To: Machaon who wrote (23481 ) 7/24/1998 2:54:00 PM From: Henry Niman Respond to of 32384
Robert, This is actually one of those "you can't tell the players without a scorecard" stories. The players may be best described in a broad sense, using their target receptors as a way to compare. Retinoids activate RARs and the active ingredient in Accutane is iso-tretinoin, aka 13-cis retinoic acid. It's molecular cousin is tretinoin, which is the active ingredient in Retin-A (for acne), Renova (for wrinkles), and Vesinoid (for APL). Vesinoid is taken orally while the other two are taken topically. Vesinoid can be fairly toxic when taken orally and can lead to some severe side effects. 13-cis retinoic acid is in the clinic for several cancers for use as monotherapy. LGND's retinoid is LGD1550 and it is also in the clinic for several cancers. It has somewhat reduced side effects. All three of the above retinoids activate RARs. LGND's other compound that activates RARs is Panretin (9-cis retinoic acid). It not only activates RARs, but also activates RXRs. LGND's Targretin is specific for RXRs. It is the only rexinoid in the clinic at this time. Interestingly, RXRs are involved with many partners. They can form heteroduplexes with RARs, but they can also form heteroduplexes with PPARs, which are activated by TXDs like Rezulin. Thus, LGND has drugs that activate all of the above players (RARs, RXRs, and PPARs). LGND has shown that Targretin can be used to prevent and treat breast cancer on its own. However it has also been shown to synergize with SERMs (such as Evista, Tamoxifen, Droloxifene, CP-366,156, and TSE424). Thus, Targretin is the only rexinoid in the clinic (although I suspect that AGN will soon move its rexinoids into the clinic) and it synergizes with several compounds (RARs, PPARs, SERMs)that have activity against breast cancer. As I have said many times previously, future treatments will involve combinations, and LGND is well positioned in many complimentary areas.