Immunotherapy Opportunity Emerges for Alzheimer Disease
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RESEARCH HIGHLIGHTS Nature Reviews Drug Discovery | Published online 26 Feb 2016; doi:10.1038/nrd.2016.38 NEURODEGENERATIVE DISEASE Immunotherapy opportunity emerges for Alzheimer disease Although an overactive immune trafficking to the brain, which 1-month interval between sessions, system was thought to be involved promoted clearance of Aβ and reached performance levels com- in the development of Alzheimer improved cognitive function in parable to control mice. Conversely, disease (AD), recent studies have a mouse model of AD. As PD1 when mice that had received a single indicated that boosting the immune checkpoint blockade has been shown session of PD1 blockade were response in the brain might ameliorate to stimulate an IFNγ-dependent examined 2 months later there was disease. Now, writing in Nature immune response in cancer only a marginal improvement in Medicine, Schwartz and colleagues immuno therapy, Schwartz and memory, suggesting that repeated report that immune-checkpoint colleagues set out to explore the treatment sessions are needed to blockade directed against the therapeutic potential of PD1 maintain the beneficial effects. programmed cell death protein 1 blockade in AD. Examination of the brains of (PD1) pathway promotes cerebral To do this, they treated the 5XFAD mice after treatment with amyloid-β (Aβ) clearance and 5 familial AD mutations (5XFAD) the PD1-specific antibody revealed a improves cognitive function in mouse model of AD at 10 months reduction in the cerebral Aβ-plaque mouse models of AD. old (an age at which cerebral pathology load in the hippocampus and in the In a previous study, the authors is advanced) with 2 intraperitoneal cerebral cortex (the main anatomical demonstrated that inhibition of injections of a PD1-specific antibody regions with robust Aβ-plaque forkhead box P3-positive regulatory at 3-day intervals. When analysed pathology), and this was more T cells increased interferon-γ 7 days after the first treatment, pronounced after two sessions of PD1 (IFNγ)-dependent leukocyte the mice exhibited a systemic IFNγ blockade. In addition, astrogliosis immune response. Analysis of was reduced in the hippocampus of the myeloid cell population in the 5XFAD mice treated with either one brains of mice following treatment or two sessions of PD1 blockade. demonstrated IFNγ-dependent Similar beneficial effects of PD1 recruitment of monocyte-derived blockade were observed in a second macrophages (characterized by high mouse AD model (APP/PS1 mice), expression of lymphocyte antigen in which the treatment reduced 6c and expression of the chemokine hippocampal Aβ-plaque load. receptor CCR2, which is associated Taken together, these findings with myeloid cell-mediated identify immune checkpoint blockade neuroprotection in AD) to the brain. as a novel therapeutic strategy for Importantly, these immune AD. Importantly, PD1-specific effects were accompanied by reduced antibodies have been shown to be cognitive deficits (as determined relatively safe and well tolerated by improvements in spatial learning in cancer immunotherapy. and memory in the radial-arm Sarah Crunkhorn water-maze task) 1 month after treatment. Moreover, when tested ORIGINAL ARTICLE Baruch, K. et al. PD-1 2 months after treatment initiation, immune checkpoint blockade reduces pathology 5XFAD mice that received 2 sessions and improves memory in mouse models of Alzheimer’s disease. Nat. Med. 22, 135–137 (2016) Brain light/Alamy Stock Photo Brain of the anti-PD1 therapy, with a NATURE REVIEWS | DRUG DISCOVERY www.nature.com/nrd ©2016 Mac millan Publishers Li mited. All ri ghts reserved. RESEARCH HIGHLIGHTS Nature Reviews Neurology | Published online 29 Jan 2016; doi:10.1038/nrneurol.2016.8 ALZHEIMER DISEASE Cancer immunotherapy drug reduces symptoms of Alzheimer disease in mice Immune checkpoint blockade, a insufficient macrophage recruitment similar to that seen in patients strategy used to treat certain cancers, to the CNS. “Anti-inflammatory and with AD. PD1 blockade evoked an The treatment might represent a novel therapeutic immunosuppressive strategies have IFN‑γ‑dependent systemic immune not only strategy against Alzheimer disease failed in the clinical trials,” explains response, which promoted clearance arrested (AD), according to a recent mouse Schwartz. “To drive an immune- of existing amyloid-β deposits, study published in Nature Medicine. dependent cascade needed for brain reduced neuroinflammation and disease The cancer immunotherapy drug, repair, systemic immunity should be gliosis, and improved memory progression, administered to AD model mice, boosted, rather than suppressed.” performance. but partially evoked an immune response that The researchers assessed