,提出并应用于GPCRs的研究。我们将GPCRs与TCM相结合,以促进TCM的现代化,为中药的合理应用提供有价值的见解,促进新药的研发。本研究为中药现代化提供了理论支持,并为开发安全有效的药物提供了新的思路。
    G protein-coupled receptors (GPCRs) widely exist in vivo and participate in many physiological processes, thus emerging as important targets for drug development. Approximately 30% of the Food and Drug Administration (FDA)-approved drugs target GPCRs. To date, the \'one disease, one target, one molecule\' strategy no longer meets the demands of drug development. Meanwhile, small-molecule drugs account for 60% of FDA-approved drugs. Traditional Chinese medicine (TCM) has garnered widespread attention for its unique theoretical system and treatment methods. TCM involves multiple components, targets and pathways. Centered on GPCRs and TCM, this paper discusses the similarities and differences between TCM and GPCRs from the perspectives of syndrome of TCM, the consistency of TCM\'s multi-component and multi-target approaches and the potential of GPCRs and TCM in the development of novel drugs. A novel strategy, \'simultaneous screening of drugs and targets\', was proposed and applied to the study of GPCRs. We combine GPCRs with TCM to facilitate the modernisation of TCM, provide valuable insights into the rational application of TCM and facilitate the research and development of novel drugs. This study offers theoretical support for the modernisation of TCM and introduces novel ideas for development of safe and effective drugs.
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  • 文章类型: Journal Article
    过度磷酸化tau蛋白的异常积累在一系列称为tau蛋白病的神经退行性疾病中起着关键作用,包括阿尔茨海默病(AD)。我们最近概念化了异源双功能嵌合体的设计,用于选择性地促进tau和磷酸酶之间的接近,因此特别促进tau去磷酸化和去除。这里,我们试图优化tau去磷酸化靶向嵌合体(DEPTAC)的构建,并获得了一个新的嵌合体D14,该嵌合体在细胞和tau病小鼠模型中都能高效降低tau磷酸化,同时显示有限的细胞毒性。此外,D14改善了用毒性tau-K18片段处理的原代培养海马神经元的神经变性,并改善tau蛋白病小鼠的认知功能。这些结果表明D14是治疗tau蛋白病的经济有效的候选药物。
    Abnormal accumulation of hyperphosphorylated tau protein plays a pivotal role in a collection of neurodegenerative diseases named tauopathies, including Alzheimer\'s disease (AD). We have recently conceptualized the design of hetero-bifunctional chimeras for selectively promoting the proximity between tau and phosphatase, thus specifically facilitating tau dephosphorylation and removal. Here, we sought to optimize the construction of tau dephosphorylating-targeting chimera (DEPTAC) and obtained a new chimera D14, which had high efficiency in reducing tau phosphorylation both in cell and tauopathy mouse models, while showing limited cytotoxicity. Moreover, D14 ameliorated neurodegeneration in primary cultured hippocampal neurons treated with toxic tau-K18 fragments, and improved cognitive functions of tauopathy mice. These results suggested D14 as a cost-effective drug candidate for the treatment of tauopathies.
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  • 文章类型: Journal Article
    美国食品和药物管理局(FDA)的突破性治疗指定(BTD)计划旨在通过支持合格的有效临床开发来增加患者获得安全有效的治疗方法,有临床意义的疗法。使用2006年至2020年间批准的药物的关键开发里程碑的新数据集,包括BTD药物和FDA专家确定的一组比较药物,我们估计了BTD计划对后期临床开发时间的影响,以药物与监管机构的第二阶段会议结束到批准上市之间经过的时间来衡量。我们的分析表明,BTD计划将后期临床开发时间缩短了30%。我们的研究结果为未来的监管和创新政策提供了洞察力,旨在提高医疗产品开发的效率,以确保患者及时获得最具临床意义的治疗方法。
    The Food and Drug Administration\'s (FDA\'s) breakthrough therapy designation (BTD) program was created to increase patient access to safe and effective therapies by supporting the efficient clinical development of qualifying, clinically meaningful therapies. Using a new data set of key development milestones for drugs approved between 2006 and 2020, including both BTD drugs and a set of comparator drugs identified by FDA experts, we estimated the BTD program\'s impact on time spent in late-stage clinical development, measured as the elapsed time between a drug\'s end-of-Phase-II meeting with regulators and its approval for marketing. Our analysis suggests that the BTD program lowers late-stage clinical development time by 30 percent. Our findings provide insight into future regulatory and innovation policies aimed at driving efficiency in medical product development to ensure timely patient access to the most clinically meaningful therapies.
