Abstract Details

Title Safety, Target Engagement and Effects of Bosutinib in Dementia with Lewy Bodies

Topic Aging and Dementia

Presentation(s) S20 - Aging and Dementia 2 (2:48 PM-3:00 PM)

Poster/Presentation
Number 010

Background

The effects of bosutinib, a dual Abelson (Abl)/Src inhibitor, were investigated in Dementia with Lewy Bodies (DLB). Bosutinib (Bosulif, Pfizer) is FDA approved at 500mg oral daily dose for leukemia. We investigated bosutinib, 100mg, which is equivalent to the lowest effective intraperitoneal daily dose (5mg/kg) in pre-clinical studies. Bosutinib was investigated in several models of neurodegeneration and it was shown to facilitate clearance of alpha-synuclein and other neurotoxic proteins via autophagy, protect dopaminergic neurons and improve motor and cognitive behavior in animals.

Objective

To investigate the safety, biomarkers effects and determine the lowest effective dose of Bosutinib in Dementia with Lewy Bodies (DLB)

Design/Methods

A single center, Phase 2, randomized, double-blind, placebo-controlled study primarily investigated the safety and pharmacokinetics of 12-week oral treatment of bosutinib,100mg. Biomarkers and clinical outcomes were exploratory.

Results

Approximately 120 subjects were approached, 39 were screened, 13 did not meet inclusion criteria and 26 were randomized and included male and female (12:1) in bosutinib and male (13) in placebo with average age 72.94±8.8 (year±SD). There was no serious adverse events (SAEs) and no difference in AEs and no dropouts. Bosutinib, 100mg, was detected in the cerebrospinal fluid (CSF) and inhibited both Abl and Src in plasma. Bosutinib significantly reduced CSF alpha-synuclein (p=0.023) and the ratio of oligomeric/total alpha-synuclein (p=0.045) compared to placebo. There was also significant decrease in plasma oligomeric alpha-synuclein (p=0.04) and ptau181/Aβ42 (p=0.03). Bosutinib significantly (p=0.034) improved activities of daily living (ADCS-ADL-MCI) compared to placebo.

Conclusions

Bosutinib is safe and enters the brain. Bosutinib, 100mg, inhibited Abl/Src indicting dual target engagement, reduced brain alpha-synuclein and improved activities of daily living, suggesting that this is lowest effective dose (100mg) in DLB. This study is underpowered (by design) but the data will guide adequately powered future studies of a higher dose range of bosutinib over longer time in DLB.

Authors/Disclosures
Fernando L. Pagan, MD, FAAN (Georgetown University Hospital Dept of Neurology) PRESENTER	Dr. Pagan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Acorda. Dr. Pagan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Adamas. Dr. Pagan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Amneal. Dr. Pagan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merz. Dr. Pagan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Kyowa Kirin. Dr. Pagan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sunovion. Dr. Pagan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Teva. Dr. Pagan has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for US World Meds. Dr. Pagan has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Supernus. Dr. Pagan has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Dr. Pagan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Acorda. Dr. Pagan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Adamas. Dr. Pagan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Amneal. Dr. Pagan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sunovion. Dr. Pagan has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Teva. Dr. Pagan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Neurocrine. Dr. Pagan has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Sunovion. Dr. Pagan has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Supernus. Dr. Pagan has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Clinical Parkinsonism and related Disorders. Dr. Pagan has stock in Keiferx. The institution of Dr. Pagan has received research support from US World Meds. The institution of Dr. Pagan has received research support from Novartis.
Yasar A. Torres-Yaghi, MD	Dr. Torres-Yaghi has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Acorda. Dr. Torres-Yaghi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Abbvie. Dr. Torres-Yaghi has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Amneal. Dr. Torres-Yaghi has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Abbott. Dr. Torres-Yaghi has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Kyowa Kirin. Dr. Torres-Yaghi has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Teva. Dr. Torres-Yaghi has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Sunovion .
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Charbel E. Moussa, PhD, MB (Georgetown University)	Dr. Moussa has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for KeifeRX LLC. Dr. Moussa has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sun Pharmaceuticals Research Industry. Dr. Moussa has received stock or an ownership interest from Orphan Therapeutics. The institution of Dr. Moussa has received research support from NIA. The institution of Dr. Moussa has received research support from Sun Pharmaceuticals Research Industry. The institution of Dr. Moussa has received research support from Alzheimer's Association . Dr. Moussa has received intellectual property interests from a discovery or technology relating to health care. Dr. Moussa has received intellectual property interests from a discovery or technology relating to health care. Dr. Moussa has received publishing royalties from a publication relating to health care. Dr. Moussa has received personal compensation in the range of $500-$4,999 for serving as a Grant reviewer with DG Information Technology. Dr. Moussa has received personal compensation in the range of $0-$499 for serving as a Peer Reviews with National Institutes of Health.