Difference between revisions of "Ponatinib (Iclusig)"
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==General information== | ==General information== | ||
| − | Class/mechanism: Tyrosine kinase inhibitor with multiple targets, including Bcr-Abl tyrosine kinase, the constitutively active tyrosine kinase resulting from the Philadelphia chromosome abnormality in CML, as well as VEGFR, PDGFR, FGFR, the SRC kinases, KIT, EPH receptors, RET, TIE2, and FLT3. Ponatinib is active against the Bcr-Abl T315I mutation.<ref name="insert">[ | + | Class/mechanism: Tyrosine kinase inhibitor with multiple targets, including Bcr-Abl tyrosine kinase, the constitutively active tyrosine kinase resulting from the Philadelphia chromosome abnormality in CML, as well as VEGFR, PDGFR, FGFR, the SRC kinases, KIT, EPH receptors, RET, TIE2, and FLT3. Ponatinib is active against the Bcr-Abl T315I mutation.<ref name="insert">[https://www.iclusig.com/pdf/ICLUSIG-Prescribing-Information.pdf Ponatinib (Iclusig) package insert]</ref><ref>[[:File:Ponatinib.pdf | Ponatinib (Iclusig) package insert (locally hosted backup)]]</ref><ref>[http://iclusig.com/ Iclusig manufacturer's website]</ref> |
<br>Route: PO | <br>Route: PO | ||
<br>Extravasation: n/a | <br>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 [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 prescribing information.<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 prescribing information.<ref name="insert"></ref> | ||
| + | ==Toxicity management== | ||
| + | *2013-10-31: [http://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm373072.htm Suspended by FDA] because of the risk of life-threatening blood clots and severe narrowing of blood vessels. | ||
| + | *2013-12-20: [http://www.iclusigrems.com/ REMS] program put in place and medication is once again available; REMS was discontinued in August 2018. | ||
==Diseases for which it is used== | ==Diseases for which it is used== | ||
| − | *[[ | + | *[[Chronic myeloid leukemia]] |
| − | *[[ | + | *[[B-cell_acute_lymphoblastic_leukemia,_Ph-positive|Ph+ B-cell ALL]] |
==Patient drug information== | ==Patient drug information== | ||
| − | * | + | *[https://www.iclusig.com/pdf/ICLUSIG-Prescribing-Information.pdf Ponatinib (Iclusig) package insert]<ref name="insert"></ref> |
| + | *[https://chemocare.com/druginfo/ponatinib.aspx Ponatinib (Iclusig) patient drug information (Chemocare)]<ref>[https://chemocare.com/druginfo/ponatinib.aspx Ponatinib (Iclusig) patient drug information (Chemocare)]</ref> | ||
| + | *[http://www.uptodate.com/contents/ponatinib-patient-drug-information Ponatinib (Iclusig) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/ponatinib-patient-drug-information Ponatinib (Iclusig) patient drug information (UpToDate)]</ref> | ||
==History of changes in FDA indication== | ==History of changes in FDA indication== | ||
| − | *12 | + | *2012-12-14: Accelerated approval for the treatment of adult patients with chronic phase, accelerated phase, or blast phase [[Chronic myeloid leukemia|chronic myeloid leukemia (CML)]] that is resistant or intolerant to prior [[Regimen_classes#Tyrosine_kinase_inhibitor_therapy|tyrosine kinase inhibitor therapy]] ''(Based on OPTIC)'' |
| − | * | + | *2012-12-14: Accelerated approval for the treatment of adult patients with [[Biomarkers#BCR-ABL1|Philadelphia chromosome positive]] [[:Category:Acute lymphoblastic leukemias|acute lymphoblastic leukemia]] (Ph+ ALL) that is resistant or intolerant to prior [[Regimen_classes#Tyrosine_kinase_inhibitor_therapy|tyrosine kinase inhibitor therapy]]. ''(Based on PACE)'' |
| − | + | *2016-11-29: Granted full approval for the treatment of adult patients with chronic-phase, accelerated-phase, or blast-phase [[Chronic myeloid leukemia | chronic myeloid leukemia (CML)]] or [[Biomarkers#BCR-ABL1|Philadelphia chromosome-positive]] [[:Category:Acute lymphoblastic leukemias| acute lymphoblastic leukemia (ALL)]] for whom no other tyrosine kinase inhibitor therapy is indicated. ''(Based on PACE)'' | |
| − | + | *2016-11-29: Granted full approval for the treatment of adult patients with [[Biomarkers#T315I|T315I]]-positive [[Chronic myeloid leukemia|CML]] (chronic phase, accelerated phase, or blast phase). ''(Based on PACE)'' | |
