title: ZD6474, a novel tyrosine kinase inhibitor of vascular endothelial growth factor receptor and epidermal growth factor receptor, inhibits tumor growth of multiple nervous system tumors.
abstract: OBJECTIVE
  Primary central nervous system (CNS) tumors represent a diverse group of tumor types with heterogeneous molecular mechanisms that underlie their formation and maintenance. CNS tumors depend on angiogenesis and often display increased activity of ErbB-associated pathways. Current nonspecific therapies frequently have poor efficacy in many of these tumor types, so there is a pressing need for the development of novel targeted therapies.
  
  
  METHODS
  ZD6474 is a novel, orally available low molecular weight inhibitor of the kinase activities associated with vascular endothelial growth factor receptor-2 and epidermal growth factor receptor. We hypothesized that ZD6474 may provide benefit in the treatment of several CNS tumor types.
  
  
  RESULTS
  In mice bearing established s.c. tumor xenografts of CNS tumors (malignant glioma and ependymoma) or rhabdomyosarcoma, a limited course of ZD6474 treatment produced significant tumor growth delays and a high rate of partial tumor regression in most models examined. Mice with i.c. malignant glioma xenografts treated with ZD6474 experienced a significant prolongation of survival. Tumors from mice treated with ZD6474 displayed a lower proliferative index and disrupted tumor vascularity. Notably, some of these models are insensitive to low molecular weight kinase inhibitors targeting only vascular endothelial growth factor receptor-2 or epidermal growth factor receptor functions, suggesting that the combined disruption of both epidermal growth factor receptor and vascular endothelial growth factor receptor-2 activities may significantly increase tumor control.
  
  
  CONCLUSIONS
  In conclusion, ZD6474 shows significant activity against xenograft models of several primary human CNS tumor types. Consideration for clinical development in this disease setting seems warranted.
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA. rich0001@mc.duke.edu
authors.forename: Jeremy N
authors.initials: JN
authors.lastname: Rich
authors.forename: Sith
authors.initials: S
authors.lastname: Sathornsumetee
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Keir
authors.forename: Mark W
authors.initials: MW
authors.lastname: Kieran
authors.forename: Andrea
authors.initials: A
authors.lastname: Laforme
authors.forename: Arja
authors.initials: A
authors.lastname: Kaipainen
authors.forename: Roger E
authors.initials: RE
authors.lastname: McLendon
authors.forename: Michael W
authors.initials: MW
authors.lastname: Graner
authors.forename: B K Ahmed
authors.initials: BK
authors.lastname: Rasheed
authors.forename: Ling
authors.initials: L
authors.lastname: Wang
authors.forename: David A
authors.initials: DA
authors.lastname: Reardon
authors.forename: Anderson J
authors.initials: AJ
authors.lastname: Ryan
authors.forename: Catherine
authors.initials: C
authors.lastname: Wheeler
authors.forename: Isaiah
authors.initials: I
authors.lastname: Dimery
authors.forename: Darell D
authors.initials: DD
authors.lastname: Bigner
authors.forename: Henry S
authors.initials: HS
authors.lastname: Friedman
mesh_terms: D000818:Animals; D045744:Cell Line, Tumor; D002465:Cell Movement / Q000187:drug effects; D049109:Cell Proliferation / Q000187:drug effects; D016543:Central Nervous System Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D004305:Dose-Response Relationship, Drug; D004806:Ependymoma / Q000188:drug therapy / Q000473:pathology; D066246:ErbB Receptors / Q000037:antagonists & inhibitors* / Q000378:metabolism; D005910:Glioma / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D051379:Mice; D008819:Mice, Nude; D019950:Mitogen-Activated Protein Kinase 1 / Q000378:metabolism; D048052:Mitogen-Activated Protein Kinase 3 / Q000378:metabolism; D009389:Neovascularization, Pathologic / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control; D010766:Phosphorylation / Q000187:drug effects; D010880:Piperidines / Q000494:pharmacology*; D011799:Quinazolines / Q000494:pharmacology*; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors* / Q000378:metabolism; D023041:Xenograft Model Antitumor Assays
chemical_list: D019394:Ki-67 Antigen; D010880:Piperidines; D011799:Quinazolines; D066246:ErbB Receptors; D040262:Receptors, Vascular Endothelial Growth Factor; D019950:Mitogen-Activated Protein Kinase 1; D048052:Mitogen-Activated Protein Kinase 3; C452423:vandetanib