Topical administration of regorafenib eye drops: Phase I dose-escalation study in healthy volunteers

Abstract

Aim

Regorafenib is a multi-kinase inhibitor under investigation for use in neovascular age-related macular degeneration. In this Phase I study, regorafenib eye drops were administered to healthy volunteers to provide information on safety, tolerability and systemic exposure.

Methods

This was a single-centre, randomized, double-masked, parallel-group, dose-escalation, placebo-controlled study. Subjects received regorafenib eye drops (30 mg ml^–1, 25 μL) as a 0.75 mg single dose (Cohort 1), 0.75 mg twice daily (bid) or thrice daily (tid) over 14 days (Cohorts 2 and 3) or 1.5 mg tid unilaterally for 3 days, then bilaterally up to 14 days (Cohort 4), or placebo. Plasma samples were taken to estimate systemic exposure. Safety and functional assessments were performed throughout the study.

Results

Thirty-six subjects received regorafenib and 12 received placebo. Regorafenib was safe and well tolerated over the dose range. No pathologic changes in the anterior, vitreous or posterior eye compartments occurred. Mild eyelid redness, oedema and conjunctival hyperaemia were observed across all regorafenib cohorts; these were comparable with placebo. Predominant symptoms were blurred vision in active and placebo groups. Systemic safety evaluations showed no clinically relevant findings. Absolute systemic exposure after multiple administration of regorafenib eye drops 0.75 mg was 600–700-fold lower than after multiple oral administration of 160 mg day^–1, the dose approved in cancer indications.

Conclusion

These results indicate a favourable safety and tolerability profile of regorafenib eye drops up to 30 mg ml^–1 tid for use in clinical studies.

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