Research & Development

Italfarmaco is an important player in the Italian pharma industry landscape due to both, its products and its R&D activities.

The first molecule (imidazole salicylate) developed in its Research Center was a non-steroidal anti-inflammatory drug, marketed in 1984. Subsequently, a protein iron complex was developed for the treatment of anemia resulting from iron deficiency, today marketed in over 40 countries worldwide. In 1988, the company began marketing choline alfoscerate, while also overseeing its international development for treating cerebral cognitive disorders, including both vascular and non-vascular Alzheimer’s disease. In the cardiovascular area it was a pioneer in the development of antithrombotic drugs, such as unfractionated and low molecular weight heparin, in the chronic treatment of ischemic heart disease and in the prophylaxis and therapy of venous and arterial thrombosis.

Our present research is centered around neuromuscular disorders, fibrosis and cancer (including oncology supportive care) with a special focus on rare diseases. While our capabilities span three treatment modalities, small molecules, peptides and monoclonal antibodies from which we chose to best match the biology of the selected target, the distinctive feature of the ITF R&D group is its expertise in the field of zinc-dependent histone deacetylase (HDAC) inhibitors. Zn-dependent HDACs are a family of 11 related proteins that are involved in the post-translational modification of proteins and polyamines.

Several HDACs are involved in the control of gene expression and their inhibitors have the potential of repro- gramming cell fates by interfering with these processes. Our most advanced compound, Givinostat (a non-selective HDAC inhibitor), has recently been approved by the FDA for the treatment of Duchenne Muscular Dystrophy (DMD) in patients six years of age and older, and is also in an advanced stage of clinical development in Polycythemia Vera, a rare hematologic cancer. Our R&D group is working to identify exquisitely subtype-selective, second-generation inhibitors to specifically interfere with a defined subset of biological processes controlled by HDACs.

In addition to the development of new chemical entities, Italfarmaco’s R&D group also develops new formulations of established drugs to better respond to patient needs and generics/biosimilars of complex molecules. Examples developed up to market in Europe, USA and Rest of the World are the liquid formulations of antidepressants or hypnotic agents and of Riluzole for the treatment of Amiotrophic Lateral Sclerosis (ALS). Regarding the development of generics/biosimilar of complex molecules, Italfarmaco’s R&D group has developed a generic/biosimilar of enoxaparin which is currently marketed in Europe, USA and Rest of the World.

Our Focus

The goal of Italfarmaco’s research activity is to provide caregivers and patients with effective and safe drugs, to improve the health and to ensure a better quality of life of patients.

Our Focus

The goal of Italfarmaco’s research activity is to provide caregivers and patients with effective and safe drugs, to improve the health and to ensure a better quality of life of patients.

Our path to R&D journey

Italfarmaco’s Research and Development (R&D) is organized to bring innovation to patients and to swiftly progress our discoveries from early conceptualization all the way down to market approval in the shortest timeframe possible. To optimize this process, the group is divided into two main departments: the New Drug Incubator (NDI) and the Drug Development (DD) units.

The R&D department of the Italfarmaco Group is primarily based in Milan, with additional units in Rome and Madrid. For the chemical development and manufacturing of molecules, we rely on Chemi, a leading active ingredient manufacturer within our group.

Our R&D department is dedicated to driving scientific excellence and innovation, working collaboratively across specialized units to bring groundbreaking therapies to the market.

Led by our Chief Scientific Officer (CSO), the NDI group is dedicated to the discovery of new chemical entities that are developed up to the stage of preclinical candidates (PCCs), i.e. molecules that are ready to enter IND-enabling studies. Initial target identification and validation activities are often carried out in close collaboration with academic groups, The research activities from hit identification to lead optimization are conducted in a semi-virtual mode: all competences and skillsets are present internally and are flexibly expanded according to project needs using external service providers. For the identification of novel hits we use fragment screens, structure-based drug design and AI-powered computational approaches. The antibody unit at Exiris in Rome uses a novel phage display technology to identify fully human therapeutic monoclonal antibodies. The NDI group comprises several specialized units:

