Sorafenib Tosylate

Sorafenib tosylate, also named nexavar, is a small-molecule anticancer compound [1]. It is also a novel oral Raf kinase and a vascular endothelial growth factor receptor (VEGFR) inhibitor. It inhibits tumor cell proliferation and tumor angiogenesis [2]. To HepG2 cells (1× 106), the IC50 of sorafenib tosylate is 2.09μg/ml [3].  
Raf is a mitogen-stimulated protein kinase that functions as a component of the signaling cascade that leads to the stimulation of mitogen-activated protein kinase [4].
Vascular endothelial growth factor (VEGF) is a highly specific mitogen for vascular endothelial cells [5].
Treatment with nexavar potently inhibited the cell proliferation of MV4-11 cells (FLT3-ITD) in a dose-dependent manner with an IC50 of 0.88 nM. In MV4-11 cells, sorafenib tosylate of a concentration of 100 nM induced 43.6±5.2% of the cells to undergo apoptosis whereas in EOL-1 cells a concentration as low as 10 nM induced 89.29±1.8% of the cells to be apoptotic [6].
Nude rats at the age of 6 weeks injected with 105 MDA-MB-231 cells were involved. After monotherapy with sorafenib tosylate a significant reduction of the osteolytic lesion volume was observed on days 45 and 55 and of the soft tissue component volume on day 55 in comparison to untreated animals (p < 0.05). Compared to controls, treatment with sorafenib tosylate made bone metastases show significantly decreased values of Amplitude A and kep from day 35 to 55 (Amplitude A: p<0.01; kep p<0.01 on days 35 and 55; p<0.05 on day 45) [7].
References:
[1]. Chetan Lathia, John Lettieri, Frank Cihon, et al. Lack of effect of ketoconazole-mediated CYP3A inhibition on sorafenib clinical pharmacokinetics. Cancer Chemother Pharmacol, 2006, 57: 685-692.
[2]. M. J. Gnoth, S. Sandmann, K. Engel, et al. In Vitro to In Vivo Comparison of the Substrate Characteristics of Sorafenib Tosylate toward P-Glycoprotein. Drug Metabolism & Disposition, 2010, 38: 1341–1346.
[3]. Sayantan Dey, Subhadeep Roy, Nilanjana Deb, et al. Anti-carcinogenic Activity of Ruellia Tuberosa L. (Acanthaceae) Leaf Extract on Hepatoma Cell Line & Increased Superoxide Dismutase Activity on Macrophage Cell Lysate. Int J Pharm Pharm Sci, 2010, 5(Suppl 3): 854-861.
[4]. Markus Wartmann and Roger J. Davis. The Native Structure of the Activated Raf Protein Kinase Is a Membrane-bound Multi-subunit Complex. The Journal of Biological Chemistry, 1994, 269(9): 6695-6701.
[5]. Gera Neufeld, Tzafra Cohen, Stela Gengrinovitch, et al. Vascular endothelial growth factor (VEGF) and its receptors. The FASEB Journal, 1999, 13: 9-22.
[6]. D Auclair, D Miller, V Yatsula, et al. Antitumor activity of sorafenib in FLT3-driven leukemic cells. Leukemia, 2007, 21:439-445.
[7]. Maximilian Merz, Dorde Komljenovic, Stefan Zwick, et al. Sorafenib tosylate and paclitaxel induce anti-angiogenic, anti-tumour and anti-resorptive effects in experimental breast cancer bone metastases. European Journal of Cancer, 2011, 47:277-286.

Improving anti-tumor activity of sorafenib tosylate by lipid- and polymer-coated nanomatrix.[Pubmed:28165798]

Drug Deliv. 2017 Nov;24(1):270-277.

In the present study, we select the Sylysia 350 (Sylysia) as mesoporous material, distearoylphosphatidylethanolamine-poly(ethylene glycol)2000 (DSPE-PEG) as absorption enhancer and hydroxy propyl methyl cellulose (HPMC) as crystallization inhibitor to prepare Sorafenib Tosylate (SFN) nanomitrix (MSNM@SFN) for improving the anti-tumor activity of SFN. The MSNM@SFN was prepared by solvent evaporation method. The solubility, dissolution, and bioavailability of SFN in MSNM@SFN were also investigated. The anti-tumor activity of MSNM@SFN was evaluated in vitro and in vivo. Our results indicated that the solubility and dissolution of SFN in MSNM@SFN were significantly increased. The oral bioavailability of SFN in MSNM@SFN was greatly improved 7.7-fold compared with that in SFN suspension. The enhanced anti-tumor activity of MSNM@SFN was confirmed in vitro and in vivo experiments. This nanomatrix developed in this study could be a promising drug delivery platform for improving the therapeutic efficacy of poorly water-soluble drugs.

A large-scale prospective registration study of the safety and efficacy of sorafenib tosylate in unresectable or metastatic renal cell carcinoma in Japan: results of over 3200 consecutive cases in post-marketing all-patient surveillance.[Pubmed:26206897]

Jpn J Clin Oncol. 2015 Oct;45(10):953-62.

