The effect of Bcrp1 (Abcg2) on the in vivo pharmacokinetics and brain penetration of imatinib mesylate (Gleevec): implications for the use of breast cancer resistance protein and P-glycoprotein inhibitors to enable the brain penetration of imatinib in patients

Cancer Res. 2005 Apr 1;65(7):2577-82. doi: 10.1158/0008-5472.CAN-04-2416.

Abstract

Imatinib mesylate (signal transduction inhibitor 571, Gleevec) is a potent and selective tyrosine kinase inhibitor, which was shown to effectively inhibit platelet-derived growth factor-induced glioblastoma cell growth preclinically. However, in patients, a limited penetration of imatinib into the brain has been reported. Imatinib is transported in vitro and in vivo by P-glycoprotein (P-gp; ABCB1), which thereby limits its distribution into the brain in mice. Previously, imatinib was shown to potently inhibit human breast cancer resistance protein (BCRP; ABCG2). Here, we show that imatinib is efficiently transported by mouse Bcrp1 in transfected Madin-Darby canine kidney strain II (MDCKII) monolayers. Furthermore, we show that the clearance of i.v. imatinib is significantly decreased 1.6-fold in Bcrp1 knockout mice compared with wild-type mice. At t = 2 hours, the brain penetration of i.v. imatinib was significantly 2.5-fold increased in Bcrp1 knockout mice compared with control mice. We tested the hypothesis that P-gp and BCRP inhibitors, such as elacridar and pantoprazole, improve the brain penetration of imatinib. Firstly, we showed in vitro that pantoprazole and elacridar inhibit the Bcrp1-mediated transport of imatinib in MDCKII-Bcrp1 cells. Secondly, we showed that co-administration of pantoprazole or elacridar significantly reduced the clearance of i.v. imatinib in wild-type mice by respectively 1.7-fold and 1.5-fold. Finally, in wild-type mice treated with pantoprazole or elacridar, the brain penetration of i.v. imatinib significantly increased 1.8-fold and 4.2-fold, respectively. Moreover, the brain penetration of p.o. imatinib increased 5.2-fold when pantoprazole was co-administered in wild-type mice. Our results suggest that co-administration of BCRP and P-gp inhibitors may improve delivery of imatinib to malignant gliomas.

MeSH terms

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • ATP Binding Cassette Transporter, Subfamily B, Member 1 / antagonists & inhibitors*
  • ATP Binding Cassette Transporter, Subfamily B, Member 1 / metabolism
  • ATP Binding Cassette Transporter, Subfamily G, Member 2
  • ATP-Binding Cassette Transporters / antagonists & inhibitors*
  • ATP-Binding Cassette Transporters / genetics
  • ATP-Binding Cassette Transporters / metabolism
  • Acridines / pharmacology*
  • Animals
  • Benzamides
  • Benzimidazoles / pharmacology*
  • Biological Transport / drug effects
  • Brain / drug effects
  • Brain / metabolism*
  • Dogs
  • Drug Synergism
  • Humans
  • Imatinib Mesylate
  • Male
  • Membranes / metabolism
  • Methotrexate / pharmacokinetics
  • Mice
  • Mice, Knockout
  • Neoplasm Proteins / antagonists & inhibitors*
  • Neoplasm Proteins / deficiency
  • Neoplasm Proteins / genetics
  • Neoplasm Proteins / metabolism
  • Omeprazole / analogs & derivatives*
  • Omeprazole / pharmacology*
  • Pantoprazole
  • Piperazines / pharmacokinetics*
  • Pyrimidines / pharmacokinetics*
  • Spodoptera
  • Sulfoxides / pharmacology*
  • Tetrahydroisoquinolines / pharmacology*

Substances

  • 2-Pyridinylmethylsulfinylbenzimidazoles
  • ABCG2 protein, human
  • ATP Binding Cassette Transporter, Subfamily B, Member 1
  • ATP Binding Cassette Transporter, Subfamily G, Member 2
  • ATP-Binding Cassette Transporters
  • Acridines
  • Benzamides
  • Benzimidazoles
  • Neoplasm Proteins
  • Piperazines
  • Pyrimidines
  • Sulfoxides
  • Tetrahydroisoquinolines
  • Imatinib Mesylate
  • Pantoprazole
  • Omeprazole
  • Elacridar
  • Methotrexate