Flavopiridol (L86 8275; NSC 649890), a new kinase inhibitor for tumor therapy.

Flavopiridol is a new synthetic flavone, structurally related to a natural alkaloid, originally purified from Dysoxylum binectariferum, a plant indigenous to India and used in Indian folk medicine. Flavopiridol was detected by a tandem screening system consisting in inhibition of the EGF-receptor Tyrosine phosphokinase and cytotoxicity. As a cytostatic mechanism, however, Flavopiridol strongly inhibits the cyclin-dependent kinases (cdk1, cdk2, cdk4, cdk7), with the potential to cause inhibition of cell cycle progression in G(1) and G(2) by multiple mechanisms relatable to cdk inhibition. In certain cell types, Flavopiridol induces apoptosis. The antitumor activity of that compound on human xenograft tumors is similar to standard cytostatic drugs and superior to them at least in prostate carcinoma. The dose limiting toxicity is diarrhea. Compared with other flavonoids or other kinase inhibitors Flavopiridol can be regarded as unique as no other compound is yet known that as specifically and potently inhibits nearly all the main cyclin dependent kinases and by that mechanisms can arrest cell cycle progression in G(1) as well as in G(2) and no other specific kinase inhibitor is known, which after i.v. or oral application reduces the growth of subcutaneous or subrenal xenografts of human tumors of different types. Initial results of a phase I study at the National Cancer Institute (NCI), USA, (Investigational New Drug Application no. 46211) provided some clinical and laboratory evidence for antineoplastic effect at nontoxic doses (no grade IV toxicities encountered). Thus, Flavopiridol is clearly in need of further clinical evaluation of its tumor therapeutic potential. In this review the chemical profile, tumorpharmacology (in vitro activity, inhibition of cdk's and preclinical in vivo activity), preclinical toxicology and pharmacokinetic of Flavopiridol are reviewed to provide a comprehensive source to aid further developmental efforts.