Interleukin-1 receptor associated kinases (IRAKs) are serine/threonine protein kinases belonging to tyrosine-like kinase (TLK) family. The IRAK family consists of IRAK1, IRAK2, IRAK3 and IRAK4 out of which only IRAK1 and IRAK4 exhibit kinase activity. IRAKs function as mediators of Toll-like receptor (TLR) and interleukin-1 receptor (IL-1R) signaling pathways and play an important role in innate immune signaling. Recent studies have reported the occurrence of oncogenic mutations in MYD88 in 30% of activated B cell diffuse large B-cell lymphoma (ABC DLBCL) and 90% of Waldenstrom's macroglobulinemia (WM) leading to constitutive activation of the IRAK4 and NFkB pathway. Recent studies have also highlighted the association of dysregulated innate immune signaling with Myelodysplastic syndrome (MDS) and Acute Myeloid leukaemia (AML). TLRs and their associated signal transducers are frequently overexpressed and/or constitutively activated in MDS. Overexpression and activation of IRAK1 is observed in AML. Thus IRAKs are attractive therapeutic targets for treatment of tumors with altered innate immune signaling such as ABC DLBCL and AML.

We have designed, synthesized and tested small molecule inhibitors of IRAK4 based on hits originating from Aurigene's compound library. We have identified a series of novel bicyclic heterocycles as potent inhibitors of IRAK-4 with moderate to very high selectivity (S35 score = 0.03) in a 329 kinase panel. Lead compounds were profiled in proliferation and mechanistic assays (p-IRAK1 and p-TAK1 inhibition) in appropriate ABC DLBCL/AML cell lines. Aurigene lead compounds demonstrate potent inhibition of cellular proliferation with a good correlation to inhibition of phosphorylation of signaling intermediates in mechanistic assays. Lead compounds exhibit excellent PK profile and good oral bioavailability in mice. Preliminary in-vitro toxicology studies indicate a clean safety profile. Selected compounds demonstrate excellent in-vivo efficacy in relevant tumor models with >90% tumor growth inhibition and good in-vivo PD modulation. In summary, a series of potent and selective IRAK4 inhibitors have been discovered and are being evaluated for treatment of cancers with dysregulated innate immune signaling.

Citation Format: Venkateshwar Rao, Wesley Roy Balasubramanian, Kavitha Nellore, Sivapriya Marappan, Aravind Basavaraju, Bharathi Raja Ainan, Girish Daginakatte, Sreevalsam Gopinath, Sanjeev Giri, Thomas Antony, Shekar Chelur, Susanta Samajdar, Chetan Pandit, Murali Ramachandra. Efficacy of novel IRAK4 inhibitors in ABC-DLBCL and AML models. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2015 Nov 5-9; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2015;14(12 Suppl 2):Abstract nr C191.