A Review of RRx-001: A Late-Stage Multi-Indication Inhibitor of NLRP3 Activation and Chronic Inflammation.


Journal

Drugs
ISSN: 1179-1950
Titre abrégé: Drugs
Pays: New Zealand
ID NLM: 7600076

Informations de publication

Date de publication:
Apr 2023
Historique:
accepted: 22 01 2023
medline: 29 3 2023
pubmed: 16 3 2023
entrez: 15 3 2023
Statut: ppublish

Résumé

Chronic unresolving inflammation is emerging as a key underlying pathological feature of many if not most diseases ranging from autoimmune conditions to cardiometabolic and neurological disorders. Dysregulated immune and inflammasome activation is thought to be the central driver of unresolving inflammation, which in some ways provides a unified theory of disease pathology and progression. Inflammasomes are a group of large cytosolic protein complexes that, in response to infection- or stress-associated stimuli, oligomerize and assemble to generate a platform for driving inflammation. This occurs through proteolytic activation of caspase-1-mediated inflammatory responses, including cleavage and secretion of the proinflammatory cytokines interleukin (IL)-1β and IL-18, and initiation of pyroptosis, an inflammatory form of cell death. Several inflammasomes have been characterized. The most well-studied is the nucleotide-binding domain (NOD)-like receptor protein 3 (NLRP3) inflammasome, so named because the NLRP3 protein in the complex, which is primarily present in immune and inflammatory cells following activation by inflammatory stimuli, belongs to the family of nucleotide-binding and oligomerization domain (Nod) receptor proteins. Several NLRP3 inflammasome inhibitors are in development, all with multi-indication activity. This review discusses the current status, known mechanisms of action, and disease-modifying therapeutic potential of RRx-001, a direct NLRP3 inflammasome inhibitor under investigation in several late-stage anticancer clinical trials, including a phase 3 trial for the treatment of third-line and beyond small cell lung cancer (SCLC), an indication with no treatment, in which RRx-001 is combined with reintroduced chemotherapy from the first line, carboplatin/cisplatin and etoposide (ClinicalTrials.gov Identifier: NCT03699956). Studies from multiple independent groups have now confirmed that RRx-001 is safe and well tolerated in humans. Additionally, emerging evidence in preclinical animal models suggests that RRx-001 could be effective in a wide range of diseases where immune and inflammasome activation drives disease pathology.

Identifiants

pubmed: 36920652
doi: 10.1007/s40265-023-01838-z
pii: 10.1007/s40265-023-01838-z
pmc: PMC10015535
doi:

Substances chimiques

Inflammasomes 0
NLR Family, Pyrin Domain-Containing 3 Protein 0
RRx-001 0
Nucleotides 0

Banques de données

ClinicalTrials.gov
['NCT03699956']

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

389-402

Informations de copyright

© 2023. The Author(s).

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Auteurs

Nanthini Jayabalan (N)

Faculty of Medicine, UQ Centre for Clinical Research (UQCCR), The University of Queensland, Brisbane, 4029, Australia.

Bryan Oronsky (B)

EpicentRx, Torrey Pines, CA, 92307, USA. boronsky@epicentrx.com.

Pedro Cabrales (P)

UCSD Department of Bioengineering, La Jolla, CA, 92093, USA.

Tony Reid (T)

EpicentRx, Torrey Pines, CA, 92307, USA.

Scott Caroen (S)

EpicentRx, Torrey Pines, CA, 92307, USA.

Aishwarya M Johnson (AM)

Department of Veterinary Medicine College of Food and Agriculture, Emirates University, Al Ain, UAE.

Natalia A Birch (NA)

Faculty of Medicine, UQ Centre for Clinical Research (UQCCR), The University of Queensland, Brisbane, 4029, Australia.

John D O'Sullivan (JD)

Faculty of Medicine, UQ Centre for Clinical Research (UQCCR), The University of Queensland, Brisbane, 4029, Australia.

Richard Gordon (R)

Faculty of Medicine, UQ Centre for Clinical Research (UQCCR), The University of Queensland, Brisbane, 4029, Australia. r.gordon1@uq.edu.au.
Centre for Microbiome Research, School of Biomedical Science, Translational Research Institute, Queensland University of Technology, Brisbane, 4102, Australia. r.gordon1@uq.edu.au.

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