Delving into the Latest Updates on PR-104 with Synapse

Overview

Basic Info

Drug Type

Small molecule drug

Synonyms

PR 104, SN-29244

Target

DNA

Mechanism

DNA inhibitors(DNA inhibitors), DNA alkylating agents

Therapeutic Areas

NeoplasmsImmune System DiseasesDigestive System Disorders+ [2]

Active Indication-

Inactive Indication

Acute Lymphoblastic LeukemiaAdvanced Hepatocellular CarcinomaAdvanced Lung Non-Small Cell Carcinoma+ [4]

Originator Organization

Proacta, Inc.

Active Organization-

Inactive Organization

Proacta, Inc.

Drug Highest PhaseDiscontinuedPhase 2

First Approval Date-

Regulation-

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Structure/Sequence

Molecular FormulaC14H20BrN4O12PS

InChIKeyGZSOKPMDWVRVMG-UHFFFAOYSA-N

CAS Registry851627-62-8

The current understanding of PR104 justifies the evaluation of PR104 in subjects with relapsed/refractory AML and ALL. These include:
Hypoxia. Leukemic bone marrow is likely to demonstrate a level of hypoxia sufficient to activate PR104 to its active metabolites PR104H and PR104M.
Myelotoxicity as the primary toxicity at MTD. In prior clinical studies in subjects with solid tumors PR104 has demonstrated myelotoxicity as the primary toxicity. This observation suggests that PR104 will exert a similar effect on leukemic cells.
AKR1C3. AML has been reported to exhibit high levels of AKR1C3 which should lead to selective activation of PR104 within both hypoxic and oxic leukemic cells.
Preclinical data. PR104 has demonstrated impressive activity in an initial study using primary human ALL in a mouse model.
The initial dose finding phase of the study will provide estimates of the activity and toxicity of PR104 in subjects with refractory/relapsed AML, and determine the optimal individualized dose to give each subject based on his/her covariates (prior CR duration, prior number of salvage therapies, age). Once a potentially beneficial dose has been determined, an expanded cohort of subjects with AML or ALL will receive PR104 at a uniform dose. This information will prove valuable in defining the future clinical development of PR104, and in determining if PR104 has sufficient activity and acceptable safety in AML to warrant future phase II or phase III studies in this indication.
Primary objectives
Determine the toxicities and recommended dose of PR104 when administered IV to subjects with relapsed/refractory AML and ALL.
Secondary objectives
Evaluate the pharmacokinetics (PK) of PR104 and a series of PR104 metabolites
Evaluate any anti-tumor effects of PR104
Evaluate the expression of AKR1C3 in bone marrow and leukemic cells
Evaluate potential biomarkers of hypoxia

Start Date01 Jan 2010

Sponsor / Collaborator

Proacta, Inc.

NCT00862082

/ TerminatedPhase 1/2

A Randomized Phase I/II, Multi-Center, Open-Label Trial of PR104 and Sorafenib in Patients With Advanced Hepatocellular Carcinoma

The current understanding of PR104 justifies the evaluation of PR104 with sorafenib in patients with hepatocellular carcinoma. These include:
Hypoxia. Hepatocellular Carcinoma (HCC) is likely to demonstrate a level of hypoxia sufficient to activate PR104 to its active metabolites PR104H and PR104M. In addition, in preclinical models, sorafenib has been demonstrated to increase the degree of hypoxia in tumors following treatment.
Non-overlapping toxicity. PR104 and sorafenib do not share major toxicities. It is anticipated that both drugs can be administered at their full single agent dose when used in combination.
Aldo-keto reductase 1C3 (AKR1C3). HCC has been shown to express high levels of AKR1C3 which should lead to selective activation of PR104 within both hypoxic and oxic HCC cells.
Preclinical data. The use of sorafenib and PR104 alone and in combination in a hepatocellular carcinoma model demonstrates activity of PR104 as a single agent and increased activity when PR104 and sorafenib are used in combination.
The current study will provide an estimate of the activity of PR104 in subjects with HCC. This information will prove valuable in defining the future clinical development of PR104, and in determining if PR104 has sufficient activity in HCC to warrant a larger phase III registration study in this indication.
Primary objectives
Phase I: Determine the maximum tolerated dose (MTD) of PR104 when used in combination with standard dose sorafenib
Phase II: Estimate the response rate (RR) of PR104/sorafenib [Note: Phase II was never initiated]
Secondary objectives
Evaluate survival
Evaluate Progression Free Survival (PFS)
Evaluate time to progression (TTP)
Evaluate safety
Evaluate the pharmacokinetics (PK) of sorafenib, PR104 and PR104 metabolites
Collect diagnostic biopsy samples for the determination of aldo-keto reductase 1C3
Collect plasma samples for assessment of potential biomarkers of tumor hypoxia

