Safety, target engagement, and biomarker effects of bosutinib in dementia with Lewy bodies

Fernando L Pagan; Yasar Torres-Yaghi; Michaeline L Hebron; Barbara Wilmarth; R Scott Turner; Sara Matar; Dalila Ferrante; Jaeil Ahn; Charbel Moussa

doi:10.1002/trc2.12296

Safety, target engagement, and biomarker effects of bosutinib in dementia with Lewy bodies

Alzheimers Dement (N Y). 2022 Jun 1;8(1):e12296. doi: 10.1002/trc2.12296. eCollection 2022.

Authors

Fernando L Pagan^{1

2}, Yasar Torres-Yaghi^{1

2}, Michaeline L Hebron¹, Barbara Wilmarth^{1

2}, R Scott Turner³, Sara Matar¹, Dalila Ferrante¹, Jaeil Ahn⁴, Charbel Moussa¹

Affiliations

¹ Translational Neurotherapeutics Program Laboratory for Dementia and Parkinsonism Department of Neurology Lewy Body Dementia Association Research Center of Excellence Georgetown University Medical Center Washington DC USA.
² MedStar Georgetown University Hospital Movement Disorders Clinic Department of Neurology Washington DC USA.
³ Memory Disorders Program Department of Neurology Georgetown University Medical Center Washington DC USA.
⁴ Department of Biostatistics Bioinformatics and Biomathematics Georgetown University Medical Center Washington DC USA.

Abstract

Introduction: Bosutinib, a dual Abelson/Src inhibitor, was investigated in individuals with dementia with Lewy bodies (DLB).

Methods: A single site, randomized, double-blind, placebo-controlled study of the effects of oral bosutinib, 100 mg once daily for 12 weeks on primary safety and pharmacokinetics and secondary biomarker outcomes.

Results: Twenty-six participants were randomized and included male and female (12:1) in the bosutinib arm and all male (13) in the placebo arm. The average age was 72.9 ± 8.1 (year ± standard deviation). There were no serious adverse events and no dropouts. Bosutinib was measured in the cerebrospinal fluid (CSF) and inhibited Abelson. Bosutinib reduced CSF alpha-synuclein and dopamine catabolism.

Discussion: Bosutinib is safe and well tolerated and penetrates the blood-brain barrier to inhibit Abelson and reduce CSF alpha-synuclein and dopamine catabolism, suggesting that bosutinib (100 mg) may be at or near the lowest effective dose in DLB. These results will guide adequately powered studies to determine the efficacy of a dose range of bosutinib and longer treatment in DLB.

Highlights: Bosutinib is a dual Abl/Src inhibitor that penetrates the blood brain barrierBosutinib is safe and tolerated in individuals with dementia with Lewy bodiesBosutinib engages its target via inhibition of Abl and SrcBosutinib reduces CSF alpha-synuclein and attenuates breakdown of dopamineBosutinib improves activities of daily living in dementia with Lewy bodies.

Keywords: Abelson; activities of daily living; alpha‐synuclein; dementia with Lewy bodies; dopamine.