Leading with Science: Developing Non-Hormonal Approaches for Endometriosis

Dr. Tanya Petrossian discusses how the distinct biology of endometriosis can inform new directions in drug development.

Endometriosis can affect fertility, cause persistent pain and produce symptoms that overlap with other conditions. Diagnosis can therefore take time, leaving some patients without a clear explanation for their symptoms.

For Dr. Tanya Petrossian, Founder and CEO of Endocyclic Therapeutics, her own diagnosis added a personal perspective to a field she already knew professionally. Her background spans biochemistry, molecular biology, bioinformatics and women’s health product development. The experience prompted her to look more closely at how endometriosis is treated and where further research may be needed.

“I always want to let science do the talking,” said Dr. Petrossian.

In this exclusive Xtalks Clinical Edge feature, she discussed the challenges surrounding endometriosis diagnosis and treatment, as well as Endocyclic Therapeutics’ work on non-hormonal therapeutic and imaging candidates intended to target lesions directly.

Endometriosis Is Still Difficult to Address

Endometriosis is characterized by tissue resembling the uterine lining growing outside the uterus. Lesions can attach to different organs, trigger inflammation and produce symptoms based partly on where they are located.

A lesion affecting the bladder, for example, may produce symptoms resembling a urinary tract infection. Lesions affecting reproductive organs may contribute to fertility problems. Other patients may experience bowel symptoms, widespread pain or few obvious symptoms at all.

It can be difficult to confirm the cause. Dr. Petrossian explained that surgery has historically played a central role in diagnosing endometriosis, allowing clinicians to identify and examine suspected lesions. However, small or difficult-to-see lesions may be missed.

From her own experience, Dr. Petrossian shared the burden that surgery can involve, “I had a four hour surgery. It was not an easy surgery to recover from.”

Current care may include pain medication, hormonal treatment or surgery. These approaches can help some patients manage symptoms or remove visible lesions, but they may not meet every patient’s needs.

“The current treatment options right now just are not enough,” said Dr. Petrossian.

Hormonal therapies may be unsuitable for patients trying to become pregnant or those who cannot tolerate their effects. Surgery can remove lesions, but surgical treatment depends on locating the affected tissue.

Xtalks Insights

Get industry leading pharma and biotech news, events and expert insights delivered to your inbox.

First Name *

Email *

By clicking this checkbox, I agree to receive Xtalks communications and understand that I may unsubscribe at any time. Please review the Xtalks privacy policy here.

Protected by reCAPTCHA.

Continue

What topics would you like to hear more about?

Select all that apply.

Science and Discovery Clinical Development Regulatory Safety and Quality Manufacturing and Supply Chain Commercial and Market Access Data AI and Digital Therapeutic Areas

Progress

1 2 3

Next Step

Want to get even more specific?

Help us narrow down the sub-topics that you're most interested in.

Progress

1 2 3

Save Preferences

Thank you!

For webinars, videos, podcasts and more from Xtalks, join our community today.

BECOME A FREE MEMBER

Progress

1 2 3

Targeting the Lesion Rather Than Hormonal Cycling

Endocyclic Therapeutics is investigating peptides intended to act on biological pathways involved in lesion survival rather than altering hormonal cycling.

According to Dr. Petrossian, the company is studying why abnormal endometrial-like cells can migrate, invade surrounding tissue and avoid being cleared by the immune system. Endometriosis lesions can also develop their own blood supply and nerve connections, helping the tissue persist outside the uterus.

“Our targets are non-hormonal… it allows the tissue to be starved of its survival signals and it just goes through a very quiet cell death, the apoptosis,” said Dr. Petrossian.

In preclinical studies, the company’s peptides have shown no evidence of affecting hormonal cycling, according to Dr. Petrossian. The proposed approach is intended to induce apoptosis, or programmed cell death, by disrupting signals that help the lesions survive.

The goal is to develop a treatment that could reduce lesion burden without suppressing hormonal cycling or requiring surgical removal. These findings remain preclinical, however, and human studies will be needed to determine whether the selectivity and effects observed so far translate clinically.

Applying Lesion Targeting to Diagnosis

The same lesion-targeting concept may also have diagnostic applications.

Dr. Petrossian said the company’s peptides appear to accumulate in endometriosis lesions while showing limited uptake in healthy tissue in preclinical studies.

The diagnostic challenge is also personal for Dr. Petrossian. “I was initially told that I potentially had ovarian cancer. And so I was not only undiagnosed, I was certainly misdiagnosed for a period of time.”

If that selectivity translates into humans, an imaging test could potentially help clinicians locate lesions without relying first on surgery. It could also help explain organ-specific symptoms that may otherwise be attributed to gastrointestinal, urinary or reproductive conditions.

“To be able to have that clarity” could change how patients understand their disease, Dr. Petrossian said.

She added that preclinical imaging studies have detected different subtypes of endometriosis, including lesions in less common locations such as the thoracic cavity. Clinical development will need to establish whether this apparent lesion specificity can be reproduced in patients and provide reliable information about where disease is located.

Moving Carefully From Preclinical Research to Clinical Trials

Dr. Petrossian also stressed the importance of a disease-specific approach to endometriosis R&D.

“I do not think that just trying to repurpose the solutions from other diseases is going to actually address this very unique disease,” she said.

That principle also applies as investigational approaches move toward human studies. Dr. Petrossian said she does not want to see therapies enter clinical trials based primarily on evidence that a similar strategy worked in another disease.

“I don’t think we should be skipping steps because it’s not fair to the patient to not do a very thorough analysis,” she said.

Endocyclic is working toward clinical development of its therapeutic and imaging programs, with Dr. Petrossian discussing plans to advance the imaging candidate through investigational new drug allowance and clinical trials.

The endometriosis pipeline is also examining treatment approaches beyond hormonal therapy and surgical management. Lesion-targeted therapies and imaging tools remain at an early stage, and clinical studies will need to establish whether findings observed in preclinical research translate into clear benefits for patients.