Q2 · MEDICINE
Article
Author: Pu, Yu-Ming ; Tao, Zhi-Fu ; Phillips, Darren C. ; Sanzgiri, Yeshwant D. ; Menon, Rajeev M. ; Marks, Richard A. ; Edalji, Rohinton ; Klix, Russell C. ; Rosenberg, Saul H. ; Ku, Yi-Yin ; Ji, Jianguo ; Hong, Richard ; Salem, Ahmed Hamed ; Suleiman, Ahmed A. ; Park, Chang H. ; Elmore, Steven W. ; Shi, Yi ; Marsh, Kennan C. ; Bueno, Orlando F. ; Leverson, Joel D. ; Judge, Russell A. ; Jenkins, Gary J. ; Kalvass, John C. ; Wang, Xilu ; Chen, Jie ; Stolarik, Deanne ; Zhang, Geoff G.Z. ; Chen, Shuang ; Harper, Kaid C. ; Sheikh, Ahmad Y. ; Fournier, Keith M. ; Souers, Andrew J. ; Catron, Nathaniel D.
Abstract:Since gaining approval for the treatment of chronic lymphocytic leukemia (CLL), the BCL-2 inhibitor venetoclax has transformed the treatment of this and other blood-related cancers. Reflecting the large and hydrophobic BH3-binding groove within BCL-2, venetoclax has significantly higher molecular weight and lipophilicity than most orally administered drugs, along with negligible water solubility. Although a technology-enabled formulation successfully achieves oral absorption in humans, venetoclax tablets have limited drug loading and therefore can present a substantial pill burden for patients in high-dose indications. We therefore generated a phosphate prodrug (3, ABBV-167) that confers significantly increased water solubility to venetoclax and, upon oral administration to healthy volunteers either as a solution or high drug-load immediate release tablet, extensively converts to the parent drug. Additionally, ABBV-167 demonstrated a lower food effect with respect to venetoclax tablets. These data indicate that beyond-rule-of-5 molecules can be successfully delivered to humans via a solubility-enhancing prodrug moiety to afford robust exposures of the parent drug following oral dosing.