Start Date01 Mar 2009

Sponsor / Collaborator

Proacta, Inc.

NCT00862134

/ TerminatedPhase 2

A Randomized Phase II, Multi-Center, Open-Label Trial of PR104 and Docetaxel in Patients With Advanced Non-Small Cell Lung Cancer

The current understanding of PR104 justifies the evaluation of PR104 with docetaxel in subjects with Non Small Cell Lung Cancer (NSCLC). These include:
Aldo-keto reductase 1C3 (AKR1C3). NSCLC has been shown to express high levels of AKR1C3 in about one half of tumors tested. Subjects with high levels of AKR1C3 should have increased activation of PR104 within their tumor.
Hypoxia. NSCLC has been demonstrated to be a tumor with hypoxia based on both direct tumor measurements (oxygen electrodes) and hypoxic positron emission tomography (PET) imaging. Tumor hypoxia in NSCLC should be sufficient to activate PR104 to its active metabolites PR104H and PR104M.
Preclinical data. The use of docetaxel and PR104 alone and in combination in preclinical models demonstrates activity of PR104 as a single agent and supraadditive activity when PR104 and docetaxel are used in combination.
Manageable toxicity. PR104 and docetaxel with Granulocyte Colony-stimulating Factor (G-CSF) have been combined in a prior phase I study. A Maximum Tolerated Dose (MTD) has been identified and the major toxicities of this combination are understood.
The current study will provide an estimate of the activity of PR104 in subjects with NSCLC. This information will prove valuable in defining the future clinical development of PR104, and in determining if PR104 has sufficient activity in NSCLC to warrant a larger phase III registration study in this indication.
Primary objectives
• Estimate the response rate (RR) of PR104/docetaxel
Secondary objectives
Evaluate survival
Evaluate progression free survival (PFS)
Evaluate time to progression (TTP)
Evaluate safety
Evaluate the pharmacokinetics of PR104 and its metabolites
Evaluate the pharmacokinetics of docetaxel
Evaluate the tumor hypoxia using 18F-fluoromisonidazole (18F-MISO) PET imaging
Collect diagnostic biopsy samples for the determination of AKR1C3
Collect plasma samples for assessment of potential biomarkers of tumor hypoxia

Start Date01 Mar 2009

Sponsor / Collaborator

Proacta, Inc.

100 Clinical Results associated with PR-104

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100 Translational Medicine associated with PR-104

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100 Patents (Medical) associated with PR-104

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37

Literatures (Medical) associated with PR-104

01 Jul 2022·Cancer gene therapyQ2 · MEDICINE

Bioreductive prodrug PR-104 improves the tumour distribution and titre of the nitroreductase-armed oncolytic adenovirus ONYX-411NTR leading to therapeutic benefit

Q2 · MEDICINE

Article

Author: Smaill, Jeff B ; Mowday, Alexandra M ; Li, Dan ; Ashoorzadeh, Amir ; Syddall, Sophie P ; Singleton, Dean C ; Bai, Sally Y ; Guise, Chris P ; Wilson, William R ; Patterson, Adam V