  1. Medicinal Chemistry Unit: This unit focuses on the design and synthesis of New Chemical Entities (NCEs). The team of expert chemists employs advanced methodologies to create novel compounds with potential therapeutic benefits.
  2. Biology Unit: Responsible for the in-vitro proof of concept (POC) studies, this unit conducts extensive laboratory tests to evaluate the biological activity of new compounds. Their work is crucial in identifying promising candidates for further development.
  3. In-vivo Target Validation Unit: This unit performs in-vivo POC studies to validate the therapeutic targets and the efficacy of new compounds in living Their findings provide essential data for advancing compounds into preclinical development.
  4. Antibody Unit at Exiris: Responsible for the development of antibody drugs, the development of novel antibody technologies and a platform technology for conjugation of antibodies or peptides to cytotoxic.

Under the leadership of our Chief Medical Officer (CMO), the DD group is accountable for the development of drug candidates from the preclinical stage to clinical development and, eventually to the approval of the drug by regulatory authorities. It is composed of the following units:

  1. Preclinical Development Unit: This Unit is accountable for the development of preclinical candidates conducting a series of tests to ensure the safety, efficacy, and pharmacokinetics of the candidates before they enter clinical trials (IND enabling activities). This Unit is also accountable for the conduct of DMPK and toxicology studies of new molecules up to registration.
  2. Chemical Development: This unit is accountable for the development of the synthetic process of new molecules up to registration. In this role they ensure that the new molecules can be manufactured efficiently and effectively from small to large commercial scales.
  3. Pharmaceutical Development Unit: This unit is accountable for the development of the formulation (and its manufacturing process and packaging) of new molecules from candidate selection up to clinical develop- ment and registration. In this role it ensures the development of the suitable dosage form for the delivery of the compound and its stability and scalability so as that it can be manufactured efficiently and effectively for clinical supply and future commercialization. This unit is also accountable for either optimization or development of new formulations/dosage forms of already registered drugs as part of their life cycle management.
  4. Clinical R&D Unit: This Unit is accountable for the clinical development of molecules. This includes the ideation, development and implementation of the development plan of the new molecules. This Unit is also accountable for the ideation and implementation of clinical trials. They ensure that new drugs meet regulatory standards and demonstrate safety and efficacy in human subjects.
  5. Biometrics & Data Sciences: this unit is accountable for the rigorous use of quantitative sciences to maximize clinical trials accuracy and compliance from early to late phase of clinical Statisticians, data scientists and statistical programmers enable internal decision making ensuring strategic support for clinical trial’s designs, delivery and interpretation of results.

Research Focus Areas

Our pipeline currently encompasses a range of ongoing discovery and development projects, with a primary focus on epigenetics. Specifically, we are targeting the histone deacetylase (HDAC) family of enzymes.

This diversified approach underscores our dedication to addressing a broad spectrum of medical challenges through cutting-edge scientific research and development. Our efforts are directed towards several key clinical indications.

Rare Diseases

We have developed expertise in neuromuscular disorders, aiming to provide novel therapeutic options for these challenging conditions.

Fibrosis

Our research is exploring innovative approaches to treat various fibrotic diseases, seeking to address unmet medical needs in this area.

Oncology

We are committed to advancing cancer treatments, focusing on both direct anti-tumor therapies and supportive care for oncologic patients, to improve overall patient outcomes and quality of life.

Pipeline

  Lead
Optimization
Candidate
Selection
IND
Enabling
Phase
I
Phase
II
Phase
III
NDA
MAA
Expected
Launch
Givinostat
Pan-HDAC Inhibitor
Duchenne Muscular Dystrophy*
            NDA Approved
MAA under review
US: 2024
EU: 2025
Givinostat
Pan-HDAC Inhibitor
Polycythemia Vera*
          In progress   2027
Givinostat
Pan-HDAC Inhibitor
Becker Muscular Dystrophy*
              TBC
ITF3756
HDAC6 Inhibitor
Solid Tumors
      In progress       2028
ITF3912
Peptide-Drug Conjugate
Solid Tumors
    In progress         TBC
ITF-undiscl
HDAC6 Inhibitor
Peripheral Neuropathies
    In progress         TBC
ITF-undiscl
Antibody
Fibrosis
  In progress           TBC
ITF-undiscl
HDAC Class I Inhibitor
Fibrosis
In progress             TBC

Italfarmaco’s R&D group is not only dedicated to discovering and developing new chemical entities (NCEs) but is also engaged in developing complex generics and biosimilars. In recent years, the company successfully launched enoxaparin in the US and the EU. Currently, the ANDAs for Glatiramer and Pentosan are under review by the FDA.

