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

AimRegorafenib is a multikinase 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. MethodsThis was a single-centre, randomized, double-masked, parallel-group, dose-escalation, placebo-controlled study. Subjects received regorafenib eye drops (30mg ml(-1), 25l) as a 0.75mg single dose (Cohort 1), 0.75mg twice daily (bid) or thrice daily (tid) over 14days (Cohorts 2 and 3, respectively), 1.5mg tid unilaterally for 3days, then bilaterally for up to 14days (Cohort 4), or placebo. Plasma samples were taken to estimate systemic exposure. Safety and functional assessments were performed throughout the study. ResultsThirty-six subjects received regorafenib and 12 received placebo. Regorafenib was safe and well tolerated over the dose range. No pathological changes occurred in the anterior, vitreous or posterior eye compartments. Mild eyelid redness, oedema and conjunctival hyperaemia were observed across all regorafenib cohorts; these were comparable with the effects seen with placebo. Predominant symptoms were blurred vision in the active and placebo groups. Systemic safety evaluations showed no clinically relevant findings. Absolute systemic exposure after multiple administrations of regorafenib eye drops at a dose of 0.75mg was 600-700-fold lower than after multiple oral administration of 160mg day(-1), the dose approved in cancer indications. ConclusionThese results indicate a favourable safety and tolerability profile of regorafenib eye drops up to 30mg ml(-1) tid for use in clinical studies.