Altiratinib

Altiratinib (DCC-2701) is a potent inhibitor of c-MET/TIE-2/VEGFR with IC50 values of 2.7, 8.0 and 9.2 nM, respectively [1].

Hepatocyte growth factor receptor (c-MET) is a tyrosine kinase receptor for hepatocyte growth factor and is essential for wound healing and embryonic development. TEK tyrosine kinase (TIE-2) is a receptor for angiopoietin-1 (ANG-1) and is important for endothelial cell-smooth muscle cell communication. VEGFR is a tyrosine kinase receptor for vascular endothelial growth factor that involved in both vasculogenesis and angiogenesis.

Altiratinib (DCC-2701) is a potent c-MET/TIE-2/VEGFR inhibitor. Altiratinib potently inhibited MET kinase and activating oncogenic MET mutations and also inhibited TRKA, TRKB and TRKC kinases with IC50 values of 0.85, 4.6, and 0.83 nM, respectively. In EBC-1 NSCLC and MKN-45 gastric cancer cell lines overexpressing MET, altiratinib inhibited MET phosphorylation with IC50 values of 0.85 and 2.2 nM, respectively. In VEGF-stimulated HUVECs, altiratinib inhibited VEGFR2 phosphorylation with IC50 value of 4.7 nM. In HUVECs and EA.hy926 cells, altiratinib inhibited TIE2 phosphorylation stimulated by ANG-1 with IC50 values of 1.0 and 2.6 nM, respectively [1].

In the MET-amplified MKN-45 xenograft model, altiratinib (30 mg/kg) inhibited MET phosphorylation by >95% for the 24-hour period [1]. In nude mouse xenografted SKOV3 cells, DCC-2701 (10 or 20 mg/kg for 28 days) significantly reduced tumor burden by 53% and 52%, respectively [2].

References:
[1].  Smith BD, Kaufman MD, Leary CB, et al. Altiratinib Inhibits Tumor Growth, Invasion, Angiogenesis, and Microenvironment-Mediated Drug Resistance via Balanced Inhibition of MET, TIE2, and VEGFR2. Mol Cancer Ther, 2015.
[2].  Kwon Y, Smith BD, Zhou Y, et al. Effective inhibition of c-MET-mediated signaling, growth and migration of ovarian cancer cells is influenced by the ovarian tissue microenvironment. Oncogene, 2015, 34(2): 144-153.

Altiratinib Inhibits Tumor Growth, Invasion, Angiogenesis, and Microenvironment-Mediated Drug Resistance via Balanced Inhibition of MET, TIE2, and VEGFR2.[Pubmed:26285778]

Mol Cancer Ther. 2015 Sep;14(9):2023-34.

Altiratinib (DCC-2701) was designed based on the rationale of engineering a single therapeutic agent able to address multiple hallmarks of cancer (1). Specifically, Altiratinib inhibits not only mechanisms of tumor initiation and progression, but also drug resistance mechanisms in the tumor and microenvironment through balanced inhibition of MET, TIE2 (TEK), and VEGFR2 (KDR) kinases. This profile was achieved by optimizing binding into the switch control pocket of all three kinases, inducing type II inactive conformations. Altiratinib durably inhibits MET, both wild-type and mutated forms, in vitro and in vivo. Through its balanced inhibitory potency versus MET, TIE2, and VEGFR2, Altiratinib provides an agent that inhibits three major evasive (re)vascularization and resistance pathways (HGF, ANG, and VEGF) and blocks tumor invasion and metastasis. Altiratinib exhibits properties amenable to oral administration and exhibits substantial blood-brain barrier penetration, an attribute of significance for eventual treatment of brain cancers and brain metastases.

Novel MET/TIE2/VEGFR2 inhibitor altiratinib inhibits tumor growth and invasiveness in bevacizumab-resistant glioblastoma mouse models.[Pubmed:26965451]

Neuro Oncol. 2016 Sep;18(9):1230-41.

BACKGROUND: Glioblastoma highly expresses the proto-oncogene MET in the setting of resistance to bevacizumab. MET engagement by hepatocyte growth factor (HGF) results in receptor dimerization and autophosphorylation mediating tumor growth, invasion, and metastasis. Evasive revascularization and the recruitment of TIE2-expressing macrophages (TEMs) are also triggered by anti-VEGF therapy. METHODS: We investigated the activity of Altiratinib (a novel balanced inhibitor of MET/TIE2/VEGFR2) against human glioblastoma stem cell lines in vitro and in vivo using xenograft mouse models. The biological activity of Altiratinib was assessed in vitro by testing the expression of HGF-stimulated MET phosphorylation as well as cell viability after Altiratinib treatment. Tumor volume, stem cell and mesenchymal marker levels, microvessel density, and TIE2-expressing monocyte infiltration were evaluated in vivo following treatment with a control, bevacizumab alone, bevacizumab combined with Altiratinib, or Altiratinib alone. RESULTS: In vitro, HGF-stimulated MET phosphorylation was completely suppressed by Altiratinib in GSC17 and GSC267, and Altiratinib markedly inhibited cell viability in several glioblastoma stem cell lines. More importantly, in multiple xenograft mouse models, Altiratinib combined with bevacizumab dramatically reduced tumor volume, invasiveness, mesenchymal marker expression, microvessel density, and TIE2-expressing monocyte infiltration compared with bevacizumab alone. Furthermore, in the GSC17 xenograft model, Altiratinib combined with bevacizumab significantly prolonged survival compared with bevacizumab alone. CONCLUSIONS: Together, these data suggest that Altiratinib may suppress tumor growth, invasiveness, angiogenesis, and myeloid cell infiltration in glioblastoma. Thus, Altiratinib administered alone or in combination with bevacizumab may overcome resistance to bevacizumab and prolong survival in patients with glioblastoma.

Altiratinib (DCC-2701) is a multi-targeted kinase inhibitor with IC50s of 2.7, 8, 9.2, 9.3, 0.85, 4.6, 0.83 nM for MET, TIE2, VEGFR2, FLT3, Trk1, Trk2, and Trk3 respectively.

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