Scientific Publications

Mercuri E, Vilchez JJ, Boespflug-Tanguy O, Zaidman CM, Mah JK, Goemans N, Müller-Felber W, Niks EH, Schara-Schmidt U, Bertini E, Comi GP, Mathews KD, Servais L, Vandenborne K, Johannsen J, Messina S, Spinty S, McAdam L, Selby K, Byrne B, Laverty CG, Carroll K, Zardi G, Cazzaniga S, Coceani N, Bettica P, McDonald CM; EPIDYS Study Group. Safety and efficacy of givinostat in boys with Duchenne muscular dystrophy (EPIDYS): a multicentre, randomised, double-blind, placebo-controlled, phase 3 trial. Lancet Neurol. 2024 Apr;23(4):393-403. doi: 10.1016/S1474-4422(24)00036-X. Erratum in: Lancet Neurol. 2024 Jun;23(6):e10. doi: 10.1016/S1474-4422(24)00172-8. PMID: 38508835.

Fiorentini F, Germani M, Del Bene F, Pellizzoni C, Cazzaniga S, Rocchetti M, Bettica P. Population pharmacokinetic-pharmacodynamic analysis of givinostat. Expert Opin Drug Metab Toxicol. 2023 Apr;19(4):229-238. doi: 10.1080/17425255.2023.2219839. Epub 2023 Jun 12. PMID: 37306105.

Licandro SA, Crippa L, Pomarico R, Perego R, Fossati G, Leoni F, Steinkühler C. The pan HDAC inhibitor Givinostat improves muscle function and histological parameters in two Duchenne muscular dystrophy murine models expressing different haplotypes of the LTBP4 gene. Skelet Muscle. 2021 Jul 22;11(1):19. doi: 10.1186/s13395-021-00273-6. PMID: 34294164; PMCID: PMC8296708.

Lavezzi SM, Rocchetti M, Bettica P, Petrini S, De Nicolao G. Assessing drug effect from distributional data: A population approach with application to Duchenne Muscular Dystrophy treatment. Comput Methods Programs Biomed. 2019 Sep;178:329-342. doi: 10.1016/j.cmpb.2019.06.002. Epub 2019 Jun 6. PMID: 31416560.

Bettica P, Petrini S, D’Oria V, D’Amico A, Catteruccia M, Pane M, Sivo S, Magri F, Brajkovic S, Messina S, Vita GL, Gatti B, Moggio M, Puri PL, Rocchetti M, De Nicolao G, Vita G, Comi GP, Bertini E, Mercuri E. Histological effects of givinostat in boys with Duchenne muscular dystrophy. Neuromuscul Disord. 2016 Oct;26(10):643-649. doi: 10.1016/j.nmd.2016.07.002. Epub 2016 Jul 11. PMID: 27566866.

Comi GP, Niks EH, Vandenborne K, Cinnante CM, Kan HE, Willcocks RJ, Velardo D, Magri F, Ripolone M, van Benthem JJ, van de Velde NM, Nava S, Ambrosoli L, Cazzaniga S, Bettica PU. Givinostat for Becker muscular dystrophy: A randomized, placebo-controlled, double-blind study. Front Neurol. 2023 Jan 30;14:1095121. doi: 10.3389/fneur.2023.1095121. PMID: 36793492; PMCID: PMC9923355.