Advances in the field of cancer immunotherapy have stimulated renewed interest in adenoviruses as oncolytic agents. Clinical experience has shown that oncolytic adenoviruses are safe and well tolerated but possess modest single-agent activity. One approach to improve the potency of oncolytic viruses is to utilise their tumour selectivity to deliver genes encoding prodrug-activating enzymes. These enzymes can convert prodrugs into cytotoxic species within the tumour; however, these cytotoxins can interfere with viral replication and limit utility. In this work, we evaluated the activity of a nitroreductase (NTR)-armed oncolytic adenovirus ONYX-411^NTR in combination with the clinically tested bioreductive prodrug PR-104. Both NTR-expressing cells in vitro and xenografts containing a minor population of NTR-expressing cells were highly sensitive to PR-104. Pharmacologically relevant prodrug exposures did not interfere with ONYX-411^NTR replication in vitro. In vivo, prodrug administration increased virus titre and improved virus distribution within tumour xenografts. Colonisation of tumours with high ONYX-411^NTR titre resulted in NTR expression and prodrug activation. The combination of ONYX-411^NTR with PR-104 was efficacious against HCT116 xenografts, whilst neither prodrug nor virus were active as single agents. This work highlights the potential for future clinical development of NTR-armed oncolytic viruses in combination with bioreductive prodrugs.

01 Feb 2022·Cancer gene therapyQ2 · MEDICINE

Use of an optimised enzyme/prodrug combination for Clostridia directed enzyme prodrug therapy induces a significant growth delay in necrotic tumours

Q2 · MEDICINE

Article

Author: Kubiak, Aleksandra M ; Smaill, Jeff B ; Theys, Jan ; Ackerley, David F ; Lambin, Philippe ; Guise, Christopher P ; Chan-Hyams, Jasmine V E ; Ashoorzadeh, Amir ; Dubois, Ludwig J ; Mowday, Alexandra M ; Minton, Nigel P ; Patterson, Adam V

Necrosis is a typical histological feature of solid tumours that provides a selective environment for growth of the non-pathogenic anaerobic bacterium Clostridium sporogenes. Modest anti-tumour activity as a single agent encouraged the use of C. sporogenes as a vector to express therapeutic genes selectively in tumour tissue, a concept termed Clostridium Directed Enzyme Prodrug Therapy (CDEPT). Here, we examine the ability of a recently identified Neisseria meningitidis type I nitroreductase (NmeNTR) to metabolise the prodrug PR-104A in an in vivo model of CDEPT. Human HCT116 colon cancer cells stably over-expressing NmeNTR demonstrated significant sensitivity to PR-104A, the imaging agent EF5, and several nitro(hetero)cyclic anti-infective compounds. Chemical induction of necrosis in human H1299 xenografts by the vascular disrupting agent vadimezan promoted colonisation by NmeNTR-expressing C. sporogenes, and efficacy studies demonstrated moderate but significant anti-tumour activity of spores when compared to untreated controls. Inclusion of the pre-prodrug PR-104 into the treatment schedule provided significant additional activity, indicating proof-of-principle. Successful preclinical evaluation of a transferable gene that enables metabolism of both PET imaging agents (for vector visualisation) and prodrugs (for conditional enhancement of efficacy) is an important step towards the prospect of CDEPT entering clinical evaluation.

01 Aug 2018·Biochemical pharmacologyQ2 · MEDICINE

Drug-DNA adducts as biomarkers for metabolic activation of the nitro-aromatic nitrogen mustard prodrug PR-104A

Q2 · MEDICINE

Article

Author: Gu, Yongchuan ; Wilson, William R ; Liyanage, H D Sarath ; Stornetta, Alessia ; Sturla, Shana J ; Danielli, Sara ; Deng, Kai-Cheng Kieren

PR-104A is a clinical-stage nitrogen mustard prodrug that is activated for DNA alkylation by reduction of a nitro group to the corresponding hydroxylamine (PR-104H) or amine (PR-104M). Metabolic reduction is catalysed by flavoreductases such as cytochrome P450 oxidoreductase (POR) under hypoxia, or by aldo-ketoreductase 1C3 (AKR1C3) independently of hypoxia. The unstable reduced metabolites are challenging to measure in biological samples, and biomarkers of the metabolic activation of PR-104A have not been used in the clinical evaluation of PR-104 to date. Here, we employ a selected reaction monitoring mass spectrometry assay for DNA crosslinks to assess the capacity of human cancer cells to bioactivate PR-104A. We also test whether the more abundant DNA monoadducts could be used for the same purpose. DNA monoadducts and crosslinks from PR-104A itself, and from its reduced metabolites, accumulated over 4 h in AKR1C3-expressing TF1 erythroleukaemia cells under hypoxia, whereas intracellular concentrations of unstable PR-104H and PR-104M reached steady state within 1 h. We then varied rates of PR-104A reduction by manipulating hypoxia or reductase expression in a panel of cell lines, in which AKR1C3 and POR were quantified by targeted proteomics. Hypoxia or reductase overexpression induced large increases in PR-104A sensitivity (inhibition of proliferation), DNA damage response (γH2AX formation), steady-state concentrations of PR-104H/M and formation of reduced drug-DNA adducts but not DNA adducts retaining the dinitro groups of PR-104A. The fold-change in the sum of PR-104H and PR-104M correlated with the fold-change in reduced crosslinks or monoadducts (R² = 0.87 for both), demonstrating their potential for assessing the capacity of cancer cells to bioactivate PR-104A.

