In early 2020, severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) infections leading to COVID-19 disease reached a global level leading to the World Health Organization (WHO) declaration of a pandemic. Scientists around the globe rapidly responded to try and discover novel therapeutics and repurpose extant drugs to treat the disease. This work describes the preclinical discovery efforts that led to the invention of PF-07321332 (nirmatrelvir, 14), a potent and orally active inhibitor of the SARS CoV-2 main protease (Mpro) enzyme. At the outset we focused on modifying PF-00835231 (1) discovered in 2004 as a potent inhibitor of the SARS CoV-1 Mpro with poor systemic exposure. Our effort was focused on modifying 1 with the goal of engineering in oral bioavailability by design, while maintaining cellular potency and low metabolic clearance. Modifications of 1 ultimately led to the invention of nirmatrelvir 14, the Mpro inhibitor component in PAXLOVID.

KAT6A, and its paralog KAT6B, are histone lysine acetyltransferases (HAT) that acetylate histone H3K23 and regulate lineage-specific transcriptional programs. KAT6A is amplified/overexpressed in breast cancer and exerts an oncogenic role, thus emerging as a promising therapeutic target. Here, we describe discovery and structure of the first KAT6i to enter the clinic, PF-07248144, a highly potent, selective and orally bioavailable KAT6A/B inhibitor derived from a novel benzisoxazole series. PF-8144 demonstrated dose-dependent anti-tumor activity in ER+HER2- breast cancer in correlation with H3K23Ac inhibition, inducing durable tumor regressions in vivo. PF-8144 anti-tumor activity was observed across a varied spectrum of ER+ breast cancer patient-derived xenograft (PDX) models, including models harboring ESR1 or PIK3CA mutations, and models refractory to endocrine therapy and/or cell cycle inhibitors. Transcriptional and epigenetic profiling studies showed reduced RNA Pol II binding and downregulation of genes involved in estrogen signaling, cell cycle, Myc and stem cell pathways associated with KAT6i response. CRISPR screens were performed to identify regulators of KAT6i response and potential combination partners. PF-8144 combination with endocrine therapy and cell cycle inhibitors showed synergistic anti-tumor activity associated with deeper inhibition of estrogen and cell cycle pathways. In the Ph1 study, PF-07248144 + Fulvestrant demonstrated deep and durable anti-tumor activity with 37.2% ORR and 10.7 months mPFS. Based on the strength of these data, a pivotal Ph3 trial of PF-07248144 + Fulvestrant is planned in HR+HER2- mBC after progression on CDK4/6i + ET. Shikhar Sharma, Paul F. Richardson, Jelena Petrovic, Joan Cao, Xinmeng J. Mu, Chi-Yeh Chung, Sean Uryu, Samantha Greasley, Eric Johnson, Oleg Brodsky, Colin Flaveny, Yong Zhang, Pei-Pei Kung, Scott Sutton, Eric Greenwald, Shinji Yamazaki, Rhys Jones, Karen Maegley, Patrick Bingham, Hieu Lam, Aida Sacaan, Hendrik Falk, Paul A. Stupple, Ylva E. Bozikis, Brendon J. Monahan, Ian P. Street, Thomas A. Paul. PF-07248144 – First-in-class potent, selective KAT6i in ER+HER2− breast cancer [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics; 2025 Oct 22-26; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2025;24(10 Suppl):Abstract nr C029.

The worldwide outbreak of COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic. Alongside vaccines, antiviral therapeutics are an important part of the healthcare response to countering the ongoing threat presented by COVID-19. Here, we report the discovery and characterization of PF-07321332, an orally bioavailable SARS-CoV-2 main protease inhibitor with in vitro pan-human coronavirus antiviral activity and excellent off-target selectivity and in vivo safety profiles. PF-07321332 has demonstrated oral activity in a mouse-adapted SARS-CoV-2 model and has achieved oral plasma concentrations exceeding the in vitro antiviral cell potency in a phase 1 clinical trial in healthy human participants.

By virtue of its role in cellular proliferation, microtubule-associated serine/threonine kinase-like (MASTL) represents a novel target and a first-in-class (FIC) opportunity to provide a new impactful therapeutic agent to oncology patients. Herein, we describe a hit-to-lead optimization effort that resulted in the delivery of two highly selective MASTL inhibitors. Key strategies leveraged to enable this work included structure-based drug design (SBDD), analysis of lipophilic efficiency (LipE) and novel synthesis. The resulting advanced lead compounds enabled a tumor growth inhibition study which was pivotal in assessing the potential value of MASTL as an oncology therapeutic target.