Comi GP, Niks EH, Cinnante CM, Kan HE, Vandenborne K, Willcocks RJ, Velardo D, Ripolone M, van Benthem JJ, van de Velde NM, Nava S, Ambrosoli L, Cazzaniga S, Bettica PU. Characterization of patients with Becker muscular dystrophy by histology, magnetic resonance imaging, function, and strength assessments. Muscle Nerve. 2022 Mar;65(3):326-333. doi: 10.1002/mus.27475. Epub 2021 Dec 30. PMID: 34918368; PMCID: PMC9302983

Tosca EM, De Carlo A, Bartolucci R, Fiorentini F, Di Tollo S, Caserini M, Rocchetti M, Bettica P, Magni P. In silico trial for the assessment of givinostat dose adjustment rules based on the management of key hematological parameters in polycythemia vera patients. CPT Pharmacometrics Syst Pharmacol. 2024 Mar;13(3):359-373. doi: 10.1002/psp4.13087. Epub 2024 Feb 7. PMID: 38327117; PMCID: PMC10941510.

Rambaldi A, Iurlo A, Vannucchi AM, Martino B, Guarini A, Ruggeri M, von Bubnoff N, De Muro M, McMullin MF, Luciani S, Martinelli V, Nogai A, Rosti V, Ricco A, Bettica P, Manzoni S, Di Tollo S. Long-term safety and efficacy of givinostat in polycythemia vera: 4-year mean follow up of three phase 1/2 studies and a compassionate use program. Blood Cancer J. 2021 Mar 6;11(3):53. doi: 10.1038/s41408-021-00445-z. PMID: 33677466; PMCID: PMC7936975.

Rambaldi A, Iurlo A, Vannucchi AM, Noble R, von Bubnoff N, Guarini A, Martino B, Pezzutto A, Carli G, De Muro M, Luciani S, McMullin MF, Cambier N, Marolleau JP, Mesa RA, Tibes R, Pancrazzi A, Gesullo F, Bettica P, Manzoni S, Di Tollo S. Safety and efficacy of the maximum tolerated dose of givinostat in polycythemia vera: a two-part Phase Ib/II study. Leukemia. 2020 Aug;34(8):2234-2237. doi: 10.1038/s41375-020-0735-y. Epub 2020 Feb 11. PMID: 32047238; PMCID: PMC7387307.

Finazzi G, Vannucchi AM, Martinelli V, Ruggeri M, Nobile F, Specchia G, Pogliani EM, Olimpieri OM, Fioritoni G, Musolino C, Cilloni D, Sivera P, Barosi G, Finazzi MC, Tollo SD, Demuth T, Barbui T, Rambaldi A. A phase II study of Givinostat in combination with hydroxycarbamide in patients with polycythaemia vera unresponsive to hydroxycarbamide monotherapy. Br J Haematol. 2013 Jun;161(5):688-694. doi: 10.1111/bjh.12332. Epub 2013 Apr 10. PMID: 23573950.

Amaru Calzada A, Pedrini O, Finazzi G, Leoni F, Mascagni P, Introna M, Rambaldi A, Golay J; Associazione Italiana per la Ricerca sul Cancro-Gruppo Italiano Malattie Mieloproliferative Investigators. Givinostat and hydroxyurea synergize in vitro to induce apoptosis of cells from JAK2(V617F) myeloproliferative neoplasm patients. Exp Hematol. 2013 Mar;41(3):253-60.e2. doi: 10.1016/j.exphem.2012.10.013. Epub 2012 Oct 27. PMID: 23111067.

Rambaldi A, Dellacasa CM, Finazzi G, Carobbio A, Ferrari ML, Guglielmelli P, Gattoni E, Salmoiraghi S, Finazzi MC, Di Tollo S, D’Urzo C, Vannucchi AM, Barosi G, Barbui T. A pilot study of the Histone-Deacetylase inhibitor Givinostat in patients with JAK2V617F positive chronic myeloproliferative neoplasms. Br J Haematol. 2010 Aug;150(4):446-55. doi: 10.1111/j.1365-2141.2010.08266.x. Epub 2010 Jun 15. PMID: 20560970.

