Merck’s efforts have to be considered to be the strongest in RNAi Therapeutics among Big Pharma. Its RNAi Therapeutics strategy so far, however, has consisted largely of
trying to replicate the most promising technologies in-house.
The latest
publication by Merck RNAi scientists on the expression pattern of the
asialoglycoprotein receptor (ASGPR1;
Shi et al. 2013) confirms this as ASGPR is
the target receptor of the two most advanced SNALP alternatives for gene
silencing in the liver: the trail-blazing DPCs by Arrowhead Research (first use of GalNAc-targeted RNAi Therapeutics in
Rozema et al.2007) and more recently the GalNAc-targeted siRNA conjugates by Alnylam (what these really seem
to be will be covered in an upcoming blog...so stay tuned!).
Surveying ASGPR expression levels
When developing ligand-targeted therapeutics, it is important
that the corresponding receptor is present on the target cell population. Especially when targeting cancer, it can be
difficult to find receptors that are not only present in large quantities, but
also throughout the cell population.
In
the case of liver cancer (hepatocellular carcinoma/HCC), this question has occupied the RNAi field ever since the finding that SNALPs work really well for
knockdown in normal liver due to uptake mediated by the LDL-receptor. But is this mechanism also present on cells in liver cancer, a cancer of high unmet need where RNAi Therapeutics could have the biggest impact in oncology near- to midterm?
The Merck scientists set out to answer essentially the same
question, but instead of interrogating LDL-receptor expression, they wanted to
know about ASGPR expression on HCC cells.
Using tissue microarrays, they were able to test an impressively large
set of 100s of tissues, including healthy human livers, liver cancer biopsies,
and biopsies for other hepatic diseases such as viral hepatitis, chronic active
hepatitis and cirrhosis.
Despite some apparent limitations with the tissue microarrays (e.g. normal
liver samples were often marked as false negatives despite the known very high ASGPR expression
level), the results seem to confirm that liver cancers in general have a
tendency towards lower ASGPR expression and that inter-sample heterogeneity is comparatively large (some liver cancer samples had much more ASGPR expression than normal
liver).
This suggests that just as in
the case in breast cancer where treatment decisions are often based
on receptor expression levels, ASGPR-targeted liver cancer RNAi Therapeutics
should also be combined with a companion diagnostics for ASGPR.
For those curious about the status of ASGPR expression in chronic HBV since Arrowhead’s exciting ARC520 program for this indication involves a GalNAc-targeted melittin-like peptide, relax: livers infected with HBV express ASGPR just as well as normal livers.
Home-brew versus licensing
Based on the literature and conference presentations, it is reasonable to assume that Merck is well behind
Arrowhead, and even Alnylam in developing GalNAc-targeted RNAi Therapeutics. This begs the question, as it has in the
case of SNALP, why does Merck not take a license or even acquire the original?
Of course, it always takes two for a deal, but given the
financial capabilities of a Merck, if it wanted access, it could get
it.
The likely explanation is that Merck's strategy in replicating technologies in-house is to first identify target technologies by validating them and then to develop viable IP workaround solutions. In fact, in the apparent absence of a broad gate-keeping patent estate around GalNAc-targeted therapeutics, ASGPR has been a recognized drug target receptors well back into the 90's, there should be relatively little restrictions on the use of GalNAc per se.
Instead, a competitive advantage is largely gained through specific know-how like how to best link the GalNAc ligand to the oligonucleotide payload and synthesize the molecules cost effectively. The latter issue came to my attention recently when access to '
proprietary process for manufacturing GalNAc conjugates' from Alnylam
was mentioned as the top corporate highlight in the quarterly update provided by Regulus Therapeutics.
For the aficionados, the triantennary GalNAcs as practiced by Alnylam are much more costly to synthesize than single GalNAcs as in the case of the liver-targeted DPC versions (where high affinity through multivalency is achieved by having multiple single GalNAcs along the DPC).
This situation is not unlike other areas in the drug development
industry. Take for example antibodies
where, despite the various patent battles, there have been a number of commercially
viable platforms based on specific libraries or optimization methods. Nevertheless, despite this apparent
freedom-to-operate, the way by which Big Pharma ended up gaining access to
monoclonal antibodies was not by way of successfully developing them in-house,
but by acquiring them.
I don't expect this to be any different in RNAi Therapeutics.
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