Ninlaro, INN-Ixazomib
Total Page:16
File Type:pdf, Size:1020Kb
Load more
Recommended publications
-
Vorinostat—An Overview Aditya Kumar Bubna
E-IJD RESIDENTS' PAGE Vorinostat—An Overview Aditya Kumar Bubna Abstract From the Consultant Vorinostat is a new drug used in the management of cutaneous T cell lymphoma when the Dermatologist, Kedar Hospital, disease persists, gets worse or comes back during or after treatment with other medicines. It is Chennai, Tamil Nadu, India an efficacious and well tolerated drug and has been considered a novel drug in the treatment of this condition. Currently apart from cutaneous T cell lymphoma the role of Vorinostat for Address for correspondence: other types of cancers is being investigated both as mono-therapy and combination therapy. Dr. Aditya Kumar Bubna, Kedar Hospital, Mugalivakkam Key Words: Cutaneous T cell lymphoma, histone deacytelase inhibitor, Vorinostat Main Road, Porur, Chennai - 600 125, Tamil Nadu, India. E-mail: [email protected] What was known? • Vorinostat is a histone deacetylase inhibitor. • It is an FDA approved drug for the treatment of cutaneous T cell lymphoma. Introduction of Vorinostat is approximately 9. Vorinostat is slightly Vorinostat is a histone deacetylase (HDAC) inhibitor, soluble in water, alcohol, isopropanol and acetone and is structurally belonging to the hydroxymate group. Other completely soluble in dimethyl sulfoxide. drugs in this group include Givinostat, Abexinostat, Mechanism of action Panobinostat, Belinostat and Trichostatin A. These Vorinostat is a broad inhibitor of HDAC activity and inhibits are an emergency class of drugs with potential anti- class I and class II HDAC enzymes.[2,3] However, Vorinostat neoplastic activity. These drugs were developed with the does not inhibit HDACs belonging to class III. Based on realization that apart from genetic mutation, alteration crystallographic studies, it has been seen that Vorinostat of HDAC enzymes affected the phenotypic and genotypic binds to the zinc atom of the catalytic site of the HDAC expression in cells, which in turn lead to disturbed enzyme with the phenyl ring of Vorinostat projecting out of homeostasis and neoplastic growth. -
FARYDAK (Panobinostat) RATIONALE for INCLUSION in PA PROGRAM
FARYDAK (panobinostat) RATIONALE FOR INCLUSION IN PA PROGRAM Background Farydak (panobinostat) is the first histone deacetylase (HDAC) inhibitor approved to treat multiple myeloma in patients who have received at least two prior standard therapies, including bortezomib and an immunomodulatory agent. Farydak is to be used in combination with bortezomib, a type of chemotherapy, and dexamethasone, an anti-inflammatory medication. Multiple myeloma causes plasma cells to rapidly multiply and crowd out other healthy blood cells from the bone marrow. When the bone marrow has too many plasma cells, the cells may move to other parts of the body. Farydak works by inhibiting the activity of enzymes, known as histone deacetylases (HDACs). The inhibition of these enzymes may slow the over development of plasma cells in multiple myeloma patients or cause these dangerous cells to die (1). Regulatory Status FDA-approved indication: Farydak, a histone deacetylase inhibitor, in combination with bortezomib and dexamethasone, is indicated for the treatment of patients with multiple myeloma who have received at least 2 prior regimens, including bortezomib and an immunomodulatory agent (2). Farydak carries a Boxed Warning alerting patients and health care professionals that severe diarrhea and severe and fatal cardiac events, arrhythmias and electrocardiogram (ECG) changes have occurred in patients receiving Farydak. Arrhythmias may be exacerbated by electrolyte abnormalities. The most common laboratory abnormalities were low levels of phosphorus in the blood (hypophosphatemia), low potassium levels in the blood (hypokalemia), low levels of salt in the blood (hyponatremia), increased creatinine, low platelets (thrombocytopenia), low white blood cell counts (leukopenia) and low red blood cell counts (anemia). -