To facilitate the detection and management of potential clinical antiviral resistance, in vitro selection of drug-resistant severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) against the virus Mpro inhibitor nirmatrelvir (Paxlovid active component) was conducted. Six Mpro mutation patterns containing T304I alone or in combination with T21I, L50F, T135I, S144A, or A173V emerged, with A173V+T304I and T21I+S144A+T304I mutations showing >20-fold resistance each. Biochemical analyses indicated inhibition constant shifts aligned to antiviral results, with S144A and A173V each markedly reducing nirmatrelvir inhibition and Mpro activity. SARS-CoV-2 surveillance revealed that in vitro resistance-associated mutations from our studies and those reported in the literature were rarely detected in the Global Initiative on Sharing All Influenza Data database. In the Paxlovid Evaluation of Protease Inhibition for COVID-19 in High-Risk Patients trial, E166V was the only emergent resistance mutation, observed in three Paxlovid-treated patients, none of whom experienced COVID-19-related hospitalization or death.

KAT6A, and its paralog KAT6B, are histone lysine acetyltransferases (HAT) that acetylate histone H3K23 and exert an oncogenic role in several tumor types including breast cancer where KAT6A is frequently amplified/overexpressed. However, pharmacologic targeting of KAT6A to achieve therapeutic benefit has been a challenge. Here we describe identification of a highly potent, selective, and orally bioavailable KAT6A/KAT6B inhibitor CTx-648 (PF-9363), derived from a benzisoxazole series, which demonstrates anti-tumor activity in correlation with H3K23Ac inhibition in KAT6A over-expressing breast cancer. Transcriptional and epigenetic profiling studies show reduced RNA Pol II binding and downregulation of genes involved in estrogen signaling, cell cycle, Myc and stem cell pathways associated with CTx-648 anti-tumor activity in ER-positive (ER+) breast cancer. CTx-648 treatment leads to potent tumor growth inhibition in ER+ breast cancer in vivo models, including models refractory to endocrine therapy, highlighting the potential for targeting KAT6A in ER+ breast cancer.

The COVID-19 pandemic continues to be a public health threat with emerging variants of SARS-CoV-2. Nirmatrelvir (PF-07321332) is a reversible, covalent inhibitor targeting the main protease (Mpro) of SARS-CoV-2 and the active protease inhibitor in PAXLOVID ™ (nirmatrelvir tablets and ritonavir tablets). We evaluated the in vitro catalytic activity and in vitro potency of nirmatrelvir against the main protease (M pro ) of prevalent variants of concern (VOC) or variants of interest (VOI): Alpha (α, B.1.1.7), Beta (β, B.1.351), Delta (δ, B1.617.2), Gamma ( γ , P.1), Lambda (λ, B.1.1.1.37/C37), Omicron (o, B.1.1.529) as well as the original Washington or wildtype strain. These VOC/VOI carry prevalent mutations at varying frequencies in the M pro specifically for: α, β, γ (K90R), λ (G15S) and o (P132H). In vitro biochemical enzymatic assay characterization of the enzyme kinetics of the mutant M pros demonstrate that they are catalytically comparable to wildtype. Nirmatrelvir has similar potency against each mutant M pro including P132H that is observed in the Omicron variant with a Ki of 0.635 nM as compared to a Ki of 0.933nM for wildtype. The molecular basis for these observations were provided by solution-phase structural dynamics and structural determination of nirmatrelvir bound to the o, λ and β Mpro at 1.63 - 2.09 Å resolution. These in vitro data suggest that PAXLOVID has the potential to maintain plasma concentrations of nirmatrelvir many-fold times higher than the amount required to stop the SARS-CoV-2 VOC/VOI, including Omicron, from replicating in cells (1).

Abstract Nomination of new oncology targets has been greatly aided by advances in genetic screening and profiling, but developing potent, selective small molecule inhibitors against these targets remains a resource intensive pursuit. To significantly de-risk this process we applied a chemical biology strategy to model pharmacological inhibition of the MASTL kinase and showed that selective enzymatic inhibition accurately mimicked targeted genetic perturbation. Specifically, we engineered an electrophile-sensitive version of MASTL through a single amino acid substitution, Asp117Cys, within the ATP-binding site hinge region. Only 11 human kinases contain a cysteine handle in this particular hinge position (H10), which drastically limits the scope of off-targets prone to any H10 Cys-selective covalent inhibitors but also demonstrates that an H10 Cys is not incompatible with kinase activity. Furthermore, endogenous H10 Cys kinases include several targets of successful covalent inhibitor development campaigns (e.g. EGFR, JAK3 and BTK). This broad availability of optimized compounds allowed us to quickly screen and identify potent inhibitors of the MASTL Asp117Cys recombinant mutant. MASTL overexpression is observed across a broad spectrum of solid tumors, so to directly examine how its inhibition would impact cancer cell growth, Asp117Cys was created in the endogenous MASTL gene through CRISPR-directed gene editing. Pancreatic cancer cells homozygous for MASTL Asp117Cys showed clear dose-dependent growth inhibition when treated with a T790M mutant-specific EGFR covalent inhibitor (PF-06459988). Moreover, inhibitor treatment induced a visible phenotype of large multi-nucleated cells that phenocopies genetic perturbation of MASTL and aligns with MASTL's functional role regulating mitotic division. These inhibitor induced effects were not observed in unmodified parental cells and affinity purification experiments utilizing an alkyne probe of PF-06459988 confirmed binding specifically in engineered Asp117Cys mutant cells. When these Asp117Cys mutant cells are propagated as mouse xenografts, their in vivo tumor growth rate is indistinguishable from parental, but PF-06459988 treatment selectively induces tumor growth inhibition of mutant cells, thus demonstrating that selective enzymatic inhibition is sufficient to drive anti-tumor effects. Herein our application of an electrophile-sensitive mutant demonstrates how existing, optimized covalent small molecule inhibitors can be repurposed as chemical probes against engineered kinase domains. This engineered system provides a valuable orthogonal benchmark in advance of a drug discovery campaign, reveals target-dependent biology, and is likely to translate to additional kinase targets due to structural conservation within this enzymatic domain. Citation Format: Jon A. Oyer, Ted W. Johnson, Andrew C. Wang, Michael F. Maestre, Ana Flores-Bojorquez, Roksolana Melnychuk, Sergei Timofeevski, Sherry Niessen, Zhenxiong Wang, Jian Li, Wade C. Diehl, Koleen J. Eisele, Nathan V. Lee, Aihua Zou, Carl Davis, Eric C. Greenwald, Jacob DeForest, Martha Ornelas, Bryan Li, Stephanie Scales, Penney L. Khamphavong, Catherine M. Ambler, Yun Huang, Romelia Salomon-Ferrer, Samantha E. Greasley, Ben Bolanos, Neil Grodsky, Lawrence Lum, Todd L. VanArsdale, Indrawan J. McAlpine. Engineering electrophile-sensitive kinase mutants to accelerate oncology target validation [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 330.

Two novel compounds were identified as Naa50 binders/inhibitors using DNA-encoded technology screening. Biophysical and biochemical data as well as cocrystal structures were obtained for both compounds (3a and 4a) to understand their mechanism of action. These data were also used to rationalize the binding affinity differences observed between the two compounds and a MLGP peptide-containing substrate. Cellular target engagement experiments further confirm the Naa50 binding of 4a and demonstrate its selectivity toward related enzymes (Naa10 and Naa60). Additional analogs of inhibitor 4a were also evaluated to study the binding mode observed in the cocrystal structures.

Tropomyosin receptor kinases (TrkA, TrkB, TrkC) are activated by hormones of the neurotrophin family: nerve growth factor (NGF), brain derived neurotrophic factor (BDNF), neurotrophin 3 (NT3), and neurotrophin 4 (NT4). Moreover, the NGF antibody tanezumab has provided clinical proof of concept for inhibition of the TrkA kinase pathway in pain leading to significant interest in the development of small molecule inhibitors of TrkA. However, achieving TrkA subtype selectivity over TrkB and TrkC via a Type I and Type II inhibitor binding mode has proven challenging and Type III or Type IV allosteric inhibitors may present a more promising selectivity design approach. Furthermore, TrkA inhibitors with minimal brain availability are required to deliver an appropriate safety profile. Herein, we describe the discovery of a highly potent, subtype selective, peripherally restricted, efficacious, and well-tolerated series of allosteric TrkA inhibitors that culminated in the delivery of candidate quality compound 23.

Hormones of the neurotrophin family, nerve growth factor (NGF), brain derived neurotrophic factor (BDNF), neurotrophin 3 (NT3), and neurotrophin 4 (NT4), are known to activate the family of Tropomyosin receptor kinases (TrkA, TrkB, and TrkC). Moreover, inhibition of the TrkA kinase pathway in pain has been clinically validated by the NGF antibody tanezumab, leading to significant interest in the development of small molecule inhibitors of TrkA. Furthermore, Trk inhibitors having an acceptable safety profile will require minimal brain availability. Herein, we discuss the discovery of two potent, selective, peripherally restricted, efficacious, and well-tolerated series of pan-Trk inhibitors which successfully delivered three candidate quality compounds 10b, 13b, and 19. All three compounds are predicted to possess low metabolic clearance in human that does not proceed via aldehyde oxidase-catalyzed reactions, thus addressing the potential clearance prediction liability associated with our current pan-Trk development candidate PF-06273340.

Tumors use tryptophan-catabolizing enzymes such as indoleamine 2,3-dioxygenase (IDO-1) to induce an immunosuppressive environment. IDO-1 is induced in response to inflammatory stimuli and promotes immune tolerance through effector T-cell anergy and enhanced Treg function. As such, IDO-1 is a nexus for the induction of a key immunosuppressive mechanism and represents an important immunotherapeutic target in oncology. Starting from HTS hit 5, IDO-1 inhibitor 6 (EOS200271/PF-06840003) has been developed. The structure activity relationship around 6 is described and rationalized using the X-ray crystal structure of 6 bound to human IDO-1, which shows that 6, differently from most of the IDO-1 inhibitors described so far, does not bind to the heme iron atom and has a novel binding mode. Clinical candidate 6 shows good potency in an IDO-1 human whole blood assay and also shows a very favorable ADME profile leading to favorable predicted human pharmacokinetic properties, including a predicted half-life of 16-19 h.