乳腺癌耐药蛋白和 P-糖蛋白限制索拉非尼在脑部的蓄积。

Breast cancer resistance protein and P-glycoprotein limit sorafenib brain accumulation.

机构信息

Division of Molecular Biology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, the Netherlands.

出版信息

Mol Cancer Ther. 2010 Feb;9(2):319-26. doi: 10.1158/1535-7163.MCT-09-0663. Epub 2010 Jan 26.

Abstract

Sorafenib is a second-generation, orally active multikinase inhibitor that is approved for the treatment of patients with advanced renal cell carcinoma and patients with unresectable hepatocellular carcinoma. We studied active transport of sorafenib in MDCK-II cells expressing human P-glycoprotein (P-gp/ABCB1) or ABCG2 (breast cancer resistance protein) or murine Abcg2. Sorafenib was moderately transported by P-gp and more efficiently by ABCG2 and Abcg2. Because sorafenib is taken orally, we orally administered sorafenib to wild-type, Abcb1a/1b(-/-), Abcg2(-/-), and Abcb1a/1b;Abcg2(-/-) mice, completely lacking functional Abcb1a/1b, Abcg2, or both, respectively, and we studied plasma pharmacokinetics and brain accumulation. The systemic exposure on oral administration was not different among all strains. However, brain accumulation was 4.3-fold increased in Abcg2(-/-) mice and 9.3-fold increased in Abcb1a/1b;Abcg2(-/-) mice. Moreover, when wild-type mice were treated with sorafenib in combination with the dual P-gp and ABCG2 inhibitor elacridar, brain accumulation was similar to that observed for Abcb1a/1b;Abcg2(-/-) mice. These results show that the brain accumulation of sorafenib is primarily restricted by ABCG2. This contrasts with previous studies using shared ABCG2 and P-gp substrates, which all suggested that P-gp dominates at the blood-brain barrier, and that an effect of ABCG2 is only evident when both transporters are absent. Interestingly, for sorafenib, it is the other way around, that is, ABCG2, and not P-gp, plays the dominant role in restricting its brain accumulation. Clinically, our findings may be relevant for the treatment of renal cell carcinoma patients with central nervous system relapses, as a dual ABCG2 and P-gp inhibitor might improve the central nervous system entry and thereby the therapeutic efficacy of sorafenib.

摘要

索拉非尼是一种第二代、口服活性的多激酶抑制剂,已被批准用于治疗晚期肾细胞癌患者和不可切除的肝细胞癌患者。我们研究了索拉非尼在表达人 P-糖蛋白(P-gp/ABCB1)或 ABCG2(乳腺癌耐药蛋白)或鼠 Abcg2 的 MDCK-II 细胞中的主动转运。索拉非尼被 P-gp 中等转运,被 ABCG2 和 Abcg2 更有效地转运。由于索拉非尼是口服给药的,我们分别给野生型、Abcb1a/1b(-/-)、Abcg2(-/-)和 Abcb1a/1b;Abcg2(-/-)小鼠口服给予索拉非尼,分别完全缺乏功能性 Abcb1a/1b、Abcg2 或两者都缺乏,并研究了其血浆药代动力学和脑内蓄积。口服给药后的全身暴露在所有品系之间没有差异。然而,Abcg2(-/-)小鼠的脑内蓄积增加了 4.3 倍,Abcb1a/1b;Abcg2(-/-)小鼠的脑内蓄积增加了 9.3 倍。此外,当野生型小鼠用索拉非尼与双重 P-gp 和 ABCG2 抑制剂 elacridar 联合治疗时,脑内蓄积与 Abcb1a/1b;Abcg2(-/-)小鼠观察到的相似。这些结果表明,索拉非尼的脑内蓄积主要受 ABCG2 限制。这与之前使用共享的 ABCG2 和 P-gp 底物的研究结果形成对比,这些研究结果均表明 P-gp 在血脑屏障中起主导作用,只有当两种转运体都不存在时,ABCG2 才会产生影响。有趣的是,对于索拉非尼来说,情况正好相反,即 ABCG2 而不是 P-gp 在限制其脑内蓄积方面起主导作用。临床上,我们的发现可能与治疗有中枢神经系统复发的肾细胞癌患者有关,因为双重 ABCG2 和 P-gp 抑制剂可能会改善索拉非尼进入中枢神经系统的能力,从而提高其治疗效果。

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