Phase I Trial of Carboplatin and Etoposide in Combination with Panobinostat in Patients with Lung Cancer
ANTICANCER RESEARCH 33: 4475-4482 (2013) Phase I Trial of Carboplatin and Etoposide in Combination with Panobinostat in Patients with Lung Cancer AHMAD A. TARHINI1,2, HARIS ZAHOOR1, BRIAN MCLAUGHLIN1, WILLIAM E GOODING2, JOHN C. SCHMITZ2, JILL M. SIEGFRIED2, MARK A. SOCINSKI1,2 and ATHANASSIOS ARGIRIS3 1University of Pittsburgh Medical Center, 2University of Pittsburgh Cancer Institute, UPMC Cancer Pavilion, Pittsburgh, PA, U.S.A.; 3University of Texas Health Science Center at San Antonio, San Antonio, TX, U.S.A. Abstract. A phase I trial consisting of panobinostat (a apoptosis in response to HDAC inhibitors may also be HDAC inhibitor), carboplatin and etoposide was condacted in mediated by acetylation of non-histone proteins (such as patients with lung cancer. Patients and Methods: Patients HSP-90, p53, HIF1-α, α-tubulin) (5). received carboplatin AUC5 on day 1 and etoposide 100 mg/m2 Panobinostat, a hydroxamic acid derivative, is an oral pan- on days 1, 2 and 3, every 21 days. Concurrent oral deacetylase inhibitor (6). It affects proteins involved in cell-cycle panobinostat was given 3 times weekly on a 2-weeks-on and 1- regulation (p53, p21), angiogenesis (HIF-1α), gene transcription week-off schedule during the 4-6 cycles of chemotherapy and (transcription factors), protein stabilization (Hsp90) and then continued as maintenance therapy. Results: Six evaluable cytoskeleton (α-tubulin), through inhibition of HDACs (7, 8). patients were treated at the first dose level of panobinostat Panobinostat exhibits increased histone acetylation and (10 mg). Dose-limiting toxicity occurred in two patients (33%) has potent antiproliferative activity against a broad range of during the first cycle. -
Management of Multiple Myeloma: the Changing Paradigm
Management of Multiple Myeloma: The Changing Paradigm Relapsed/Refractory Disease Jeffrey A. Zonder, MD Karmanos Cancer Institute Objectives • Discuss use of standard myeloma therapies when used as therapy after relapse • Consider patient and disease factors which might impact therapy decisions. • Describe off-label options for patients who are not protocol candidates. Line ≠ Line ≠ Line ≠ … POLICE LINE – DO NOT CROSS POLICE LINE – DO NOT CROSS POLICE LINE – DO NOT CROSS POLICE LINE – DO NOT CROSS POLI LINE – DO NOT Define “Line” • A pre-defined course of therapy utilizing agents either simultaneously or sequentially – Len/Dex – Len/Dex ASCT – Vel/Dex ASCT Len/Dex – VDT-PACE ASCT TD ASCT VPT-PACE LD • Pts who have had the same # of “lines” of Rx may have had vastly different amounts of Rx What Is Relapsed/Refractory Disease? • Relapsed: recurrence after a response to therapy • Refractory: progression despite ongoing therapy What Do We Know About the Pt’s Myeloma? • What prior therapy has been used? • How well did it work? • Did the myeloma progress on active therapy? • High-risk cytogenetics/FISH/GEP? What Do We Know About the Patient? • Age • Other medical problems – Diabetes – Blood Clots • Lasting side effects from past therapies – Peripheral Neuropathy • Personal preferences and values Choosing Therapy for Relapsed/Refractory Myeloma Proteasome IMiDs Anthracyclines Alkylators Steroids HDACs Antibodies Inhibitors Thalidomide Bortezomib Doxil Melphalan Dex Panobinostat Elotuzumab Lenalidomide Carfilzomib Cytoxan Pred Vorinostat -
Spotlight on Ixazomib: Potential in the Treatment of Multiple Myeloma Barbara Muz Washington University School of Medicine in St
Washington University School of Medicine Digital Commons@Becker Open Access Publications 2016 Spotlight on ixazomib: Potential in the treatment of multiple myeloma Barbara Muz Washington University School of Medicine in St. Louis Rachel N. Ghazarian Washington University School of Medicine in St. Louis Monica Ou Washington University School of Medicine in St. Louis Micha J. Luderer Washington University School of Medicine in St. Louis Hubert D. Kusdono Washington University School of Medicine in St. Louis See next page for additional authors Follow this and additional works at: https://digitalcommons.wustl.edu/open_access_pubs Recommended Citation Muz, Barbara; Ghazarian, Rachel N.; Ou, Monica; Luderer, Micha J.; Kusdono, Hubert D.; and Azab, Abdel K., ,"Spotlight on ixazomib: Potential in the treatment of multiple myeloma." Drug Design, Development and Therapy.2016,10. 217-226. (2016). https://digitalcommons.wustl.edu/open_access_pubs/5207 This Open Access Publication is brought to you for free and open access by Digital Commons@Becker. It has been accepted for inclusion in Open Access Publications by an authorized administrator of Digital Commons@Becker. For more information, please contact [email protected]. Authors Barbara Muz, Rachel N. Ghazarian, Monica Ou, Micha J. Luderer, Hubert D. Kusdono, and Abdel K. Azab This open access publication is available at Digital Commons@Becker: https://digitalcommons.wustl.edu/open_access_pubs/5207 Journal name: Drug Design, Development and Therapy Article Designation: Review Year: 2016 Volume: -
UC Irvine UC Irvine Previously Published Works
UC Irvine UC Irvine Previously Published Works Title ACTR-10. A RANDOMIZED, PHASE I/II TRIAL OF IXAZOMIB IN COMBINATION WITH STANDARD THERAPY FOR UPFRONT TREATMENT OF PATIENTS WITH NEWLY DIAGNOSED MGMT METHYLATED GLIOBLASTOMA (GBM) STUDY DESIGN Permalink https://escholarship.org/uc/item/2w97d9jv Journal Neuro-Oncology, 20(suppl_6) ISSN 1522-8517 Authors Kong, Xiao-Tang Lai, Albert Carrillo, Jose A et al. Publication Date 2018-11-05 DOI 10.1093/neuonc/noy148.045 Peer reviewed eScholarship.org Powered by the California Digital Library University of California Abstracts 3 dyspnea; grade 2 hemorrhage, non-neutropenic fever; and grade 1 hand- toxicities include: 1 patient with pre-existing vision dysfunction had Grade foot. CONCLUSIONS: Low-dose capecitabine is associated with a modest 4 optic nerve dysfunction; 2 Grade 4 hematologic events and 1 Grade 5 reduction in MDSCs and T-regs and a significant increase in CTLs. Toxicity event(sepsis) due to temozolamide-induced cytopenias. CONCLUSION: has been manageable. Four of 7 evaluable patients have reached 6 months 18F-DOPA-PET -guided dose escalation appears reasonably safe and toler- free of progression. Dose escalation continues. able in patients with high-grade glioma. ACTR-10. A RANDOMIZED, PHASE I/II TRIAL OF IXAZOMIB IN ACTR-13. A BAYESIAN ADAPTIVE RANDOMIZED PHASE II TRIAL COMBINATION WITH STANDARD THERAPY FOR UPFRONT OF BEVACIZUMAB VERSUS BEVACIZUMAB PLUS VORINOSTAT IN TREATMENT OF PATIENTS WITH NEWLY DIAGNOSED MGMT ADULTS WITH RECURRENT GLIOBLASTOMA FINAL RESULTS Downloaded from https://academic.oup.com/neuro-oncology/article/20/suppl_6/vi13/5153917 by University of California, Irvine user on 27 May 2021 METHYLATED GLIOBLASTOMA (GBM) STUDY DESIGN Vinay Puduvalli1, Jing Wu2, Ying Yuan3, Terri Armstrong2, Jimin Wu3, Xiao-Tang Kong1, Albert Lai2, Jose A. -
