Brigatinib

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Brigatinib
Brigatinib structure.svg
Names
Trade namesAlunbrig, others
Other namesAP26113
  • 5-Chloro-2-N-{4-[4-(dimethylamino)piperidin-1-yl]-2-methoxyphenyl}-4-N-[2-(dimethylphosphoryl)phenyl]pyrimidine-2,4-diamine
Clinical data
Drug classTyrosine kinase inhibitor[1]
Main usesNon-small cell lung cancer (NSCLC)[2]
Side effectsDiarrhea, tiredness, nausea, rash, muscle pain, headache, high blood pressure, shortness of breath[2]
Pregnancy
category
  • AU: D
  • US: N (Not classified yet)
Routes of
use
By mouth
External links
AHFS/Drugs.comMonograph
US NLMBrigatinib
MedlinePlusa617016
Legal
License data
Legal status
  • AU: S4 (Prescription only)
  • UK: POM (Prescription only)
  • US: ℞-only
  • EU: Rx-only
Chemical and physical data
FormulaC29H39ClN7O2P
Molar mass584.10 g·mol−1
3D model (JSmol)
  • COc1cc(ccc1Nc1ncc(Cl)c(Nc2ccccc2P(C)(C)=O)n1)N1CCC(CC1)N1CCN(C)CC1
  • InChI=1S/C29H39ClN7O2P/c1-35-15-17-37(18-16-35)21-11-13-36(14-12-21)22-9-10-24(26(19-22)39-2)33-29-31-20-23(30)28(34-29)32-25-7-5-6-8-27(25)40(3,4)38/h5-10,19-21H,11-18H2,1-4H3,(H2,31,32,33,34)
  • Key:AILRADAXUVEEIR-UHFFFAOYSA-N

Brigatinib, sold under the brand name Alunbrig among others, is a medication used to treat non-small cell lung cancer (NSCLC).[2] Specifically it is used for metastatic cases that are ALK-positive.[2] It is taken by mouth.[2]

Common side effects include diarrhea, tiredness, nausea, rash, muscle pain, headache, high blood pressure, and shortness of breath.[2] Other side effects may include pneumonitis, vision problems, muscle breakdown, pancreatitis, high blood sugar, and sunburns.[2] Use in pregnancy may harm the baby.[2] It is a tyrosine kinase inhibitor that blocks ALK.[1]

Brigatinib was approved for medical use in the United States in 2017 and Europe in 2018.[2][3] In the United Kingdom 4 weeks of medication costs the NHS about £4,900 as of 2021.[4] This amount in the United States is about 17,400 USD.[5]

Medical uses

Dosage

It is taken at a dose of 90 mg once per day for 7 days and than increased to 180 mg once per day.[2]

Mechanism of action

Brigatinib is an inhibitor of ALK[6] and mutated EGFR.[7]

ALK was first identified as a chromosomal rearrangement in anaplastic large cell lymphoma (ALCL). Genetic studies indicate that abnormal expression of ALK is a key driver of certain types of non-small cell lung cancer (NSCLC) and neuroblastomas, as well as ALCL. Since ALK is generally not expressed in normal adult tissues, it represents a highly promising molecular target for cancer therapy.

Epidermal growth factor receptor (EGFR) is another validated target in NSCLC. Additionally, the T790M “gatekeeper” mutation is linked in approximately 50 percent of patients who grow resistant to first-generation EGFR inhibitors.[7] While second-generation EGFR inhibitors are in development, clinical efficacy has been limited due to toxicity thought to be associated with inhibiting the native (endogenous or unmutated) EGFR. A therapy designed to target EGFR, the T790M mutation but avoiding inhibition of native EGFR is another promising molecular target for cancer therapy.

History

Regulatory approval

Ariad Pharmaceuticals, Inc. filed an investigational new drug (IND) application to the US FDA on August 29, 2016.[8]

In 2016, brigatinib was granted orphan drug status by the FDA for treatment of NSCLC.[9]

In 28 April 2017, it was granted an Accelerated Approval from the US FDA for metastatic non-small cell lung cancer (NSCLC);[10][11] as a 2nd-line therapy for ALK-positive NSCLC.[12]

Society and culture

Intellectual property

On 22 April 2015 ARIAD Pharmaceuticals, Inc. announced the issuance of its first U.S. patent on brigatinib, the protection is through December 30, 2030. The United States Patent and Trademark Office granted U.S. Patent No. 9,012,462 under the title, “Phosphorous Derivatives as Kinase Inhibitors.” [13]

Commercialization

Brigatinib is manufactured by ARIAD Pharmaceuticals, Inc. (NASDAQ: ARIA) which is focused on rare cancers. ARIAD then was acquired by Takeda Pharmaceutical Company Limited (TSE: 4502) in February 2017 through a tender offer (for $24.00 per share in cash) and subsequent merger of ARIAD with Kiku Merger Co., Inc., a wholly owned subsidiary of Takeda Pharmaceuticals U.S.A. ARIAD is now an indirect wholly owned subsidiary of Takeda.[14]

Names

Brigatinib is the INN.[15]

References

  1. 1.0 1.1 "Brigatinib Monograph for Professionals". Drugs.com. Retrieved 11 January 2022.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 "DailyMed - ALUNBRIG- brigatinib tablet, film coated ALUNBRIG- brigatinib kit". dailymed.nlm.nih.gov. Retrieved 11 January 2022.
  3. "Alunbrig". Retrieved 11 January 2022.
  4. BNF 81: March-September 2021. BMJ Group and the Pharmaceutical Press. 2021. p. 1016. ISBN 978-0857114105.
  5. "Alunbrig Prices, Coupons & Patient Assistance Programs". Drugs.com. Retrieved 11 January 2022.
  6. Huang WS, Liu S, Zou D, Thomas M, Wang Y, Zhou T, et al. (May 2016). "Discovery of Brigatinib (AP26113), a Phosphine Oxide-Containing, Potent, Orally Active Inhibitor of Anaplastic Lymphoma Kinase". Journal of Medicinal Chemistry. 59 (10): 4948–64. doi:10.1021/acs.jmedchem.6b00306. PMID 27144831.
  7. 7.0 7.1 Sequist LV, Waltman BA, Dias-Santagata D, Digumarthy S, Turke AB, Fidias P, et al. (March 2011). "Genotypic and histological evolution of lung cancers acquiring resistance to EGFR inhibitors". Science Translational Medicine. 3 (75): 75ra26. doi:10.1126/scitranslmed.3002003. PMC 3132801. PMID 21430269.
  8. "NDA 208772 Multidisciplinary Review and Evaluation Alunbrig (brigatinib)" (PDF). FDA.gov. 29 August 2016. Retrieved 31 October 2017.
  9. "Takeda Oncology".
  10. FDA Grants Brigatinib Accelerated Approval for Metastatic Non-Small Cell Lung Cancer
  11. Takeda Announces FDA Accelerated Approval of Alunbrig (brigatinib)
  12. [1]
  13. "ARIAD Announces Issuance of Key U.S. Patent on Brigatinib". ariad.com. 22 April 2015. Retrieved 31 October 2017.[permanent dead link]
  14. "Takeda Completes Acquisition of ARIAD Pharmaceuticals, Inc". takeda.com. 26 February 2017. Retrieved 31 October 2017.
  15. "International Nonproprietary Names for Pharmaceutical Substances (INN). Recommended International Nonproprietary Names: List 75" (PDF). World Health Organization. 2016. p. 104. Retrieved 14 February 2017.

External links

External sites:
Identifiers: