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Copanlisib
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    Copanlisib

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    Copanlisib
    Copanlisib.svg
    Clinical data
    Trade names Aliqopa
    Other names BAY 80-6946
    AHFS/Drugs.com Monograph
    MedlinePlus a617044
    License data
    Routes of
    administration
    Intravenous
    Drug class PI3-Kinase inhibitor
    ATC code
    Legal status
    Legal status
    Pharmacokinetic data
    Protein binding 84.2%
    Metabolism CYP3A4/5 (≈90%), CYP1A1 (≈10%)
    Elimination half-life 39.1 hours (range: 14.6 to 82.4)
    Excretion Feces (64%), Urine (22%); 14% were not recovered
    Identifiers
    • 2-Amino-N-[7-methoxy-8-(3-morpholin-4-ylpropoxy)-2,3-dihydroimidazo[1,2-c]quinazolin-5-yl]pyrimidine-5-carboxamide
    CAS Number
    PubChem CID
    DrugBank
    ChemSpider
    UNII
    KEGG
    ChEBI
    ChEMBL
    CompTox Dashboard (EPA)
    Chemical and physical data
    Formula C23H28N8O4
    Molar mass 480.529 g·mol−1
    3D model (JSmol)
    • COC1=C(C=CC2=C1N=C(N3C2=NCC3)NC(=O)C4=CN=C(N=C4)N)OCCCN5CCOCC5
    • InChI=1S/C23H28N8O4/c1-33-19-17(35-10-2-6-30-8-11-34-12-9-30)4-3-16-18(19)28-23(31-7-5-25-20(16)31)29-21(32)15-13-26-22(24)27-14-15/h3-4,13-14H,2,5-12H2,1H3,(H2,24,26,27)(H,28,29,32)
    • Key:PZBCKZWLPGJMAO-UHFFFAOYSA-N

    Copanlisib, sold under the brand name Aliqopa, is a medication used for the treatment of adults experiencing relapsed follicular lymphoma who have received at least two prior systemic therapies.

    Adverse effects

    Data for safety and efficacy of copanlisib are described in the consumer-targeted FDA Drug Trial Snapshot. Copanlisib can cause serious side effects including infections, hyperglycemia, hypertension, pneumonitis, neutropenia and skin rashes. The most common side effects of copanlisib are hyperglycemia, diarrhea, decreased general strength and energy, hypertension, leukopenia, neutropenia, nausea, lower respiratory tract infections and thrombocytopenia. Copanlisib can cause harm to unborn babies.

    Mechanism of action

    Copanlisib is an inhibitor of phosphatidylinositol-3-kinase (PI3K) with inhibitory activity predominantly against PI3K-α and PI3K-δ isoforms expressed in malignant B-cells. It has been shown to induce tumor cell death by apoptosis and inhibition of proliferation of primary malignant B cell lines.

    History

    Efficacy resulting in the approval of copanlisib was based on the subgroup of 104 patients with follicular lymphoma from a Phase 2 clinical trial. Of these, 59 percent had a complete or partial shrinkage of their tumors that lasted about 12 months.

    To assess the safety of the drug, data from 168 adults with follicular lymphoma and other hematologic malignancies treated with copanlisib were evaluated.

    Clinical trials

    Phase II clinical trials are in progress for treatment of endometrial cancer,diffuse large B-cell lymphoma,cholangiocarcinoma, and non-Hodgkin lymphoma. Copanlisib in combination with R-CHOP or R-B (rituximab and bendamustine) is in a phase III trial for relapsed indolent non-Hodgkin lymphoma (NHL). Two separate phase III trials are investigating the use of copanlisib in combination with rituximab for indolent NHL and the other using copanlisib alone in cases of rituximab-refractory indolent NHL.

    In a preclinical study, copanlisib was effective in inhibiting HER2+ breast cancer cells with acquired resistance to the HER2-inhibitors trastuzumab and/or lapatinib. This effect was increased when copanlisib was administered along with the aforementioned HER2-inhibitors. Consequently, treatments of copanlisib with trastuzumab are being clinically trialled in HER2-positive breast cancer patients.

    Society and culture

    Legal status

    For follicular lymphoma, the U.S. Food and Drug Administration (FDA) awarded copanlisib orphan drug designation in February 2015, and fast track designation in February 2016. The New drug application for follicular lymphoma was granted priority review in May 2017.

    In September 2017, it received accelerated approval for the treatment of adults experiencing relapsed follicular lymphoma who have received at least two prior systemic therapies. Further clinical trials are to be performed as a post-marketing requirement to verify the clinical benefit.

    Copanlisib was granted orphan drug status for the treatment of splenic, nodal and extranodal subtypes of marginal zone lymphoma.

    External links


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