new anti-cancer drug | Lenatinib is an irreversible epidermal growth factor receptor (EGFR) developed by Wyeth in the United States Inhibitor. It is a small molecule tyrosine kinase inhibitor targeting HER2 and HER1 after lapatinib. It is an irreversible pan-ErbB receptor tyrosine kinase inhibitor. It can selectively inhibit HER-1 and HER-2 in EGFR family (IC50 is 92nmol/L and 59nmol/L respectively). Clinical studies have shown that it has obvious therapeutic effects on non-small cell lung cancer, colon cancer, and breast cancer. Phase II clinical trials have shown that renatinib has good efficacy and tolerance for advanced HER-2 positive breast cancer patients treated with or without trastuzumab. Phase III clinical study of breast cancer completed in September 2014. The data show that in the treatment of early HER-2 positive breast cancer, lenatinib is more effective than Herceptin (Herceptin) of Roche. |
Introduction | Lenatinib is a tyrosine kinase inhibitor. On July 17, 2017, FDA approved it for prolonged adjuvant therapy (extendedadjuvanttherapy) for early HER2-positive breast cancer. For this type of cancer, Lenatinib is the first prolonged adjuvant treatment. |
Synthesis | Using 3-chloro-4-(pyridine-2-methoxy)-aniline (2) and N-(4-chloro-3-cyano-7-ethoxyquinoline-6-yl)-acetamide (3) as raw materials, N-[4-[3-chloro-4-(pyridine-2-methoxy) anilino]-3-cyano-7-ethoxyquinoline-6-yl] acetamide (4),4 is deprotected under the action of hydrochloric acid, then the free base is precipitated in the methanol solution of potassium carbonate to prepare 3-cyano-6-amino-4-[3-chloro-4-(pyridine-2-methoxy) anilinyl]-7-ethoxyquinoline (5),5 is condensed with the acid chloride prepared by the Vilsmeier reaction of trans-4-dimethylaminocrotonic acid hydrochloride (6) to prepare natinib (1). Fig. 1 shows the synthetic route of lenatinib |
side effects | are diarrhea, nausea, vomiting and fatigue. The new anti-cancer drug, synthesis, and side effects of Lai Natinib are edited by Shi Yan. (2015-10-23) |
biological activity | Neratinib (HKI-272) is a highly selective HER2 and EGFR inhibitor with IC50 of 59 nM and 92 nM respectively in cell-free test. Weak inhibition of KDR and Src, for Akt,CDK1/2/4,IKK-2,MK-2,PDK1,c-Raf and c-Met did not significantly inhibit. Phase 3. |
target | TargetValue her2 (cell-free assay) 59 nmEGFR (cell-free assay) 92 nmkdr (cell-free assay) 800 nmsrc (cell-free assay) 1.4 μ m |
Target | Value |
HER2
(Cell-free assay)
| 59 nM |
EGFR
(Cell-free assay)
| 92 nM |
KDR
(Cell-free assay)
| 800 nM |
Src
(Cell-free assay)
| 1.4 μM |
in vitro study | Neratinib weakly inhibit tyrosine kinases KDR and Src,IC50 is 0.8 μM and 1.4 μM respectively, compared with HER-2, the activity is 14 and 24 times weaker respectively. Neratinib acting on other serine-threonine kinases such as Akt, cyclin D1/cdk4, cyclin E/cdk2, cyclin B1/cdk1, IKK-2, MK-2, PDK1, c-Raf, and Tpl-2, and tyrosine kinase c-Met have no activity. Neratinib selectively inhibited the proliferation of 3T3 cells transfected with HER-2 (3T3/neu), and also inhibited the proliferation of two other HER-2-overexpressing SK-Br-3 and BT474 cells with an IC50 of 2-3 nM, which was more than 230-fold higher than that of untransfected 3T3 cells and EGFR-and HER-2 negative MDA-MB-435 and SW620 cells. Neratinib also inhibited the proliferation of EGFR-dependent A431 cells with an IC50 of 81 nM. Neratinib acts on BT474 cells, reduces HER-2 receptor autophosphorylation, IC50 is 5 nM, acts on A431 cells, reduces EGF-dependent EGFR phosphorylation, IC50 is 3 nM. Neratinib inhibition of HER-2 leads to inhibition of downstream MAPK and Akt pathways with IC50 of 2 nM, which is more effective than Trastuzumab. Neratinib acts on BT474 cells to inhibit cyclin D1 expression and phosphorylation of Rb-sensitive gene products. IC50 is 9 nM, resulting in cell cycle stopping at G1-S phase and eventually reducing cell proliferation. |
in vivo study | Neratinib were orally treated at doses of 10, 20, 40, and 80 mg/kg daily to give 3T3/neu transplanted tumor, significantly inhibiting growth, inhibiting 34%, 53%, 98%, and 98% respectively. The Neratinib was treated at a dose of 40 mg/kg per day, and 84% HER-2 phosphorylation was inhibited within 1 hour. Accordingly, the Neratinib treated BT474 transplanted tumor at doses of 5, 10, and 40 mg/kg per day, with inhibition of 70-82%, 67%, and 93%, respectively. Neratinib is also effective in SK-OV-3 transplanted tumors, treated at doses of 5 and 60 mg/kg per day, with inhibition of 31% and 85% respectively. The effect of Neratinib on EGFR-dependent A431 transplanted tumor is weaker than that on HER-2-dependent tumor, and the inhibition is 32% and 44% respectively when treated at doses of 5 and 20 mg/kg per day. Neratinib has little activity on MCF-7 and MX-1 transplanted tumors expressing low levels of HER-2 and EGFR, and the inhibition is only 28% treated at a dose of 80 mg/kg per day, indicating that Neratinib selectively acts on cells expressing HER-2 or EGFR. |