Discovery of Asciminib (ABL001), an Allosteric Inhibitor of the Tyrosine Kinase Activity of BCR-ABL1

  • J Med Chem. 2018 Sep 27;61(18):8120-8135. doi: 10.1021/acs.jmedchem.8b01040.
Joseph Schoepfer  1 ,  Wolfgang Jahnke  1 ,  Giuliano Berellini ,  Silvia Buonamici ,  Simona Cotesta  1 ,  Sandra W Cowan-Jacob  1 ,  Stephanie Dodd  2 ,  Peter Drueckes  1 ,  Doriano Fabbro ,  Tobias Gabriel  1 ,  Jean-Marc Groell  1 ,  Robert M Grotzfeld  1 ,  A Quamrul Hassan ,  Chrystèle Henry  1 ,  Varsha Iyer ,  Darryl Jones  1 ,  Franco Lombardo ,  Alice Loo  2 ,  Paul W Manley  1 ,  Xavier Pellé  1 ,  Gabriele Rummel  1 ,  Bahaa Salem  1 ,  Markus Warmuth ,  Andrew A Wylie ,  Thomas Zoller  1 ,  Andreas L Marzinzik  1 ,  Pascal Furet  1
Affiliations
  • 1. Novartis Institutes for BioMedical Research, Novartis Campus , CH-4056 Basel , Switzerland.
  • 2. Novartis Institutes for BioMedical Research , 250 Massachusetts Avenue , Cambridge , Massachusetts 02139 , United States.
Abstract

Chronic Myelogenous Leukemia (CML) arises from the constitutive activity of the BCR-ABL1 oncoprotein. Tyrosine kinase inhibitors (TKIs) that target the ATP-binding site have transformed CML into a chronic manageable disease. However, some patients develop drug resistance due to ATP-site mutations impeding drug binding. We describe the discovery of asciminib (ABL001), the first allosteric BCR-ABL1 inhibitor to reach the clinic. Asciminib binds to the myristate pocket of BCR-ABL1 and maintains activity against TKI-resistant ATP-site mutations. Although resistance can emerge due to myristate-site mutations, these are sensitive to ATP-competitive inhibitors so that combinations of asciminib with ATP-competitive TKIs suppress the emergence of resistance. Fragment-based screening using NMR and X-ray yielded ligands for the myristate pocket. An NMR-based conformational assay guided the transformation of these inactive ligands into ABL1 inhibitors. Further structure-based optimization for potency, physicochemical, pharmacokinetic, and drug-like properties, culminated in asciminib, which is currently undergoing clinical studies in CML patients.