Volume 129, Issue 1 pp. 245-255
Cancer Therapy

Regorafenib (BAY 73-4506): A new oral multikinase inhibitor of angiogenic, stromal and oncogenic receptor tyrosine kinases with potent preclinical antitumor activity

Scott M. Wilhelm

Scott M. Wilhelm

Bayer HealthCare Pharmaceuticals, Montville, NJ

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Jacques Dumas

Jacques Dumas

Bayer HealthCare Pharmaceuticals, Montville, NJ

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Lila Adnane

Lila Adnane

Bayer HealthCare Pharmaceuticals, Montville, NJ

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Mark Lynch

Mark Lynch

Bayer HealthCare Pharmaceuticals, Montville, NJ

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Christopher A. Carter

Christopher A. Carter

Bayer HealthCare Pharmaceuticals, Montville, NJ

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Gunnar Schütz

Gunnar Schütz

Global Drug Discovery, Bayer Schering Pharma AG, Berlin, Germany

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Karl-Heinz Thierauch

Karl-Heinz Thierauch

Global Drug Discovery, Bayer Schering Pharma AG, Berlin, Germany

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Dieter Zopf

Corresponding Author

Dieter Zopf

Global Drug Discovery, Bayer Schering Pharma AG, Berlin, Germany

Tel: +49 30 468 14531

Global Drug Discovery, Bayer Schering Pharma AG, Müllerstrasse 178, Berlin 13342, GermanySearch for more papers by this author
First published: 17 December 2010
Citations: 1,071

Potential conflicts of interest: SMW, LA, GS, KHT and DZ are currently employees of the Bayer HealthCare organisation.

Abstract

Angiogenesis, a critical driver of tumor development, is controlled by interconnected signaling pathways. Vascular endothelial growth factor receptor (VEGFR) 2 and tyrosine kinase with immunoglobulin and epidermal growth factor homology domain 2 play crucial roles in the biology of normal and tumor vasculature. Regorafenib (BAY 73-4506), a novel oral multikinase inhibitor, potently inhibits these endothelial cell kinases in biochemical and cellular kinase phosphorylation assays. Furthermore, regorafenib inhibits additional angiogenic kinases (VEGFR1/3, platelet-derived growth factor receptor-β and fibroblast growth factor receptor 1) and the mutant oncogenic kinases KIT, RET and B-RAF. The antiangiogenic effect of regorafenib was demonstrated in vivo by dynamic contrast-enhanced magnetic resonance imaging. Regorafenib administered once orally at 10 mg/kg significantly decreased the extravasation of Gadomer in the vasculature of rat GS9L glioblastoma tumor xenografts. In a daily (qd)×4 dosing study, the pharmacodynamic effects persisted for 48 hr after the last dosing and correlated with tumor growth inhibition (TGI). A significant reduction in tumor microvessel area was observed in a human colorectal xenograft after qd×5 dosing at 10 and 30 mg/kg. Regorafenib exhibited potent dose-dependent TGI in various preclinical human xenograft models in mice, with tumor shrinkages observed in breast MDA-MB-231 and renal 786-O carcinoma models. Pharmacodynamic analyses of the breast model revealed strong reduction in staining of proliferation marker Ki-67 and phosphorylated extracellular regulated kinases 1/2. These data demonstrate that regorafenib is a well-tolerated, orally active multikinase inhibitor with a distinct target profile that may have therapeutic benefit in human malignancies.

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