Drug Name Plate Number Well Location % Inhibition, Screen Axitinib 1 1 20 Gefitinib (ZD1839) 1 2 70 Sorafenib Tosylate 1 3 21 Cr
Drug Name Plate Number Well Location % Inhibition, Screen Axitinib 1 1 20 Gefitinib (ZD1839) 1 2 70 Sorafenib Tosylate 1 3 21 Crizotinib (PF-02341066) 1 4 55 Docetaxel 1 5 98 Anastrozole 1 6 25 Cladribine 1 7 23 Methotrexate 1 8 -187 Letrozole 1 9 65 Entecavir Hydrate 1 10 48 Roxadustat (FG-4592) 1 11 19 Imatinib Mesylate (STI571) 1 12 0 Sunitinib Malate 1 13 34 Vismodegib (GDC-0449) 1 14 64 Paclitaxel 1 15 89 Aprepitant 1 16 94 Decitabine 1 17 -79 Bendamustine HCl 1 18 19 Temozolomide 1 19 -111 Nepafenac 1 20 24 Nintedanib (BIBF 1120) 1 21 -43 Lapatinib (GW-572016) Ditosylate 1 22 88 Temsirolimus (CCI-779, NSC 683864) 1 23 96 Belinostat (PXD101) 1 24 46 Capecitabine 1 25 19 Bicalutamide 1 26 83 Dutasteride 1 27 68 Epirubicin HCl 1 28 -59 Tamoxifen 1 29 30 Rufinamide 1 30 96 Afatinib (BIBW2992) 1 31 -54 Lenalidomide (CC-5013) 1 32 19 Vorinostat (SAHA, MK0683) 1 33 38 Rucaparib (AG-014699,PF-01367338) phosphate1 34 14 Lenvatinib (E7080) 1 35 80 Fulvestrant 1 36 76 Melatonin 1 37 15 Etoposide 1 38 -69 Vincristine sulfate 1 39 61 Posaconazole 1 40 97 Bortezomib (PS-341) 1 41 71 Panobinostat (LBH589) 1 42 41 Entinostat (MS-275) 1 43 26 Cabozantinib (XL184, BMS-907351) 1 44 79 Valproic acid sodium salt (Sodium valproate) 1 45 7 Raltitrexed 1 46 39 Bisoprolol fumarate 1 47 -23 Raloxifene HCl 1 48 97 Agomelatine 1 49 35 Prasugrel 1 50 -24 Bosutinib (SKI-606) 1 51 85 Nilotinib (AMN-107) 1 52 99 Enzastaurin (LY317615) 1 53 -12 Everolimus (RAD001) 1 54 94 Regorafenib (BAY 73-4506) 1 55 24 Thalidomide 1 56 40 Tivozanib (AV-951) 1 57 86 Fludarabine -
In Patients with Metastatic Melanoma Nageatte Ibrahim1,2, Elizabeth I
Cancer Medicine Open Access ORIGINAL RESEARCH A phase I trial of panobinostat (LBH589) in patients with metastatic melanoma Nageatte Ibrahim1,2, Elizabeth I. Buchbinder1, Scott R. Granter3, Scott J. Rodig3, Anita Giobbie-Hurder4, Carla Becerra1, Argyro Tsiaras1, Evisa Gjini3, David E. Fisher5 & F. Stephen Hodi1 1Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 2Currently at Merck & Co.,, Kenilworth, New Jersey 3Department of Pathology, Brigham and Women’s Hospital, Boston, Massachusetts 4Department of Biostatistics & Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts 5Department of Dermatology, Massachusetts General Hospital, Boston, Massachusetts Keywords Abstract HDAC, immunotherapy, LBH589, melanoma, MITF, panobinostat Epigenetic alterations by histone/protein deacetylases (HDACs) are one of the many mechanisms that cancer cells use to alter gene expression and promote Correspondence growth. HDAC inhibitors have proven to be effective in the treatment of specific Elizabeth I. Buchbinder, Dana-Farber Cancer malignancies, particularly in combination with other anticancer agents. We con- Institute, 450 Brookline Avenue, Boston, ducted a phase I trial of panobinostat in patients with unresectable stage III or 02215, MA. Tel: 617 632 5055; IV melanoma. Patients were treated with oral panobinostat at a dose of 30 mg Fax: 617 632 6727; E-mail: [email protected] daily on Mondays, Wednesdays, and Fridays (Arm A). Three of the six patients on this dose experienced clinically significant thrombocytopenia requiring dose Funding Information interruption. Due to this, a second treatment arm was opened and the dose Novartis Pharmaceuticals Corporation was changed to 30 mg oral panobinostat three times a week every other week provided clinical trial support, additional (Arm B). -
