Current Topics in Medicinal Chemistry - Volume 5, Issue 2, 2005

Cancer continues to be the second leading cause of death in developed countries despite monumental basic research and clinical efforts waged by both government and industry. Although it is clear that we are continuing to refine our understanding of mechanisms for malignant transformation, growth, and resistance of cancers, so it is also evident that we have a significantly difficult path ahead. Multiple, inter-related and redundant survival signaling pathways have been recently uncovered that convey resistance against initiallyefficacious antiproliferative agents. Fittingly, these pathways have themselves become targets for intervention and the pace of innovation and discovery toward that end has been impressive. This issue contains a collection of reviews that describe state-of -the art cancer biology and medicinal chemistry toward novel and exciting malignant disease targets. The authors have included the background biology needed to understand the target rationale and then have moved on to the lead discovery, drug optimization, and clinical results stages as appropriate. The reader will note that the papers cover antiproliferative agents that target a wide range of approaches including interruption of the p53/MDM2 interation, interference with the mitotic kinesin KSP, and the development of selective agents targeting aurora kinases, cyclin-dependent kinases, Akt, MEK, the Hedgehog signaling pathway, and pololike kinases. The breadth of this work is as impressive as the challenge itself. My hope is that this Issue will serve as an source of information and inspiration for those who would think about designing, preparing, and studying new antiproliferative therapeutics. I would like to thank each of the authors for their contributions, acknowledge their hard work and dedication as Contributors, and express hope that the efforts that they now lead will make a difference to cancer patients. Finally, I would like to dedicate my efforts in this endeavor to my mentor and graduate advisor Professor Paul G. Gassman who has had a life-long positive impact on my goals in science.

This article describes recent advances in the development and biological evaluation of small molecule inhibitors for the serine/threonine kinase Akt (PKB). Akt plays a pivotal role in cell survival and proliferation through a number of downstream effectors. Recent studies indicate that unregulated activation of the PI3K/Akt pathway is a prominent feature of many human cancers and Akt is over-expressed or activated in all major cancers. Akt is considered an attractive target for chemotherapy and it has been postulated that inhibition of Akt alone or in combination with standard cancer chemotherapeutics will reduce the apoptotic threshold and preferentially kill cancer cells. The development of specific and potent inhibitors will allow this hypothesis to be tested in animals. The majority of small molecule inhibitors in this nascent field are classic ATP-competitive inhibitors which provide little specificity. Phosphatidylinositol (PI) analogs have been reported to inhibit Akt, but these inhibitors may also have specificity problems with respect to other PH domain containing proteins and may have poor bioavailability. None of the inhibitors in these classes have been reported to have Akt isozyme specificity. Recently, novel allosteric inhibitors have been reported which are pleckstrin homology domain dependent and exhibit Akt isozyme selectivity. Inhibitors in this class may have sufficient potency and specificity to test for tumor efficacy in animal models and recently reported preliminary experiments are reviewed.

Kinesins, mechanochemical enzymes that utilize the energy of ATP to translocate along or destabilize microtubules, are essential for accurate completion of cell division. Recently, small moleculer inhibitors of one kinesin, kinesin spindle protein (KSP/Eg5/kinesin5), have been shown to be efficacious in pre-clinical studies, with one quinazolinone-based inhibitor advancing to Phase II clinical trials as a potential anticancer chemotherapeutic agent. This highlights the potential of KSP and other mitotic kinesins as targets for chemotherapeutic intervention. Ten other kinesins have been shown to play essential roles in cell division and thus may provide additional therapeutic opportunities. In this review, the biological roles of these proteins are described with emphasis on their importance to cell proliferation. In addition, kinesin motor domain structure and mechanism are described with particular attention given to the conformational changes that offer opportunities for chemical inhibition. Finally, a current list of KSP inhibitor classes is described in the context of their potential as clinical leads.

The Hedgehog (Hh) signaling pathway directs the development of multiple tissues during embryonic development, and contributes to tissue homeostasis in adults. Deficient Hh signaling results in defective embryogenesis; conversely, excessive Hh signaling is associated with an inherited cancer predisposition syndrome (Gorlin Syndrome), and a growing list of sporadic human cancers. It is now clear that multiple components of “The Hh Pathway” can be altered in tumors. The Hhs are morphogens that signal through effectors that are largely unprecedented in drug discovery, with many key concepts derived from studies in Drosophila melanogaster. However, studies in tumor cell lines have recently identified targets that can be exploited for the discovery of human Hh antagonists, with additional targets likely to emerge as the human pathway is further defined. Here, we review basic aspects of Hh signal transduction, with an emphasis on molecular targets for drug discovery. The use of first-generation Hh antagonists such as cyclopamine will also be discussed; such agents remain invaluable in ongoing efforts to validate drug discovery assays and survey tumor lines for Hh dependence. The various types and frequencies of Hh signaling defects in different human tumors will also be reviewed, as will the status of medicinal chemistry efforts to discover novel Hh antagonists. In section VI, we review assays from the literature that could be utilized to discover new Hh antagonists for the treatment of cancer.