OBJECTIVE: Real-life safety and efficacy of sorafenib in advanced renal cell carcinoma in a nationwide patient population were evaluated by post-marketing all-patient surveillance. METHODS: All patients with unresectable or metastatic renal cell carcinoma in Japan who started sorafenib therapy from February 2008 to September 2009 were registered and followed for up to 12 months. Baseline characteristics, treatment status, tumor response, survival and safety data were recorded by the prescribing physicians. RESULTS: Safety and efficacy were evaluated in 3255 and 3171 patients, respectively. The initial daily dose was 800 mg in 78.2% of patients. Median duration of treatment was 6.7 months and the mean relative dose intensity was 68.4%. Overall, 2227 patients (68.4%) discontinued the treatment by 12 months, half of which (52.0% of discontinued patients) were due to adverse events. The most common adverse drug reactions were hand-foot skin reaction (59%), hypertension (36%), rash (25%) and increase in lipase/amylase (23%). The median progression-free survival was 7.3 months (95% confidence intervals: 6.7-8.1), and the overall survival rate at 1 year was 75.4% (73.5-77.1). Prognostic factors for overall survival were mostly consistent with those in previous clinical trials in the univariate analysis and largely similar to those for progression-free survival and duration of treatment in the multivariate analysis. CONCLUSIONS: Sorafenib for the treatment of advanced renal cell carcinoma under the labeled dose was feasible in daily medical practice, for its acceptable toxicity profile and favorable clinical benefit that were consistent with those in clinical trials.

Sorafenib and its tosylate salt: a multikinase inhibitor for treating cancer.[Pubmed:21206080]

Acta Crystallogr C. 2011 Jan;67(Pt 1):o29-32.

Sorafenib, a drug that targets malignant cancer cells and cuts off the blood supply feeding the tumour, has been crystallized as the free base, 4-(4-{3-[4-chloro-3-(trifluoromethyl)phenyl]ureido}phenoxy)-N-methylpyridine-2-ca rboxamide, C(21)H(16)ClF(3)N(4)O(3), (I), and as a tosylate salt, 4-(4-{3-[4-chloro-3-(trifluoromethyl)phenyl]ureido}phenoxy)-2-(N-methylcarbamoyl) pyridinium 4-methylbenzenesulfonate, C(21)H(17)ClF(3)N(4)O(3)(+).C(7)H(7)O(3)S(-), (II). In both structures, the sorafenib molecule is in an extended conformation. The pyridine-2-carboxamide group exhibits a syn conformation of the N atoms in (I), whereas an almost anti orientation is present in (II). In both crystal structures, the two terminal groups, viz. pyridine-2-carboxamide and the trifluorophenyl ring, are oriented differently to the conformations found in enzyme-bound sorafenib. The sorafenib molecules in (I) are linked into zigzag chains by N-H...O hydrogen bonds, whereas in (II) the presence of the additional tosylate anion results in the formation of chains of fused hydrogen-bonded rings. This study reveals the variations in the solid-state conformation of the sorafenib molecule in different crystalline environments.

Sorafenib tosylate as a radiosensitizer in malignant astrocytoma.[Pubmed:24139873]

J Clin Neurosci. 2014 Jan;21(1):131-6.

Progress in research on the molecular aspects of glioblastoma has yet to provide a medical therapy that significantly improves prognosis. Glioblastoma invariably progress through current treatment regimens with radiotherapy as a key component. Activation of several signaling pathways is thought to be associated with this resistance to radiotherapy. Ras activity is exceptionally high in glioblastoma and may regulate sensitivity to radiotherapy. Raf-1, a downstream effector of Ras, demonstrates a high amount of activity in glioblastoma. Therefore, Raf-1 inhibition should be considered as a mechanism to increase the effectiveness of radiotherapy in treatment regimen. In vitro analysis was performed with a novel Raf-1 kinase inhibitor (BAY 54-9085) in culture with the glioblastoma cell line U1242. The cell line was treated in serum-containing media and analyzed for the effect of the BAY 54-9085 alone and BAY 54-9085 combined with radiation on cell death. BAY 54-9085 displayed a cytocidal effect on glioblastoma cells following a 3 day incubation with the drug in serum-containing media. A dose of 2.5 muM displayed moderate cell death which significantly increased with a dose of 5.0 muM. In addition, glioblastoma cells treated with both the BAY 54-9085 and gamma radiation displayed a significant increase in cell death (85.5%) as compared to either BAY 54-9085 (73.1%) or radiation (34.4%) alone. Radiation therapy is a key component of treatment for glioblastoma. A novel Raf-1 inhibitor displayed in vitro evidence of synergistically increasing cell death of glioblastoma cells in combination with radiation.

Sorafenib Tosylate (Bay 43-9006 Tosylate) is a potent and orally active Raf inhibitor with IC50s of 6 nM and 20 nM for Raf-1 and B-Raf, respectively. SorafenibTosylate is a multikinase inhibitor with IC50s of 90 nM, 15 nM, 20 nM, 57 nM and 58 nM for VEGFR2, VEGFR3, PDGFRβ, FLT3 and c-Kit, respectively. Sorafenib Tosylate induces autophagy and apoptosis. Sorafenib Tosylate has anti-tumor activity. Sorafenib Tosylate is a ferroptosis activator.

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