Novel Benzohydroxamate-Based Potent and Selective Histone Deacetylase 6 (HDAC6) Inhibitors Bearing a Pentaheterocyclic Scaffold: Design, Synthesis, and Biological Evaluation
Authors: Barbara Vergani, Giovanni Sandrone, Mattia Marchini, Chiara Ripamonti, Edoardo Cellupica, Elisabetta Galbiati, Gianluca Caprini, Gianfranco Pavich, Giulia Porro, Ilaria Rocchio, Maria Lattanzio, Marcello Pezzuto, Malgorzata Skorupska, Paola Cordella, Paolo Pagani, Pietro Pozzi, Roberta Pomarico, Daniela Modena, Flavio Leoni, Raffaella Perego, Gianluca Fossati, Christian Steinkühler, and Andrea Stevenazzi
Source: J. Med. Chem. 2019, 62, 10711.
DOI: https://doi.org/10.1021/acs.jmedchem.9b01194

Role of Fluorination in the Histone Deacetylase 6 (HDAC6) Selectivity of Benzohydroxamate-Based Inhibitors
Authors: Giovanni Sandrone, Cyprian D. Cukier, Karol Zrubek, Mattia Marchini, Barbara Vergani, Gianluca Caprini, Gianluca Fossati, Christian Steinkühler, and Andrea Stevenazzi
Source: ACS Med. Chem. Lett. 2021, 12, 1810.
DOI: https://doi.org/10.1021/acsmedchemlett.1c00425

Difluoromethyl-1,3,4-oxadiazoles are slow-binding substrate analog inhibitors of histone deacetylase 6 with unprecedented isotype selectivity
Authors: Edoardo Cellupica, Gianluca Caprini, Paola Cordella, Cyprian Cukier, Gianluca Fossati, Mattia Marchini, Ilaria Rocchio, Giovanni Sandrone, Maria Antonietta Vanoni, Barbara Vergani, Karol Źrubek, Andrea Stevenazzi, Christian Steinkühler
Source: J. Biol. Chem. 2023, 299(1), 102800
DOI: https://doi.org/10.1016/j.jbc.2022.102800

Mechanistic and Structural Insights on Difluoromethyl-1,3,4-Oxadiazole Inhibitors of HDAC6
Authors: Edoardo Cellupica, Aureliano Gaiassi, Ilaria Rocchio, Grazia Rovelli, Roberta Pomarico, Giovanni Sandrone, Gianluca Caprini, Paola Cordella, Cyprian Cukier, Gianluca Fossati, MattiaMarchini, Aleksandra Bebel, Cristina Airoldi, Alessandro Palmioli, Andrea Stevenazzi, Christian Steinkühler and Barbara Vergani
Source: Int. J. Mol. Sci. 2024, 25(11), 5885
DOI: https://doi.org/10.3390/ijms25115885

Translation of paclitaxel-induced peripheral neurotoxicity from mice to patients: the importance of model selection
Authors: Cavaletti, Guido; Alberti, Paola; Canta, Annalisa; Carozzi, Valentina; Cherchi, Laura; Chiorazzi, Alessia; Crippa, Luca; Marmiroli, Paola; Meregalli, Cristina; Pozzi, Eleonora; Rodriguez-Menendez, Virginia; Steinkühler, Christian; Licandro, Simonetta Andrea
Source: Pain. May 2, 2024
DOI: 10.1097/j.pain.0000000000003268.

Di Muro G, Catalano R, Treppiedi D, Barbieri AM, Mangili F, Marra G, Di Bari S, Esposito E, Nozza E, Lania AG, Ferrante E, Locatelli M, Modena D, Steinkuhler C, Peverelli E, Mantovani G. The Novel SSTR3 Agonist ITF2984 Exerts Antimitotic and Proapoptotic Effects in Human Non-Functioning Pituitary Neuroendocrine Tumor (NF-PitNET). Cells. Int J Mol Sci. 2024 Mar 23;25(7):3606. doi: 10.3390/ijms25073606. PMID: 38612419; PMCID: PMC11011875.