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  • 文章类型: Journal Article
    光动力疗法(PDT)是用于治疗皮肤皮肤癌和其他非感染性疾病的既定疗法。最近人们对使用aPDT(抗微生物PDT)治疗皮肤和软组织感染的机会感兴趣。PDT利用渗透所有细胞的光敏剂,使它们对给定波长的光“敏感”。光敏剂对给定波长的光具有很高的吸收性,当被激发时会产生,在氧气的存在下,破坏氧自由基和单线态氧。当与人细胞相比时,细菌细胞在抵抗氧化应激方面相对较差,因此可以用aPDT实现一定程度的选择性毒性。在这一章中,我们概述了使用标准实验室设备在体外测试aPDT的方法。
    Photodynamic therapy (PDT) is an established therapy used for the treatment of cutaneous skin cancers and other non-infective ailments. There has been recent interest in the opportunity to use aPDT (antimicrobial PDT) to treat skin and soft tissue infections. PDT utilizes photosensitizers that infiltrate all cells and \"sensitize\" them to a given wavelength of light. The photosensitizer is simply highly absorbent to a given wavelength of light and when excited will produce, in the presence of oxygen, damaging oxygen radicals and singlet oxygen. Bacterial cells are comparatively poor at combatting oxidative stress when compared with human cells therefore a degree of selective toxicity can be achieved with aPDT.In this chapter, we outline methodologies for testing aPDT in vitro using standard lab equipment.
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  • 文章类型: Journal Article
    3D癌症模型填补了2D癌症模型的发现空白,在癌症研究中发挥着重要作用。除了癌细胞,一系列其他因素包括基质,细胞外基质的密度和组成,癌症相关免疫细胞(例如,癌症相关的成纤维细胞癌细胞-基质相互作用和随后的相互作用,和许多其他因素(例如,体内的肿瘤脉管系统和肿瘤样微环境)在2D培养概念中被广泛忽略。尽管有这些知识,继续使用单层细胞培养方法导致一系列临床试验失败。这篇综述讨论了肿瘤微环境(TME)概述在癌症研究中的巨大重要性。优先考虑TME元件在癌症组织病理学中的个体作用。3D模型提供的TME满足了体内时空排列的要求,组件,并有助于分析临床前和临床试验中药物敏感性的各种不同方面,其中一些在这里讨论。此外,它讨论了体外不同TME元件共组装的模型,并着重于它们作为肿瘤的协同功能和反应性。此外,这篇综述广泛描述了一些最近开发的3D模型,这些模型的主要关注点仅限于药物开发及其筛选和/或这种方法在临床前和转化研究中的影响.
    The 3D cancer models fill the discovery gap of 2D cancer models and play an important role in cancer research. In addition to cancer cells, a range of other factors include the stroma, density and composition of extracellular matrix, cancer-associated immune cells (e.g., cancer-associated fibroblasts cancer cell-stroma interactions and subsequent interactions, and a number of other factors (e.g., tumor vasculature and tumor-like microenvironment in vivo) has been widely ignored in the 2D concept of culture. Despite this knowledge, the continued use of monolayer cell culture methods has led to the failure of a series of clinical trials. This review discusses the immense importance of tumor microenvironment (TME) recapitulation in cancer research, prioritizing the individual roles of TME elements in cancer histopathology. The TME provided by the 3D model fulfills the requirements of in vivo spatiotemporal arrangement, components, and is helpful in analyzing various different aspects of drug sensitivity in preclinical and clinical trials, some of which are discussed here. Furthermore, it discusses models for the co-assembly of different TME elements in vitro and focuses on their synergistic function and responsiveness as tumors. Furthermore, this review broadly describes of a handful of recently developed 3D models whose main focus is limited to drug development and their screening and/or the impact of this approach in preclinical and translational research.
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  • 文章类型: Historical Article
    自1986年mAb首次批准以来,治疗性单克隆抗体(mAb)的开发和生产药物的方法已经发展。因为过去往往是未来的序幕,这些技术的历史在这里被分为三个时代,导致人们猜测下一个时代在发展和制造战略方面可能会发生什么,以及对患者的潜在影响。生产培养滴度和生物反应器产量的大幅增加以及大规模合同生产设施的可用性可以转化为这些疗法的全球可获得性的改善和治疗性抗体适应症的扩大。
    Therapeutic monoclonal antibody (mAb) development and the processes for manufacturing drug substance have evolved since the first approval of the mAb in 1986. As the past is often the prologue to the future, the history of these technologies has been classified here into three eras, leading to speculation about what the next era may hold with regard to development and manufacturing strategies, as well as the potential impacts to patients. The substantial increase in production culture titers and bioreactor production volumes and the availability of large-scale contract manufacturing facilities could translate into improved global access for these therapies and an expansion of indications for therapeutic antibodies.
