XL147 (SAR245408)

Upregulation of PI3K activity is one of the most common characteristics of human tumor cells and can result from activation of growth factor receptors, amplification of the PIK3CA gene, activating mutations in the PIK3CA gene, downregulation of the PTEN lipid phosphatase, or activating mutations in RAS. Activation of PI3K results in stimulation of AKT and mTOR kinases resulting in promotion of tumor cell growth and survival. This survival signal plays a significant role in conferring resistance to chemo- and radio-therapy by inhibiting apoptotic cell death.

Exelixis is developing XL147 in collaboration with sanofi-aventis. Based on clinical data available to date, XL147 appears to be well tolerated and has shown clinical activity in a range of cancer types.  As a result, Exelixis and sanofi-aventis are pursuing a broad clinical development program for XL147, evaluating the compound as a single agent and in multiple combination regimens in a variety of cancer indications. Ongoing clinical trials include a phase 2 trial in endometrial cancer, phase 1b/2 trials in combination with carboplatin and paclitaxel in patients with endometrial, ovarian or non-small cell lung cancer (NSCLC), in combination with erlotinib in patients with NSCLC, and in combination with trastuzumab or trastuzumab and paclitaxel in patients with HER2-positive breast cancer, and a phase 1 trial in patients with solid tumors or lymphoma.

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