title: A dosing/cross-development study of the multikinase inhibitor sorafenib in patients with pulmonary arterial hypertension.
abstract: Pulmonary arterial hypertension (PAH) and cancer share elements of pathophysiology. This provides an opportunity for the cross-development of anticancer agents that can be used in improving PAH care. The adaptation of new drugs across these disease populations warrants a structured approach. This study was a 16-week, phase Ib, single-center, open-label trial of the multikinase/angiogenesis inhibitor sorafenib. In order to assess the safety of sorafenib in PAH, patients with advanced but stable disease on parenteral prostanoids (with or without oral sildenafil) were initiated on treatment at the lowest active dosage administered to cancer patients: 200 mg daily. Patients underwent weekly clinical evaluations and monthly functional testing and dose escalations to a final dosage of 400 mg twice daily. Among 12 patients (10 of them women), sorafenib was well tolerated at 200 mg twice daily. The most common adverse events were moderate skin reactions on the hands and feet and alopecia. Our conclusion was therefore that this is a tolerable dosing regimen for testing the therapeutic activity of sorafenib in PAH patients.
authors.affiliation: Section of Cardiology, Department of Medicine, University of Chicago, Chicago, Illinois, USA. mgomberg@medicine.bsd.uchicago.edu
authors.forename: M
authors.initials: M
authors.lastname: Gomberg-Maitland
authors.forename: M L
authors.initials: ML
authors.lastname: Maitland
authors.forename: R J
authors.initials: RJ
authors.lastname: Barst
authors.forename: L
authors.initials: L
authors.lastname: Sugeng
authors.forename: S
authors.initials: S
authors.lastname: Coslet
authors.forename: T J
authors.initials: TJ
authors.lastname: Perrino
authors.forename: L
authors.initials: L
authors.lastname: Bond
authors.forename: M E
authors.initials: ME
authors.lastname: Lacouture
authors.forename: S L
authors.initials: SL
authors.lastname: Archer
authors.forename: M J
authors.initials: MJ
authors.lastname: Ratain
mesh_terms: D000328:Adult; D000368:Aged; D001557:Benzenesulfonates / Q000008:administration & dosage* / Q000009:adverse effects; D003967:Diarrhea / Q000139:chemically induced / Q000201:enzymology; D055808:Drug Discovery / Q000379:methods; D054796:Drug Dosage Calculations; D005076:Exanthema / Q000139:chemically induced / Q000201:enzymology; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000188:drug therapy* / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D011725:Pyridines / Q000008:administration & dosage* / Q000009:adverse effects; D000077157:Sorafenib
chemical_list: D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib