Plinabulin (NPI-2358)

The IC50 values of NPI-2358 is 9.8 ± 2.4 nmol/l, 18 ± 5 nmol/l, 13 ± 1 nmol/l, 14 ± 2 nmol/l, 18 ± 1 nmol/l and 11 nmol/l for HT-29, DU 145, PC-3, MDA-MB-231, NCl-H292 and Jurkat cell lines, respectively[1].

Plinabulin (NPI-2358) is a vascular disrupting agent which binds to the colchicine-binding site of tubulin. NPI-2358 could destabilize tumor vascular endothelial architectural resulting in selective collapse of established tumor vasculature [1].

In vitro: NPI-2358 exhibited anti-tumor activity against various human tumor cell lines. In proliferating human umbilical vein endothelial cells (HUVECs), administration of NPI-2358 at 10 nmol/l induced tubulin depolymerization within 30 min [1]. In an in-vitro model of tumor vascular collapse, NPI-2358 increased HUVEC monolayer permeability in a dose-dependent manner. Plinabulin had also shown the in-vitro cytotoxic activity with IC50 values of 11 ± 5 nmol/l and 4.3 ± 2.2 nmol/l for MES-SA and HL-60 tumor cell lines, respectively[1].

In vivo: In the foot implanted C3H mammary carcinomas or leg implanted KHT sarcomas mice model, 7.5 mg/kg plinabulin (intraperitoneally injected) significantly reduced the transfer constant (K(trans)) and the initial area under curve (IAUC) within 1 hour after injection, reaching a lowest point at 3 h, but returning to normal within 24 h. A dose-dependent decrease in IAUC and K(trans) was seen at 3 h. 12.5 mg/kg and 1.5 mg/kg NPI-2358 showed significant anti-tumour effects in the C3H tumours and the KHT sarcoma, respectively .

Clinical trials: In patients evaluated at a dose of 30 mg/m?, tumor blood flow (Ktrans) showed a 16% to 82% decrease. The half-life of NPI-2358 was 6.06 ± 3.03 hours, clearance was 30.50 ± 22.88 L/h, and distributive volume was 211 ± 67.9 L.

References:
Nicholson B1, Lloyd GK, Miller BR, Palladino MA, Kiso Y, Hayashi Y, Neuteboom ST.  NPI-2358 is a tubulin-depolymerizing agent: in-vitro evidence for activity as a tumor vascular-disrupting agent.Anticancer Drugs. 2006 Jan; 17(1):25-31.
Bertelsen L B, Shen Y Y, Nielsen T, et al.  Vascular effects of plinabulin (NPI-2358) and the influence on tumour response when given alone or combined with radiation[J]. International journal of radiation biology, 2011, 87(11): 1126-1134.
Millward M, Mainwaring P, Mita A, et al.  Phase 1 study of the novel vascular disrupting agent plinabulin (NPI-2358) and docetaxel[J]. Investigational new drugs, 2012, 30(3): 1065-1073.

Vascular effects of plinabulin (NPI-2358) and the influence on tumour response when given alone or combined with radiation.[Pubmed:21815749]

Int J Radiat Biol. 2011 Nov;87(11):1126-34.

PURPOSE: This study investigated the anti-tumour effects of the novel vascular disrupting agent Plinabulin (NPI-2358) when given alone or combined with radiation. MATERIALS AND METHODS: Foot implanted C3H mammary carcinomas or leg implanted KHT sarcomas were used, with plinabulin injected intraperitoneally. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) measurements were made with gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) on a 7-tesla magnet. Treatment response was assessed using regrowth delay (C3H tumours), clonogenic survival (KHT sarcomas) or histological estimates of necrosis for both models. RESULTS: Plinabulin (7.5 mg/kg) significantly reduced the initial area under curve (IAUC) and the transfer constant (K(trans)) within 1 hour after injection, reaching a nadir at 3 h, but returning to normal within 24 h. A dose-dependent decrease in IAUC and K(trans), was seen at 3 h. No significant anti-tumour effects were observed in the C3H tumours until doses of 12.5 mg/kg were achieved, but started at 1.5 mg/kg in the KHT sarcoma. Irradiating tumours 1 h after injecting plinabulin enhanced response in both models. CONCLUSIONS: Plinabulin induced a time- and dose-dependent decrease in tumour perfusion. The KHT sarcoma was more sensitive than the C3H tumour to the anti-tumour effects of plinabulin, while radiation response was enhanced in both models.

