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20 Years of Medicinal Chemistry ΠAlways Look at the Bright Side

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20 Years of Medicinal Chemistry ÂŒ Always Look at the Bright Side SCS LaureateS and awardS & FaLL Meeting 2020 CHIMIA 2020, 74, No. 7/8 549 doi:10.2533/chimia.2020.549 Chimia 74 (2020) 549–560 © C. Boss 20 Years of Medicinal Chemistry – Always Look at the Bright Side (of Life) Christoph Boss* SCS Industrial Science Award 2019 Abstract: This paper summarizes a personal perspective on key learnings from projects the author was involved in over the last 20 years. For example, the discovery of macitentan, the most successful molecule to date from this personal collection, marketed by J&J for the treatment of pulmonary arterial hypertension (PAH).[1] Then the discovery of ACT-462206, a dual orexin receptor antagonist for the treatment of insomnia disorder with a serendipitously short story from the screening hit to the drug[2] followed by the identification of daridorexant, another dual orexin receptor antagonist. Daridorexant successfully passed first pivotal phase 3 clinical trial in April 2020 for the treatment of insomnia disorder[3] (“Good things come to those who wait”). Finally, ACT-451840, an antimalarial drug with a novel mechanism of action, identified in the perfect collaboration between academia and industry. The compound is in phase 2 clinical development.[4] In addition, the importance of the screening compound collection is briefly discussed, as a key asset for drug discovery. The measures Idorsia implemented to obtain valuable hits from high-throughput screening (HTS) campaigns are elaborated.[5] Drug discovery is a multi-disciplinary business with unlimited exciting challenges asking for excessive optimism when tackling them in a playful manner. Keywords: Endothelin receptor antagonist · G-protein-coupled receptor (GPCR) · Insomnia disorder · Malaria · Medicinal chemistry · Orexin receptor antagonist · Screening compound collection Christoph Boss studied chemistry at the ment of insomnia disorder in April 2020. Dr. Boss is co-author or University of Bern and received his PhD co-inventor on approximately 220 scientific papers or published on ‘Synthesis, Structure and Reactivity patent applications. of Cycloalkadiynes’ (Prof. Dr. Reinhard Keese) in 1996. After post-doctoral stud- The Early Days: Identifying the ‘Best’ Endothelin ies at the Scripps Research Institute in the Receptor Antagonists group of Prof. Dr. Julius Rebek, Jr., he In December 1997, Actelion Pharmaceuticals was founded joined the process development group of by Martine and Jean-Paul Clozel, Walter Fischli and Thomas Säurefabrik in Schweizerhall for one year. Widmann, four key players in the field of endothelin (ET) re- He then moved to Actelion Pharmaceuticals search, who discovered several novel endothelin receptor an- Ltd at the beginning of 1999, where he first worked as labora- tagonists inhibiting the signaling of the endothelin A (ETA) and tory head and project leader, then as group leader in medicinal the endothelin B (ETB) receptor. Their early work, performed at chemistry, later on as group leader in chemistry technologies. Hoffmann-LaRoche, described the ET system in physiology as Upon the acquisition of Actelion by Janssen Pharmaceutical, a well as in pathology in detail and pointed out the positive poten- company of Johnson&Johnson, Dr. Boss joined the newly estab- tial of inhibiting the signaling of the ET-receptors in a diverse set lished company Idorsia Pharmaceuticals Ltd as group leader on- of cardiovascular disorders.[6–10] Medicinal chemistry research at cology chemistry in 2017. In July 2019 Dr. Boss was promoted Roche resulted in the identification of orally active small mol- to department head of drug discovery chemistry and became a ecule endothelin receptor antagonists, one of which was bosentan member of the Idorsia leadership team. During his now 21 years (1).[11,12] After Roche decided to stop further clinical develop- with Actelion and Idorsia, he was a member of the team who dis- ment of bosentan (1) in congestive heart failure after Phase II, covered macitentan and aprocitentan. He contributed to the dis- Actelion obtained a license from Roche to continue bosentan’s covery of several renin inhibitors going into clinical trials, to the clinical development beyond congestive heart failure. In parallel, antimalarial ACT-451840 which is in Phase II clinical develop- the founders ofActelion wanted to establish a sustainable research ment and to the CRTH2 antagonist ACT-774312 also in Phase II organization to ensure continuity of new molecules for clinical de- clinical development. His team focused on the discovery of orexin velopment. That was when I got a job offer from Actelion which I receptor antagonists from 2006 onward and identified three clini- happily accepted. I joined a very young company and after having cal candidates, ACT-462206, a DORA, ACT-539313, a SO1RA, set-up the labs and the offices the team of young researchers I was andACT-541468, another DORA which became daridorexant and part of, received as a first task, to identify a novel, dual endothelin successfully finished pivotal Phase 3 clinical trials for the treat- receptor antagonist (ERA) with improved properties compared *Correspondence: Dr. C. Boss, E-mail: [email protected] Idorsia Pharmaceuticals, Ltd., Hegenheimermattweg 91, CH-4123 Allschwil, Switzerland 550 CHIMIA 2020, 74, No. 7/8 SCS LaureateS and awardS & FaLL Meeting 2020 to bosentan (1). The detailed story was recently described by my our multifactorial approach, in which potency, a balanced selec- colleague Martin H. Bolli in this journal.