Fosbretabulin disodium is the disodium salt of a water-soluble phosphate derivative of a natural stilbenoid phenol derived from the African bush willow (Combretum caffrum) with potential vascular disrupting and antineoplastic activities. Upon administration, the prodrug fosbretabulin is dephosphorylated to its active metabolite, the microtubule-depolymerizing agent combretastatin A4, which binds to tubulin dimers and prevents microtubule polymerization, resulting in mitotic arrest and apoptosis in endothelial cells. In addition, this agent disrupts the engagement of the endothelial cell–specific junctional molecule vascular endothelial-cadherin (VE-cadherin) and so the activity of the VE-cadherin/β-catenin/Akt signaling pathway, which may result in the inhibition of endothelial cell migration and capillary tube formation. As a result of fosbretabulin's dual mechanism of action, the tumor vasculature collapses, resulting in reduced tumor blood flow and ischemic necrosis of tumor tissue.
1: Sosa JA, Balkissoon J, Lu SP, Langecker P, Elisei R, Jarzab B, Bal CS, Marur S, Gramza A, Ondrey F. Thyroidectomy followed by fosbretabulin (CA4P) combination regimen appears to suggest improvement in patient survival in anaplastic thyroid cancer. Surgery. 2012 Dec;152(6):1078-87. doi: 10.1016/j.surg.2012.08.036. Review. PubMed PMID: 23158178.
2: Venegas B, Zhu W, Haloupek NB, Lee J, Zellhart E, Sugár IP, Kiani MF, Chong PL. Cholesterol superlattice modulates CA4P release from liposomes and CA4P cytotoxicity on mammary cancer cells. Biophys J. 2012 May 2;102(9):2086-94. doi: 10.1016/j.bpj.2012.03.063. PubMed PMID: 22824272; PubMed Central PMCID: PMC3341537.
3: Nathan P, Zweifel M, Padhani AR, Koh DM, Ng M, Collins DJ, Harris A, Carden C, Smythe J, Fisher N, Taylor NJ, Stirling JJ, Lu SP, Leach MO, Rustin GJ, Judson I. Phase I trial of combretastatin A4 phosphate (CA4P) in combination with bevacizumab in patients with advanced cancer. Clin Cancer Res. 2012 Jun 15;18(12):3428-39. doi: 10.1158/1078-0432.CCR-11-3376. Epub 2012 May 29. PubMed PMID: 22645052.
4: Rustin GJ, Shreeves G, Nathan PD, Gaya A, Ganesan TS, Wang D, Boxall J, Poupard L, Chaplin DJ, Stratford MR, Balkissoon J, Zweifel M. A Phase Ib trial of CA4P (combretastatin A-4 phosphate), carboplatin, and paclitaxel in patients with advanced cancer. Br J Cancer. 2010 Apr 27;102(9):1355-60. doi: 10.1038/sj.bjc.6605650. Epub 2010 Apr 13. PubMed PMID: 20389300; PubMed Central PMCID: PMC2865759.
5: Siemann DW, Chaplin DJ, Walicke PA. A review and update of the current status of the vasculature-disabling agent combretastatin-A4 phosphate (CA4P). Expert Opin Investig Drugs. 2009 Feb;18(2):189-97. doi: 10.1517/13543780802691068 . Review. PubMed PMID: 19236265; PubMed Central PMCID: PMC3593193.
6: Siemann DW, Shi W. Dual targeting of tumor vasculature: combining Avastin and vascular disrupting agents (CA4P or OXi4503). Anticancer Res. 2008 Jul-Aug;28(4B):2027-31. PubMed PMID: 18751370; PubMed Central PMCID: PMC2788501.
7: Petit I, Karajannis MA, Vincent L, Young L, Butler J, Hooper AT, Shido K, Steller H, Chaplin DJ, Feldman E, Rafii S. The microtubule-targeting agent CA4P regresses leukemic xenografts by disrupting interaction with vascular cells and mitochondrial-dependent cell death. Blood. 2008 Feb 15;111(4):1951-61. Epub 2007 Nov 16. PubMed PMID: 18024794; PubMed Central PMCID: PMC2234044.
8: Salmon BA, Salmon HW, Siemann DW. Monitoring the treatment efficacy of the vascular disrupting agent CA4P. Eur J Cancer. 2007 Jul;43(10):1622-9. Epub 2007 Apr 23. PubMed PMID: 17451938; PubMed Central PMCID: PMC2962830.
9: Salmon HW, Mladinich C, Siemann DW. Evaluations of vascular disrupting agents CA4P and OXi4503 in renal cell carcinoma (Caki-1) using a silicon based microvascular casting technique. Eur J Cancer. 2006 Nov;42(17):3073-8. Epub 2006 Sep 7. PubMed PMID: 16956760.
Chemical |
CAS Num |
168555-66-6 (fosbretabulin disodium) |
Chemical Formula |
C18H19Na2O8P |
Molecular Weight |
440.29 |
IUPAC Chemical Name |
Disodium [2-methoxy-5-[(Z)-2-(3,4,5-trimethoxyphenyl)ethenyl]phenyl] phosphate |
Elemental Analysis |
C, 49.10; H, 4.35; Na, 10.44; O, 29.07; P, 7.03 |
Synonym |
Combretastatin A4 phosphate disodium CA4P CA4DP Combretastatin A4 phosphate Zybrestat |
Solubility |
Soluble in DMSO, not in water |
SMILES Code |
O=P([O-])([O-])OC1=CC(/C=C\C2=CC(OC)=C(OC)C(OC)=C2)=CC=C1OC.[Na+].[Na+] |
Biological |
Targets and Effects |
N/A |
Pathways |
Apoptosis |
Physical |
Appearance |
white solid powder |
Purity |
>98% (or refer to the Certificate of Analysis) |
Shipping Condition |
Shipped under ambient temperature as non-hazardous chemical. This product is stable enough for a few weeks during ordinary shipping and time spent in Customs. |
Storage Condition |
Dry, dark and at 0 - 4 C for short term (days to weeks) or -20 C for long term (months to years). |
Shelf Life |
>2 years if stored properly |