Sonidegib

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Sonidegib
Sonidegib.svg
Names
Trade namesOdomzo
Other namesLDE225, erismodegib
  • N-[6-[(2S,6R)-2,6-Dimethylmorpholin-4-yl]pyridin-3-yl]-2-methyl-3-[4-(trifluoromethoxy)phenyl]benzamide
Clinical data
Drug classAntineoplastic agents (hedgehog pathway inhibitor[1])
Main usesBasal cell skin cancer[1]
Side effectsMuscle spasms, hair loss, taste changes, tiredness, nausea, pain, diarrhea, vomiting, itchiness[1]
InteractionsCYP3A inhibitors or inducers[1]
Pregnancy
category
  • AU: X (High risk)[2]
  • US: N (Not classified yet)[2]
  • Contraindicated
Routes of
use
By mouth (capsules)
Typical dose200 mg OD[1]
External links
AHFS/Drugs.comMonograph
US NLMSonidegib
MedlinePlusa615034
Legal
License data
Legal status
  • US: ℞-only
  • EU: Rx-only
  • In general: ℞ (Prescription only)
Pharmacokinetics
Bioavailability<10%
Protein binding>97%
MetabolismLiver (CYP3A)
Elimination half-life~28 days
ExcretionFeces (~70%), urine (30%)[1]
Chemical and physical data
FormulaC26H26F3N3O3
Molar mass485.507 g·mol−1
3D model (JSmol)
  • C[C@@H]1CN(C[C@@H](O1)C)C2=NC=C(C=C2)NC(=O)C3=CC=CC(=C3C)C4=CC=C(C=C4)OC(F)(F)F
  • InChI=1S/C26H26F3N3O3/c1-16-14-32(15-17(2)34-16)24-12-9-20(13-30-24)31-25(33)23-6-4-5-22(18(23)3)19-7-10-21(11-8-19)35-26(27,28)29/h4-13,16-17H,14-15H2,1-3H3,(H,31,33)/t16-,17+
  • Key:VZZJRYRQSPEMTK-CALCHBBNSA-N

Sonidegib, sold under the brand name Odomzo, is a medication used to treat cancer, specifically basal cell skin cancer.[1] It is used in cases in which surgery or radiation therapy has failed or is not an option.[1] It is taken by mouth.[1]

Common side effects include muscle spasms, hair loss, taste changes, tiredness, nausea, pain, diarrhea, vomiting, and itchiness.[1] Other side effects may include muscle breakdown and liver problems.[3] Use before or during pregnancy may harm the baby.[1] It is a hedgehog signaling pathway inhibitor.[1][3]

Sonidegib was approved for medical use in the United States and in the European Union in 2015.[1][4] In the United States it costs about 13,000 USD per month.[5]

Medical uses

It is indicated for the treatment of adults with locally advanced basal-cell carcinoma that has recurred following surgery or radiation therapy, or those who are not candidates for surgery or radiation therapy.[1]

Dosage

Sonidegib is taken by mouth at a dose 200 mg per day.[1]

Side effects

Common side effects include muscle spasms, hair loss, fatigue, abdominal pain, nausea, headache, and weight loss.[1]

Pharmacology

Sonidegib binds to and inhibits smoothened to inhibit activation of the Hedgehog pathway. Sonidegib is primarily metabolized by CYP3A and is eliminated hepatically.[1]

Research

It has been investigated as a potential treatment for:

It has demonstrated significant efficacy against melanoma in vitro and in vivo.[24] It also demonstrated efficacy in a mouse model of pancreatic cancer.[25]