the effect In 12‑month-old 5xFAD mice reduced amyloid plaque burden and of an antibody against programmed that received two PD1 blockade reversed it reversed cognitive impairment. cell death protein 1 (PD1; a molecule treatments, spaced 1 month apart, AD is accompanied by chronic that restrains immune activation) on spatial navigation performance was neuroinflammation. Michal pathological and cognitive correlates comparable to that of wild-type mice. Schwartz and colleagues from the of AD in 5xFAD and APP/PS1 mice. “The repeated treatment not only Weizmann Institute of Science, These mice are widely used AD arrested disease progression, but Rehovot, Israel, had previously put models that carry several mutations partially reversed it,” Schwartz says. forward the hypothesis that neuro associated with familial AD and PD1 blockers have been inflammation in AD is linked to develop cerebral amyloid pathology approved by the FDA for the treatment of metastatic melanoma Untreated Two anti-PD1 treatments and non-small-cell lung cancer, and are currently being investigated for the treatment of glioblastoma. “We believe this approach can be trans lated to clinical studies in Alzheimer disease in a relatively short time,” Schwartz contends. Hemi Malkki ORIGINAL ARTICLE Baruch, K. PD‑1 immune checkpoint blockade reduces pathology and improves memory in mouse models of Alzheimer’s disease. Nat. Med. http://dx.doi.org/10.1038/ PD1 blockade reduces Aβ deposition (red) and GFAP expression (marker of gliosis; green) in the nm.4022 hippocampus of 5xFAD mice. Scale bar 50 μm. Adapted with permission from Macmillan Publishers Ltd. Nature Reviews | Neurology NATURE REVIEWS | NEUROLOGY www.nature.com/nrneurol © 2016 Macmillan Publishers Limited. All rights reserved BIOWORLDTM TODAY THE DAILY BIOPHARMACEUTICAL NEWS SOURCE JANUARY 22 , 2016 BIOTECH’S MOST RESPECTED NEWS SOURCE FOR MORE THAN 20 YEARS VOLUME 27, NO. 14 ‘FORWARD’ MARCH? Abingworth closes Alkermes jolted by dual phase III misses $105M fund for clinical co-development work in ALKS 5461 depression program By Cormac Sheridan, Staff Writer By Michael Fitzhugh, Staff Writer DUBLIN – Abingworth has raised $105 Missed efficacy endpoints in two phase III trials ofAlkermes plc’s lead candidate, million for its first dedicated clinical co- the once-daily depression medicine ALKS 5461, dragged company shares development fund, which will extend (NASDAQ:ALKS) down by 44.2 percent, or $26.71, to close at $33.71 on Thursday, as its focus on putting up cash to help big analysts deeply discounted the drug’s chances of success, cutting millions of dollars pharma progress its pipeline without of projected revenue from the company’s future earnings. damaging its all-important P&L line. Alkermes, which is pushing ahead with the program, said that in response it will The London-based venture capital increase trial enrollment and update its statistical analysis plan for a third late-stage firm has already been doing that for See Alkermes, page 3 See Abingworth, page 4 IN THE CLINIC FINANCINGS THE BIOWORLD BIOME KEEN ON FUSION PROTEINS Vasopharm gets $22M KEYTRUDA: KEY TO NEURODEGENERATION? Staging area: Philogen bid for phase III traumatic PD-1 blockers improve targets earlier melanoma, brain injury trial cognition in Alzheimer’s phase III injecting lesions By Cormac Sheridan, Staff Writer mice, study shows By Randy Osborne, Staff Writer DUBLIN – Vasopharm GmbH raised By Anette Breindl, Senior Science Editor Philogen SpA’s “idea is to stop €20 million (US$21.7 million) in a new Treating mouse models of Alzheimer’s [melanoma] when you have metastases, funding round to take its lead molecule, disease with an antibody that blocks PD- but only at the skin,” co-founder Dario VAS203, into a European phase III 1, the same molecule targeted by Merck Neri told BioWorld Today, as his firm registration trial in traumatic brain injury & Co Inc.’s Keytruda (pembrolizumab), helped them clear amyloid plaque and See Philogen, page 5 See Vasopharm, page 6 improved their cognitive performance, scientists from the Israeli Weizmann IN THIS ISSUE REGULATORY Institute of Science reported in the Jan. 18, 2016, issue of Nature Medicine. Oversight committee The approach is counterintuitive. Financings, p. 2 may offer Shkreli Inflammation is a feature of Alzheimer’s Other news to note, p. 2, 4-6 immunity for testimony as well as many other neurodegenerative Regulatory front, p. 7, 9 disorders, and insofar as immunity has By Mari Serebrov, Regulatory Editor been a target in Alzheimer’s disease, the Appointments & advancements, p. 7-10 goal has been to reduce it, not increase it. A congressional committee is trying In the clinic, p. 9-11 to force indicted pharma exec Martin Inflammation-reducing approaches, Shkreli to appear at a hearing next week though, like many other things,