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  • 文章类型: Journal Article
    重度抑郁症(MDD)是一种精神疾病,影响全球超过3亿人,对社会产生严重影响。已知基于单胺假说的靶向脑中单胺的常规抗抑郁药在30%的MDD患者中需要延长的时间才能有效或较不有效。因此,有必要开发抗抑郁剂,这些抗抑郁剂可有效对抗难治性抑郁症,并具有不同于单胺假说的新机制.包括我们在内的越来越多的研究小组已经建立了垂体腺苷酸环化酶激活多肽(PACAP)及其受体之一,PAC1受体,与应激相关疾病如MDD的病因密切相关。因此,强烈建议PAC1受体是治疗精神疾病的有希望的靶标。我们开发了一部小说,非肽,小分子,高亲和力PAC1受体拮抗剂,并在小鼠中进行行为药理学实验,以表征新型PAC1受体拮抗剂作为MDD治疗的新选择。结果表明,我们的新型PAC1受体拮抗剂具有成为具有高安全性的新型抗抑郁药的潜力。在这次审查中,我们想介绍开发新型PAC1受体拮抗剂的背景及其对急性应激小鼠模型的影响。
    Major depressive disorder (MDD) is a psychiatric disorder that affects more than 300 million people worldwide and has a serious impact on society. Conventional antidepressants targeting monoamines in the brain based on the monoamine hypothesis are known to take a prolonged time to be effective or less effective in 30% of MDD patients. Hence, there is a need to develop antidepressants that are effective against treatment-resistant depression and have a new mechanism different from the monoamine hypothesis. An increasing number of research groups including us have been establishing that pituitary adenylate cyclase-activating polypeptide (PACAP) and one of its receptors, PAC1 receptor, are closely related to the etiology of stress-related diseases such as MDD. Therefore, it is strongly suggested that the PAC1 receptor is a promising target in the treatment of psychiatric disorders. We developed a novel, non-peptidic, small-molecule, high-affinity PAC1 receptor antagonists and conducted behavioral pharmacology experiments in mice to characterize a novel PAC1 receptor antagonist as a new option for MDD therapy. The results show that our novel PAC1 receptor antagonist has the potential to be a new antidepressant with a high safety profile. In this review, we would like to present the background of developing our novel PAC1 receptor antagonist and its effects on mouse models of acute stress.
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  • 文章类型: Journal Article
    背景:用于心房颤动(AF)的药物开发未能产生新的批准的化合物。我们试图在人类遗传学的支持下确定并优先考虑潜在的药物靶标,通过将现有证据与与AF药物开发相关的生物信息学来源相结合。
    方法:通过MEDLINE的结构化搜索鉴定了AF和相关性状的遗传命中。来自每篇论文的基因与药物相互作用的OpenTargets平台交叉引用。通过在MEDLINE和ClinialTrials.gov上对每种药物及其与AF的关联进行结构化搜索和证据审查,证明了确认/验证。
    结果:鉴定出613种独特的药物,其中21项已纳入AF指南。目前未用于房颤的心血管药物(例如雷诺嗪和卡百利肽)和抗炎药(例如地塞米松和甲泼尼龙)具有潜在益处的证据。进一步的目标被认为是可药用的,但仍可用于药物开发。
    结论:我们的系统方法,结合来自不同生物信息学平台的证据,确定了房颤的药物再利用机会和药物靶标。
    背景:KK得到了Barts慈善补助金G-002089的支持,并得到了AFGen2023-24奖学金的指导,该奖学金由AFGenNIH/NHLBI补助金R01HL092577资助。RP由UCLBHF研究加速器AA/18/6/34223和NIHR授予NIHR129463支持。AFS得到了BHF赠款PG/18/5033837,PG/22/10989和UCLBHF加速器AA/18/6/34223以及英国研究与创新(UKRI)的支持,这些资金由英国政府的HorizonEurope资金保证EP/Z000211/1和UKRI-NIHR赠款/V3867/1用于多药机制和疗法研究。AF由UCLBHF加速器AA/18/6/34223支持。CF由UCLBHF加速器AA/18/6/34223支持。
    BACKGROUND: Drug development for atrial fibrillation (AF) has failed to yield new approved compounds. We sought to identify and prioritise potential druggable targets with support from human genetics, by integrating the available evidence with bioinformatics sources relevant for AF drug development.
    METHODS: Genetic hits for AF and related traits were identified through structured search of MEDLINE. Genes derived from each paper were cross-referenced with the OpenTargets platform for drug interactions. Confirmation/validation was demonstrated through structured searches and review of evidence on MEDLINE and ClinialTrials.gov for each drug and its association with AF.
    RESULTS: 613 unique drugs were identified, with 21 already included in AF Guidelines. Cardiovascular drugs from classes not currently used for AF (e.g. ranolazine and carperitide) and anti-inflammatory drugs (e.g. dexamethasone and mehylprednisolone) had evidence of potential benefit. Further targets were considered druggable but remain open for drug development.
    CONCLUSIONS: Our systematic approach, combining evidence from different bioinformatics platforms, identified drug repurposing opportunities and druggable targets for AF.
    BACKGROUND: KK is supported by Barts Charity grant G-002089 and is mentored on the AFGen 2023-24 Fellowship funded by the AFGen NIH/NHLBI grant R01HL092577. RP is supported by the UCL BHF Research Accelerator AA/18/6/34223 and NIHR grant NIHR129463. AFS is supported by the BHF grants PG/18/5033837, PG/22/10989 and UCL BHF Accelerator AA/18/6/34223 as well as the UK Research and Innovation (UKRI) under the UK government\'s Horizon Europe funding guarantee EP/Z000211/1 and by the UKRI-NIHR grant MR/V033867/1 for the Multimorbidity Mechanism and Therapeutics Research Collaboration. AF is supported by UCL BHF Accelerator AA/18/6/34223. CF is supported by UCL BHF Accelerator AA/18/6/34223.
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