Difference between revisions of "Neratinib (Nerlynx)"

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For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the package insert.<ref name="insert"></ref>
 
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [http://online.lexi.com/ Lexicomp], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the package insert.<ref name="insert"></ref>
 
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==Diseases for which it is established==
 +
*[[Breast cancer, HER2-positive|HER2+ breast cancer]]
 
==Diseases for which it is used==
 
==Diseases for which it is used==
*[[Breast cancer, HER2-positive|HER2+ breast cancer]]
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*[[Malignant solid neoplasm, ERBB2-mutated|HER2+ tumors (site-agnostic)]]
*[[ERBB2 (HER2)|HER2+ tumors (site-agnostic)]]
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*[[Malignant solid neoplasm, ERBB3-mutated|HER3+ tumors (site-agnostic)]]
*[[ERBB3 (HER3)|HER3+ tumors (site-agnostic)]]
 
  
 
==Patient drug information==
 
==Patient drug information==
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==History of changes in FDA indication==
 
==History of changes in FDA indication==
*7/17/2017: [https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm567259.htm FDA approved] for the extended adjuvant treatment of adult patients with early stage [[Biomarkers#HER2|HER2]]-[[Biomarkers#Overexpression|overexpressed/amplified]] [[breast cancer]], to follow adjuvant [[Regimen_classes#Trastuzumab-based_regimen|trastuzumab-based therapy]]. ''(Based on ExteNET)''
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*2017-07-17: [https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm567259.htm FDA approved] for the extended adjuvant treatment of adult patients with early stage [[Biomarkers#HER2|HER2]]-[[Biomarkers#Overexpression|overexpressed/amplified]] [[breast cancer]], to follow adjuvant [[Regimen_classes#Trastuzumab-based_regimen|trastuzumab-based therapy]]. ''(Based on ExteNET)''
*2/25/2020: Approved in combination with capecitabine for adult patients with advanced or metastatic [[Biomarkers#HER2|HER2]]-[[Biomarkers#Overexpression|positive]] [[breast cancer]] who have received two or more prior [[Regimen_classes#Anti-HER2-based_regimen|anti-HER2 based regimens]] in the metastatic setting. ''(Based on NALA)''
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*2020-02-25: Approved in combination with capecitabine for adult patients with advanced or metastatic [[Biomarkers#HER2|HER2]]-[[Biomarkers#Overexpression|positive]] [[breast cancer]] who have received two or more prior [[Regimen_classes#Anti-HER2-based_regimen|anti-HER2 based regimens]] in the metastatic setting. ''(Based on NALA)''
 
==History of changes in EMA indication==
 
==History of changes in EMA indication==
*8/31/2018: Initial authorization
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*2018-08-31: Initial authorization as Nerlynx. Nerlynx is indicated for the extended adjuvant treatment of adult patients with early-stage hormone receptor positive HER2-overexpressed/amplified [[breast cancer]] and who are less than one year from the completion of prior adjuvant trastuzumab based therapy. ''(Based on ExteNET)''
 +
==History of changes in Health Canada indication==
 +
*2019-07-16: Initial notice of compliance for the extended adjuvant treatment of women with early-stage hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-overexpressed/amplified [[breast cancer]] within one year after completion of trastuzumab-based adjuvant therapy.
 +
*2021-06-23: New indication (unclear details)
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==Also known as==
 
==Also known as==
 
*'''Code name:''' HKI-272
 
*'''Code name:''' HKI-272
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[[Category:Breast cancer medications]]
 
[[Category:Breast cancer medications]]
[[Category:ERBB2 (HER2) medications]]
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[[Category:Malignant solid neoplasm, ERBB2-mutated medications]]
[[Category:ERBB3 (HER3) medications]]
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[[Category:Malignant solid neoplasm, ERBB3-mutated medications]]
  
 
[[Category:FDA approved in 2017]]
 
[[Category:FDA approved in 2017]]
 
[[Category:EMA approved in 2018]]
 
[[Category:EMA approved in 2018]]
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[[Category:Health Canada approved in 2019]]

Revision as of 21:10, 21 September 2023

General information

Class/mechanism: Irreversible pan-ErbB tyrosine kinase inhibitor of HER2 (human epidermal growth factor receptor 2), EGFR (epidermal growth factor receptor), and ERBB4. Neratinib inhibits activity and downstream signalling of the tyrosine kinase domains of these receptors, likely by interacting with cysteine residue in their ATP-binding pockets. This inhibition has been observed to cause cell cycle arrest in the G1-S (Gap 1/DNA synthesis) phase of the cell division cycle.[1] [2][3][4]
Route: PO
Extravasation: n/a

For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the package insert.[1]

Diseases for which it is established

Diseases for which it is used

Patient drug information

History of changes in FDA indication

History of changes in EMA indication

  • 2018-08-31: Initial authorization as Nerlynx. Nerlynx is indicated for the extended adjuvant treatment of adult patients with early-stage hormone receptor positive HER2-overexpressed/amplified breast cancer and who are less than one year from the completion of prior adjuvant trastuzumab based therapy. (Based on ExteNET)

History of changes in Health Canada indication

  • 2019-07-16: Initial notice of compliance for the extended adjuvant treatment of women with early-stage hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-overexpressed/amplified breast cancer within one year after completion of trastuzumab-based adjuvant therapy.
  • 2021-06-23: New indication (unclear details)

Also known as

  • Code name: HKI-272
  • Brand name: Nerlynx

References

  1. 1.0 1.1 1.2 Neratinib (Nerlynx) package insert
  2. Neratinib (Nerlynx) package insert (locally hosted backup)
  3. Nerlyn manufacturer's website
  4. Rabindran SK, Discafani CM, Rosfjord EC, Baxter M, Floyd MB, Golas J, Hallett WA, Johnson BD, Nilakantan R, Overbeek E, Reich MF, Shen R, Shi X, Tsou HR, Wang YF, Wissner A. Antitumor activity of HKI-272, an orally active, irreversible inhibitor of the HER-2 tyrosine kinase. Cancer Res. 2004 Jun 1;64(11):3958-65. link to original article PubMed