Phase 1 first-in-human trial of the vascular disrupting agent plinabulin(NPI-2358) in patients with solid tumors or lymphomas.[Pubmed:21138873]

Clin Cancer Res. 2010 Dec 1;16(23):5892-9.

PURPOSE: Plinabulin (NPI-2358) is a vascular disrupting agent that elicits tumor vascular endothelial architectural destabilization leading to selective collapse of established tumor vasculature. Preclinical data indicated plinabulin has favorable safety and antitumor activity profiles, leading to initiation of this clinical trial to determine the recommended phase 2 dose (RP2D) and assess the safety, pharmacokinetics, and biologic activity of plinabulin in patients with advanced malignancies. EXPERIMENTAL DESIGN: Patients received a weekly infusion of plinabulin for 3 of every 4 weeks. A dynamic accelerated dose titration method was used to escalate the dose from 2 mg/m(2) to the RP2D, followed by enrollment of an RP2D cohort. Safety, pharmacokinetic, and cardiovascular assessments were conducted, and Dynamic contrast-enhanced MRI (DCE-MRI) scans were performed to estimate changes in tumor blood flow. RESULTS: Thirty-eight patients were enrolled. A dose of 30 mg/m(2) was selected as the RP2D based on the adverse events of nausea, vomiting, fatigue, fever, tumor pain, and transient blood pressure elevations, with DCE-MRI indicating decreases in tumor blood flow (Ktrans) from 13.5 mg/m(2) (defining a biologically effective dose) with a 16% to 82% decrease in patients evaluated at 30 mg/m(2). Half-life was 6.06 +/- 3.03 hours, clearance was 30.50 +/- 22.88 L/h, and distributive volume was 211 +/- 67.9 L. CONCLUSIONS: At the RP2D of 30 mg/m(2), plinabulin showed a favorable safety profile, while eliciting biological effects as evidenced by decreases in tumor blood flow, tumor pain, and other mechanistically relevant adverse events. On the basis of these results additional clinical trials were initiated with plinabulin in combination with standard chemotherapy agents.

Phase 1 study of the novel vascular disrupting agent plinabulin (NPI-2358) and docetaxel.[Pubmed:21327495]

Invest New Drugs. 2012 Jun;30(3):1065-73.

BACKGROUND: Plinabulin (NPI-2358) is a vascular disrupting agent (VDA) that destabilizes tumor vascular endothelial cell architecture resulting in selective collapse of established tumor vasculature producing anti-tumor activity alone or in combination with cytotoxic agents. The objective of this study was to assess the recommended Phase 2 dose (RP2D) of plinabulin combined with docetaxel. PATIENTS AND METHODS: Patients received 75 mg/m(2) docetaxel on day 1 and plinabulin on days 1 and 8 intravenously in 21 day cycles. Plinabulin was escalated from the biologically effective dose (BED) of 13.5 mg/m(2) to the standard single agent dose of 30 mg/m(2) using a "3+3" design. RESULTS: Thirteen patients were enrolled. Adverse events were consistent with those of both agents alone. Fatigue, pain, nausea, diarrhea and vomiting were the most common events. One dose limiting toxicity of nausea, vomiting, dehydration and neutropenia occurred. The RP2D was 30 mg/m(2) of plinabulin with 75 mg/m(2) docetaxel. Pharmacokinetics did not indicate drug-drug interactions. Of the 8 patients with NSCLC evaluable for response, 2 achieved a partial response and 4 demonstrated lesser decreases in tumor measurements. CONCLUSIONS: The combination of full doses of plinabulin and docetaxel is tolerable. With encouraging antitumor activity, this supported further development of this combination.

Plinabulin (NPI-2358) is a vascular disrupting agen (VDA) against tubulin-depolymerizing with an IC50 of 9.8 nM against HT-29 cells. Plinabulin binds the colchicine binding site of β-tubulin preventing polymerization and has potent inhibitory to tumor cells.

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