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Samenvatting - From target to therapy (MED-BMS43)

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All notes of the lectures of the course from target to therapy.

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April 8, 2025
Number of pages
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Written in
2024/2025
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LE Intro

The pharmaceutical R&D phases
 Research (discovery and optimization)
 Development (human phases and registration)
 Marketing (production and market)

Forward translation = from inhibitor to clinic
Reverse translation = learning from the clinical and then reposition the
drug, back to basic research

Biomarkers = characteristics that is objectively measured and evaluated
as an indicator of normal biological processes, pathogenic processes, or
pharmacologic responses to a therapeutic intervention
 Molecular biomarkers can provide a molecular impression of a
biological system (cell, animal, human)
 Biomarkers can be various analytes

Rational selection: 5Rs assessment
 Right- target, -tissue, -safety, -patients and -commercial potential

Need for P-medicines = personalized medicines
 Insufficient efficacy as the most frequent reason
 Safety issues

Subapproaches of P-Medicine
 Using biomarkers and molecular profiling for P medicine
 Pharmacogenetics
 Patient selection is key

Drug development:
1. Target discovery (identification and validation)
2. Lead discovery (hit 2 lead)
3. Lead optimization
4. Human studies

2 routes
 You know the target
o Target identification
o Target discovery
o Target validation
o Lead discovery
 You have a drug and a desired effect (you do not know target, earlier
days)
o Target deconvolution
o Lead discovery (function of phonotypic based screening)

Hit-2-lead (target validation)
 The end of the target validation phase

, o Fragment library screening
o Compound library screening
o Epitope mapping - antibody/protein library screening

Lead finding
 Beginning of the pharmaceutical development
o Start with a hit, scaffold
o First exploration on
 Biochemical
 Toxicity
 Solubitlity and absorption
 Feasibility (chemical/biochemical)
o Need for biomarkers and screening assays
 Ends with 2 to 3 leads which can be explored and optimized

Lead optimization
 Iterative process
o Optimalization of
 Biochemical properties
 Cellular efficacy
 Physico-chemical optimalization
 Metabolism and toxicity (ADME absorption distribution
metabolism excretion)
 In vivo efficacy in disease models

Clinical candidate
 Are models translational to humans
 Very important = scalability (from mouse to human, mg > kg, is that
feasible)

Pharmacokinetics = what the body does to the drug
 ADME
Pharmacodynamics = what drug does to the body

Drug resistance and regrowth tumor (side screening to avoid these
problems)
Reasons:
 Molecular heterogeneity in diseased tissue
o Escaping cell regrow, or metastasize
 Cells adapt by
o Amplification
o Activation escape pathways


LE Genetic therapies
Target identification
4 steps of diagnosis: from mechanism to therapy
1. A detailed clinical characterisation (single/multi-organ)
 Clinical read out (diagnosis)
 Syndromic (multiple tissues are affected) vs non-syndromic
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