Mazzarella L, Santoro F, Ravasio R, Fumagalli V, Massa PE, Rodighiero S, Gavilán E, Romanenghi M, Duso BA, Bonetti E, Manganaro L, Pallavi R, Trastulli D, Pallavicini I, Gentile C, Monzani S, Leonardi T, Pasqualato S, Buttinelli G, Di Martino A, Fedele G, Schiavoni I, Stefanelli P, Meroni G, de Francesco R, Steinkuhler C, Fossati G, Iannacone M, Minucci S, Pelicci PG. Inhibition of the lysine demethylase LSD1 modulates the balance between inflammatory and antiviral responses against coronaviruses. Sci Signal. 2023 Dec 19;16(816):eade0326. doi: 10.1126/scisignal.ade0326. Epub 2023 Dec 19. PMID: 38113337.

Modena D, Moras ML, Sandrone G, Stevenazzi A, Vergani B, Dasgupta P, Kliever A, Gulde S, Marangelo A, Schillmaier M, Luque RM, Bäuerle S, Pellegata NS, Schulz S, Steinkühler C. Identification of a Novel SSTR3 Full Agonist for the Treatment of Nonfunctioning Pituitary Adenomas. Cancers (Basel). 2023 Jun 30;15(13):3453. doi: 10.3390/cancers15133453. PMID: 37444563; PMCID: PMC10340464.

Characterization of the cardiac structure and function of conscious D2.B10- Dmdmdx/J (D2- mdx) mice from 16-17 to 24-25 weeks of age
Authors: Daria De Giorgio, Deborah Novelli, Francesca Motta, Marianna Cerrato, Davide Olivari, Annasimon Salama, Francesca Fumagalli, Roberto Latini, Lidia Staszewsky, Luca Crippa, Christian Steinkühler and Simonetta Andrea Licandro
Source: Int J Mol Sci. 2023, 24(14):11805
DOI: 10.3390/ijms241411805.

Boccanegra B, Mantuano P, Conte E, Cerchiara AG, Tulimiero L, Quarta R, Caputo E, Sanarica F, Forino M, Spadotto V, Cappellari O, Fossati G, Steinkühler C, De Luca A. LKB1 signaling is altered in skeletal muscle of a Duchenne muscular dystrophy mouse model. Dis Model Mech. 2023 Jul 1;16(7):dmm049930. doi: 10.1242/dmm.049930. Epub 2023 Jul 10. PMID: 37427454; PMCID: PMC10354716.

Ripamonti C, Spadotto V, Pozzi P, Stevenazzi A, Vergani B, Marchini M, Sandrone G, Bonetti E, Mazzarella L, Minucci S, Steinkühler C, Fossati G. HDAC Inhibition as Potential Therapeutic Strategy to Restore the Deregulated Immune Response in Severe COVID-19. Front Immunol. 2022 May 3;13:841716. doi: 10.3389/fimmu.2022.841716. PMID: 35592335; PMCID: PMC9111747.

Travers JG, Wennersten SA, Peña B, Bagchi RA, Smith HE, Hirsch RA, Vanderlinden LA, Lin YH, Dobrinskikh E, Demos-Davies KM, Cavasin MA, Mestroni L, Steinkühler C, Lin CY, Houser SR, Woulfe KC, Lam MPY, McKinsey TA. HDAC Inhibition Reverses Preexisting Diastolic Dysfunction and Blocks Covert Extracellular Matrix Remodeling. Circulation. 2021 May 11;143(19):1874-1890. doi: 10.1161/CIRCULATIONAHA.120.046462. Epub 2021 Mar 8. PMID: 33682427; PMCID: PMC8884170.

Soranno DE, Kirkbride-Romeo L, Wennersten SA, Ding K, Cavasin MA, Baker P, Altmann C, Bagchi RA, Haefner KR, Steinkühler C, Montford JR, Keith B, Gist KM, McKinsey TA, Faubel S. Acute Kidney Injury Results in Long-Term Diastolic Dysfunction That Is Prevented by Histone Deacetylase Inhibition. JACC Basic Transl Sci. 2021 Feb 22;6(2):119-133. doi: 10.1016/j.jacbts.2020.11.013. PMID: 33665513; PMCID: PMC7907538.