References

  1. 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 "Odomzo- sonidegib capsule". DailyMed. 29 May 2019. Retrieved 9 June 2020.
  2. 2.0 2.1 "Sonidegib (Odomzo) Use During Pregnancy". Drugs.com. 17 May 2019. Retrieved 9 June 2020.
  3. 3.0 3.1 "Sonidegib Monograph for Professionals". Drugs.com. Retrieved 14 October 2021.
  4. "Odomzo". European Medicines Agency. 17 September 2018. Retrieved 9 June 2020.
  5. "Odomzo Prices, Coupons & Patient Assistance Programs". Drugs.com. Retrieved 14 October 2021.
  6. "A Biomarker Study to Identify Predictive Signatures of Response to LDE225 (Hedgehog Inhibitor) In Patients With Resectable Pancreatic Cancer". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  7. "Gemcitabine + Nab-paclitaxel With LDE-225 (Hedgehog Inhibitor) as Neoadjuvant Therapy for Pancreatic Adenocarcinoma". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  8. "Dose-escalation, and Safety Study of LDE225 and Gemcitabine in Locally Advanced or Metastatic Pancreatic Cancer Patients". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  9. "A Pilot Study of a Hedgehog Pathway Inhibitor (LDE-225) in Surgically Resectable Pancreas Cancer". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  10. "Study With LDE225 in Combination With Docetaxel in Triple Negative (TN) Advanced Breast Cancer (ABC) Patients (EDALINE)". ClinicalTrials.gov. National Institutes of Health. 13 February 2014.
  11. "LDE225 in Treating Patients With Stage II-III Estrogen Receptor- and HER2-Negative Breast Cancer". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  12. "A Phase II Study of Efficacy and Safety in Patients With Locally Advanced or Metastatic Basal Cell Carcinoma (BOLT)". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  13. "To Evaluate the Safety, Local Tolerability, PK and PD of LDE225 on Sporadic Superficial and Nodular Skin Basal Cell Carcinomas(sBCC)". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  14. "A Trial to Evaluate the Safety, Local Tolerability, Pharmacokinetics and Pharmacodynamics of LDE225 on Skin Basal Cell Carcinomas in Gorlin Syndrome Patients". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  15. "Combination of the Hedgehog Inhibitor, LDE225, With Etoposide and Cisplatin in the First-Line Treatment of Patients With Extensive Stage Small Cell Lung Cancer (ES-SCLC)". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  16. "A Phase III Study of Oral LDE225 Versus (vs) Temozolomide (TMZ) in Patients With Hedge-Hog (Hh)-Pathway Activated Relapsed Medulloblastoma (MB)". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  17. "A Phase I Dose Finding and Safety Study of Oral LDE225 in Children and a Phase II Portion to Assess Preliminary Efficacy in Recurrent or Refractory MB". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  18. "Phase Ib, Dose Escalation Study of Oral LDE225 in Combination With BKM120 in Patients With Advanced Solid Tumors". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  19. "Dose Finding and Safety of Oral LDE225 in Patients With Advanced Solid Tumors". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  20. "LDE225 and Paclitaxel in Solid Tumors". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  21. "Study of Efficacy and Safety of LDE225 in Adult Patients With Relapsed/Refractory Acute Leukemia". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  22. "Nilotinib and LDE225 in the Treatment of Chronic or Accelerated Phase Myeloid Leukemia in Patients Who Developed Resistance to Prior Therapy". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  23. "A Phase Ib/II Dose-finding Study to Assess the Safety and Efficacy of LDE225 + INC424 in Patients With MF". ClinicalTrials.gov. National Institutes of Health. 13 February 2014. Retrieved 16 February 2014.
  24. Jalili A, Mertz KD, Romanov J, Wagner C, Kalthoff F, Stuetz A, et al. (30 July 2013). "NVP-LDE225, a potent and selective SMOOTHENED antagonist reduces melanoma growth in vitro and in vivo". PLOS ONE. 8 (7): e69064. Bibcode:2013PLoSO...869064J. doi:10.1371/journal.pone.0069064. PMC 3728309. PMID 23935925.
  25. Fendrich V, Wiese D, Waldmann J, Lauth M, Heverhagen AE, Rehm J, Bartsch DK (November 2011). "Hedgehog inhibition with the orally bioavailable Smo antagonist LDE225 represses tumor growth and prolongs survival in a transgenic mouse model of islet cell neoplasms". Annals of Surgery. 254 (5): 818–23, discussion 823. doi:10.1097/SLA.0b013e318236bc0f. PMID 22042473. S2CID 12947375.

External links

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