Dosing Guide | NINLARO® (Ixazomib)
DOSING GUIDE Indication NINLARO® (ixazomib) is indicated in combination with lenalidomide and dexamethasone for the treatment of patients with multiple myeloma who have received at least one prior therapy. Please see Important Safety Information on pages 20-21 and accompanying NINLARO (ixazomib) full Prescribing Information. The NINLARO® (ixazomib) regimen* offers the convenience of oral administration1-3 Dosing • The recommended starting dose of NINLARO is 4 mg (one capsule) in combination with lenalidomide and dexamethasone1† CONTENTS: Communicating with your patients Tips and reminders have been included in this brochure to DOSING facilitate communication with patients. You can recognize Pages 3-5 them by their orange callout box. DOSING CONSIDERATIONS Pages 6-9 Share the following information at the start of treatment to ensure patients and caregivers are well informed: ADVERSE REACTIONS Pages 10-14 • Drug and indication • Dose and dosing schedule • Start date DOSE MODIFICATIONS • Handling instructions Pages 15-19 • Administration and what to do if a dose is missed or too much NINLARO is taken • Food and drug interactions SAFETY • Side effects and management Pages 20-21 *The NINLARO regimen includes NINLARO+lenalidomide+dexamethasone. †A 3-mg starting dose is recommended for patients with moderate or severe hepatic impairment and patients with severe renal impairment or end-stage renal disease requiring dialysis. A 2.3-mg dose is also available for subsequent dose reductions due to adverse reactions (ARs). Please see Important Safety -
Ixazomib with Lenalidomide and Dexamethasone for Treating Relapsed Or Refractory Multiple Myeloma
CONFIDENTIAL UNTIL PUBLISHED NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE Final appraisal determination Ixazomib with lenalidomide and dexamethasone for treating relapsed or refractory multiple myeloma 1 Recommendations 1.1 Ixazomib, with lenalidomide and dexamethasone, is recommended for use within the Cancer Drugs Fund as an option for treating multiple myeloma in adults only if: they have already had 2 or 3 lines of therapy and the conditions in the managed access agreement for ixazomib are followed. 1.2 This recommendation is not intended to affect treatment with ixazomib that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop. Why the committee made these recommendations Ixazomib, with lenalidomide and dexamethasone, has a marketing authorisation to treat multiple myeloma in people who have already had 1 or more lines of therapy. But it is likely to be used only for people who have already had 2 or 3 lines of therapy, for whom current treatment is lenalidomide plus dexamethasone, so the appraisal focused on this population. Final appraisal determination – Ixazomib with lenalidomide and dexamethasone for relapsed or refractory multiple myeloma Page 1 of 20 Issue date: December 2017 © NICE 2017. All rights reserved. Subject to Notice of rights. CONFIDENTIAL UNTIL PUBLISHED The main clinical trial is ongoing. For people who have already had 2 or 3 lines of therapy, ixazomib (with lenalidomide and dexamethasone) increases the length of time they live without their disease progressing, when compared with lenalidomide plus dexamethasone alone. -
Targeting NAD+ Biosynthesis Overcomes Panobinostat and Bortezomib-Induced Malignant
Author Manuscript Published OnlineFirst on April 1, 2020; DOI: 10.1158/1541-7786.MCR-19-0669 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. Targeting NAD+ biosynthesis overcomes panobinostat and bortezomib-induced malignant glioma resistance Esther P. Jane, 1, 2 Daniel R. Premkumar, 1, 2, 3 Swetha Thambireddy, 1 Brian Golbourn, 1 Sameer Agnihotri, 1, 2, 3 Kelsey C. Bertrand, 4 Stephen C. Mack, 4 Max I. Myers, 1 Ansuman Chattopadhyay, 5 D. Lansing Taylor, 6, 7, 8 Mark E. Schurdak, 6, 7, 8 Andrew M. Stern, 7, 8 and Ian F. Pollack 1, 2, 3 Department of Neurosurgery 1, University of Pittsburgh School of Medicine 2, University of Pittsburgh Cancer Institute Brain Tumor Center 3, Texas Children's Hospital, Baylor College of Medicine 4, University of Pittsburgh Molecular Biology Information Service 5, University of Pittsburgh Cancer Institute 6, University of Pittsburgh Drug Discovery Institute 7, Department of Computational and Systems Biology, University of Pittsburgh School of Medicine 8, Pittsburgh, Pennsylvania, U.S.A. Disclosure of Potential Conflict of Interest The authors have declared that no conflict of interest exists. 1 Downloaded from mcr.aacrjournals.org on October 2, 2021. © 2020 American Association for Cancer Research. Author Manuscript Published OnlineFirst on April 1, 2020; DOI: 10.1158/1541-7786.MCR-19-0669 Author manuscripts have been peer reviewed and accepted for publication but have not yet been edited. Keywords: Panobinostat, bortezomib, synergy, resistance, glioma, -
HEM/ONC News by Devon Schuyler
HEM/ONC News By Devon Schuyler Ixazomib Approved for Use in Myeloma FDA Approves Elotuzumab for Myeloma The US Food and Drug Administration (FDA) approved The FDA approved elotuzumab (Empliciti, Bristol-Myers ixazomib (Ninlaro, Takeda/Millennium) on Novem- Squibb) on November 30 for the treatment of patients ber 20 for use in patients with multiple myeloma who with multiple myeloma who have received 1 to 3 prior have received at least 1 prior treatment. Ixazomib, which medications. The agent is for use in combination with is the first oral proteasome inhibitor, is approved for use lenalidomide and dexamethasone. in combination with lenalidomide (Revlimid, Celgene) Approval of elotuzumab was based on an open-label and dexamethasone. trial of 646 patients with relapsed or refractory multiple Approval of ixazomib was based on the results of an myeloma. Patients were randomly assigned to receive international, double-blind clinical trial of 722 patients lenalidomide/dexamethasone either with or without elotu- with relapsed or refractory multiple myeloma. Patients zumab. Median progression-free survival was significantly were randomly assigned to receive lenalidomide/dexa- longer in the group taking elotuzumab (19.4 months) methasone plus either placebo or ixazomib. Median than in the group not taking elotuzumab (14.9 months). progression-free survival was significantly longer in the In addition, the rate of complete or partial response was ixazomib group (20.6 months) than in the placebo group 78.5% with elotuzumab and 65.5% without elotuzumab. (14.7 months). The most common side effects of elotuzumab are The most common side effects of ixazomib are fatigue, diarrhea, pyrexia, constipation, cough, periph- diarrhea, constipation, thrombocytopenia, peripheral eral neuropathy, nasopharyngitis, upper respiratory tract neuropathy, nausea, peripheral edema, vomiting, and infection, decreased appetite, and pneumonia.