The discovery of the key negative regulator MDM2 (mouse double minute 2, also termed HDM2 for its human equivalent) provided a great opportunity to manipulate the levels of the tumor suppressor p53 in cancer cells. Activation of p53 in tumor cells by inhibiting the interaction of MDM2 with p53 has therefore been the focus of a large effort in drug discovery. The modulation of protein-protein interactions, however, has historically been very difficult to achieve owing to the large surface area of interaction. In this article, we review the recent accomplishments in this area and our quest for a clinically viable MDM2 inhibitor.

Loss of normal cell cycle regulation is the hallmark of human cancers, and alteration of the components involved in cell cycle regulation occurs in most human tumors. This suggests that Cyclin dependent kinases (CDKs) are an attractive target for the development of pharmacological agents for the treatment of cancer. Recently, CDK family members that are not directly involved in cell cycle regulation have been identified. This includes CDK7, CDK8, and CDK9, which participate in transcription regulation, and CDK5, which plays a role in neuronal and secretory functions. Given the involvement of CDKs in multiple cellular processes, development of selective small molecule inhibitors for specific CDKs is expected to help clarify whether improved specificity of cell cycle CDK inhibitors will enhance their therapeutic potential in cancer treatment. Selective inhibitors are also needed as tools to explore the biology of diseases in which CDKs may participate and to help develop therapeutics to treat them. Intensive screening and drug design based on CDK/inhibitor co-crystal structure and SAR studies have led to the identification of a large variety of chemical inhibitors of CDKs. Although they are competitive with ATP at the catalytic site, their kinase selectivity varies greatly, and inhibitors selective for certain CDKs have begun to be identified. There are currently two categories of selective CDK inhibitors: those that are selective for CDK2 and CDK1 and those that are selective for CDK4/6. These two types of inhibitors have different effects on tumor cells and are expected to be useful in the treatment of cancer.

Polo-like kinases (PLKs) are key enzymes that control mitotic entry of proliferating cells and regulate many aspects of mitosis necessary for successful cytokinesis. Of the four known human PLKs, PLK1 is the best characterized and is overexpressed in many tumour types with aberrant elevation frequently constituting a prognostic indicator of poor disease outcome. Despite the fact that PLK1 has been regarded as a validated mitotic cancer target for a number of years, very few reports of small-molecule PLK inhibitors have appeared to date. In order to provide a starting point for the discovery and development of selective PLK inhibitors, we have characterized a number of known generic kinase inhibitors with hitherto unknown activity against PLK1, as well as discovering novel inhibitors through structure-guided design. Previously, the only characterized biochemical PLK1 inhibitor was scytonemin, a symmetric indolic marine natural product that is a micromolar non-specific ATP competitor. In addition to the progress in the development of ATPcompetitive small-molecule PLK inhibitors, recent reports on the use of antisense oligonucleotides (ASONs) and small interfering RNAs (siRNAs) directed against PLK1 have shown selective antiproliferative effects on cancer cells both in vitro and in vivo, producing phenotypes consistent with known PLK functions, and confirming that targeting PLKs with conventional small-molecule agents may be a valid and effective anticancer strategy. Here we present a progress update on the approaches taken so far in developing PLK inhibitors.

Errors in the mitotic process are thought to be one of the principal sources of the genetic instability that hallmarks cancer. Unsurprisingly, many of the proteins that regulate mitosis are aberrantly expressed in tumour cells when compared to their normal counterparts. These may represent a good source of targets for the development of novel anticancer agents. The Aurora kinases represent one such family of mitotic regulators. In recent years there has been intense interest in both understanding the role of the Aurora kinases in cell cycle regulation and also in developing small molecule inhibitors as potential novel anti-cancer drugs. With several companies now starting to take Aurora kinase inhibitors into clinical development, the time is right to review the medicinal chemistry contribution to developing the field, in particular to review the increasingly broad range of small molecule inhibitors with activity against this kinase family.

This paper reviews recent progress in the design and evaluation of MEK inhibitors as cancer therapeutics. Activation of the Ras / Raf / MEK / MAP kinase pathway has been implicated in uncontrolled cell proliferation and tumor growth. Mutated, oncogenic forms of Ras are found in 50% of colon, 90% of pancreatic and 30% of lung cancers. Recently, B-Raf mutations have been identified in more than 60% of malignant melanomas and from 40-70% of papillary thyroid cancers. MEK, a dual specificity kinase, is a key player in this pathway; it is downstream of both Ras and Raf and activates ERK1/2 through phosphorylation of key tyrosine and threonine residues. Representative examples of both ATP competitive and non-competitive inhibitors as well as natural product based inhibitors will be discussed.