100 Deals associated with PR-104

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External Link

KEGG	Wiki	ATC	Drug Bank
-	PR-104	-	DB05968

R&D Status

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Acute Lymphoblastic Leukemia	Phase 2	US	Proacta, Inc.	01 Jan 2010
Refractory Acute Leukemia	Phase 2	US	Proacta, Inc.	01 Jan 2010
Refractory acute myeloid leukemia	Phase 2	US	Proacta, Inc.	01 Jan 2010
Advanced Hepatocellular Carcinoma	Phase 2	US	Proacta, Inc.	01 Mar 2009
Advanced Hepatocellular Carcinoma	Phase 2	HK	Proacta, Inc.	01 Mar 2009
Advanced Hepatocellular Carcinoma	Phase 2	SG	Proacta, Inc.	01 Mar 2009
Advanced Hepatocellular Carcinoma	Phase 2	TW	Proacta, Inc.	01 Mar 2009
Advanced Lung Non-Small Cell Carcinoma	Phase 2	US	Proacta, Inc.	01 Mar 2009
Advanced Lung Non-Small Cell Carcinoma	Phase 2	CA	Proacta, Inc.	01 Mar 2009
Advanced Lung Non-Small Cell Carcinoma	Phase 2	NZ	Proacta, Inc.	01 Mar 2009

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Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT01037556 (ASCO2013)	Phase 1/2	refractory acute lymphoid leukemia in relapse	50	PR104	bnebsfjapk(laorwacyke) = hepatic failure (n=1), enterocolitis (n=1), pneumonia (n=1) bbasltxzxj (acstwckmsc ) View more	-	20 May 2013
NCT00862134 (CTgov)	Phase 2	Advanced Lung Non-Small Cell Carcinoma	42	Docetaxel (Docetaxel)	stymdherhb(fgzxosalnx) = ramqwegncq bqcqbqlbkp (iyvyaiqjfs, uscekxdkxa - rbclfgogxy) View more	-	10 Jan 2013
NCT00862134 (CTgov)	Phase 2	Advanced Lung Non-Small Cell Carcinoma	42	PR104+Docetaxel (PR104 + Docetaxel)	stymdherhb(fgzxosalnx) = brpwpvrrcu bqcqbqlbkp (iyvyaiqjfs, fchyjhkpkb - updgmdwmyr) View more	-	10 Jan 2013
NCT00544674 (CTgov)	Phase 2	Recurrent Lung Small Cell Carcinoma	5	F-18-fluoromisonidazole+PR104	imtkxdksvn(kehkbktyje) = duiskmhoyc hclilqmcfp (wphtniaivz, bgxoczdyln - iygunjrsak) View more	-	07 Jul 2011
ASCO2010	Phase 1	Solid tumor	26	PR104	xzmkfrdrjp(priazqxgol) = byfieibryk yswemodzja (phnjbxamlc, 0.11)	-	20 May 2010
ASCO2008	Phase 1	Solid tumor	-	PR-104	cstxzzqwhu(zysxkmpatd) = vfthnpuzxb lsennulpeq (ibledybexf )	-	20 May 2008
ASCO2008	Phase 1	Solid tumor	13	PR-104	npkqmwshir(vhclhaxafs) = ytiboescoz igrgejgadl (khxvedvnbt )	-	20 May 2008
ASCO2008	Phase 1	Advanced cancer	23	PR-104 + Gemcitabine	wipowdhxdn(bwcnsekjah) = iwchrstbsn zkvvxtjnja (kgacryutut )	-	20 May 2008