[13] Therefore, I will only tivity profile, and safety were program goals. One of our starting briefly summarize our quest for the best ERA. points was bosentan (1), a pyrimidine-based molecule.[20] In Fig. 1 our medicinal chemistry program from the starting point bosentan The Endothelin System (1) to the discovery of macitentan (10) is summarized.[1,17,21] The endothelium is an organ consisting of a single layer of Over the course of our medicinal chemistry program, we cells that separate the blood vessel wall from the blood stream. modified structure 1, including by adding specifically designed It is of key importance for the maintenance of blood vessel tone new structural features. We worked on the sulfonamide moiety, and therefore, for blood pressure regulation. It also provides a increasing the distance between the phenyl ring and the sulfur by non-adhesive surface to prevent blood clot formation. Endothelial putting a double bond in between. We also removed the t-butyl- cells produce for example endothelin, nitric oxide or prostacy- substituent on the phenyl ring. This resulted in phenylethane sul- clin. While endothelin has pronounced vasoconstrictive proper- fonamide 2 with activity on both endothelin receptors comparable ties and promotes cell proliferation, prostacyclin and nitric ox- to our starting point 1. Reducing the double bond to a single bond ide result in vasodilation, prevent platelet adhesion and inhibit gave 3, exhibiting similar ETA antagonistic activity but reduced vascular smooth muscle cell proliferation. In healthy situations potency on the ETB receptor. We also attached a pyrimidine ring the actions of endothelin, prostacyclin and nitric oxide are in bal- to the ethylene glycol moiety and obtained 4. This resulted in a ance. In pathological situations an overproduction of endothelin ~3-fold potency gain on both receptors. Switching from an un- combined with low levels of nitric oxide and prostacyclin result in substituted pyrimidine unit to, for example a 5-bromo-pyrimidine vasoconstriction, the promotion of fibrotic processes and vascular moiety (5) delivered highly potent ERAs. These molecules were and cardiac remodeling. The endothelin system consists of three large and rather lipophilic, increasing the probability of poor structurally related peptides, endothelin-1 (ET-1), endothelin-2 DMPK and safety behavior, based on low aqueous solubility, low (ET-2) and endothelin-3 (ET-3) and two G-protein-coupled recep- microsomal metabolic stability or cytochrome inhibition.[22–24] tors (GPCR’s), the ETA and ETB receptors, which are activated We removed the phenyl ring from the sulfonamide part result- by the three peptides.[14,15] The ETA-receptor is most strongly ac- ing in, for example, an almost equipotent butane sulfonamide 6. tivated by ET-1, a 21-amino acid peptide. The ETB receptor is The key step towards the discovery of 10 (macitentan) was the activated with high affinity by all three ET-peptide homologs.[16] replacement of the sulfonamide moiety by the sulfamide moiety, Historically, ETA-selective antagonists and dual ETA/ETB antag- to this date unknown in the field of ERAs. Even though 7 had onists were considered as treatment options for a broad variety of similar molecular weight when compared to 5, the introduction of cardiovascular diseases such as congestive heart failure, chronic the sulfamide functionality introduced surprising and interesting heart failure, acute heart failure, myocardial infarction, cerebral features, such as increased potency on both endothelin receptors, vasospasm, subarachnoid hemorrhage, renal failure, hypertension, in particular the ETB receptor. We removed the pyrimidine ring pulmonary hypertension and prostate cancer. This huge therapeu- attached to the 2-position of the core pyrimidine, which reduced tic potential resulted in significant activities in the pharmaceutical molecular weight and resulted in an only minor loss of potency, industry to obtain small molecule ERAs with diverse selectivity as can be seen with 8. Replacing the 2-methoxyphenoxy unit at- profiles.[17] Our analysis of the situation led to the decision to tar- tached to the 5 position of the core pyrimidine ring, by a directly get dual ETA/ETB receptor antagonists, as these showed higher linked phenyl-ring yielded a relative potency gain (e.g. 9). Further efficacy and better safety in animal models.[18,19] We had then to in detail SAR investigations of the sulfamide functionality and decide in which chemical space we wanted to start working. We further investigation into the the peripheral aromatic systems selected multiple starting points, from which we prepared and finally culminated in 10 (macitentan). During our quest for the tested thousands of ERAs.
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