| − | + | *2016-11-29: Granted full approval for the treatment of adult patients with [[Biomarkers#T315I|T315I]]-positive, [[Biomarkers#BCR-ABL1|Philadelphia chromosome-positive]] [[:Category:Acute lymphoblastic leukemias|ALL]]. ''(Based on PACE)'' | |
| + | *2024-03-19: Granted accelerated approval in combination with chemotherapy for adult patients with newly diagnosed Philadelphia chromosome-positive [[:Category:Acute lymphoblastic leukemias|acute lymphoblastic leukemia]] (Ph+ ALL). ''(Based on PhALLCON)'' | ||
| + | ==History of changes in EMA indication== | ||
| + | *2013-07-01: Initial authorization | ||
| + | ==History of changes in Health Canada indication== | ||
| + | *2015-04-02: Initial notice of compliance with conditions | ||
| + | *2022-10-03: Conditions were met | ||
| + | ==History of changes in PMDA indication== | ||
| + | *2016-09-28: New approval for the treatment of [[Chronic myeloid leukemia|chronic myelogenous leukemia]] with resistance or intolerance to prior drug therapies. | ||
| + | *2016-09-28: New approval for the treatment of recurrent or refractory Philadelphia chromosome-positive [[:Category:Acute lymphoblastic leukemias|acute lymphoblastic leukemia]]. | ||
==Also known as== | ==Also known as== | ||
| − | *'''Code name:''' | + | *'''Code name:''' AP-24534 |
*'''Generic name:''' ponatinib hydrochloride | *'''Generic name:''' ponatinib hydrochloride | ||
*'''Brand name:''' Iclusig | *'''Brand name:''' Iclusig | ||
| Line 27: | Line 41: | ||
<references/> | <references/> | ||
| − | [[Category: | + | [[Category:Drugs]] |
[[Category:Oral medications]] | [[Category:Oral medications]] | ||
| + | [[Category:Mutation-specific medications]] | ||
| + | |||
| − | |||
[[Category:Bcr-Abl inhibitors]] | [[Category:Bcr-Abl inhibitors]] | ||
[[Category:FGFR inhibitors]] | [[Category:FGFR inhibitors]] | ||
| Line 37: | Line 52: | ||
[[Category:RET inhibitors]] | [[Category:RET inhibitors]] | ||
[[Category:SRC inhibitors]] | [[Category:SRC inhibitors]] | ||
| − | [[Category: | + | [[Category:VEGFR inhibitors]] |
[[Category:PDGFR inhibitors]] | [[Category:PDGFR inhibitors]] | ||
[[Category:B-cell acute lymphoblastic leukemia medications]] | [[Category:B-cell acute lymphoblastic leukemia medications]] | ||
| − | [[Category:Chronic | + | [[Category:Chronic myeloid leukemia medications]] |
| − | [[Category: | + | [[Category:FDA approved in 2012]] |
| − | [[Category: | + | [[Category:EMA approved in 2013]] |
| − | [[Category:PMDA approved | + | [[Category:Health Canada approved in 2015]] |
| + | [[Category:PMDA approved in 2016]] | ||
Latest revision as of 20:20, 22 March 2024
General information
Class/mechanism: Tyrosine kinase inhibitor with multiple targets, including Bcr-Abl tyrosine kinase, the constitutively active tyrosine kinase resulting from the Philadelphia chromosome abnormality in CML, as well as VEGFR, PDGFR, FGFR, the SRC kinases, KIT, EPH receptors, RET, TIE2, and FLT3. Ponatinib is active against the Bcr-Abl T315I mutation.[1][2][3]
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 prescribing information.[1]
Toxicity management
- 2013-10-31: Suspended by FDA because of the risk of life-threatening blood clots and severe narrowing of blood vessels.
- 2013-12-20: REMS program put in place and medication is once again available; REMS was discontinued in August 2018.
Diseases for which it is used
Patient drug information
- Ponatinib (Iclusig) package insert[1]
- Ponatinib (Iclusig) patient drug information (Chemocare)[4]
- Ponatinib (Iclusig) patient drug information (UpToDate)[5]
History of changes in FDA indication
- 2012-12-14: Accelerated approval for the treatment of adult patients with chronic phase, accelerated phase, or blast phase chronic myeloid leukemia (CML) that is resistant or intolerant to prior tyrosine kinase inhibitor therapy (Based on OPTIC)
- 2012-12-14: Accelerated approval for the treatment of adult patients with Philadelphia chromosome positive acute lymphoblastic leukemia (Ph+ ALL) that is resistant or intolerant to prior tyrosine kinase inhibitor therapy. (Based on PACE)
- 2016-11-29: Granted full approval for the treatment of adult patients with chronic-phase, accelerated-phase, or blast-phase chronic myeloid leukemia (CML) or Philadelphia chromosome-positive acute lymphoblastic leukemia (ALL) for whom no other tyrosine kinase inhibitor therapy is indicated. (Based on PACE)
- 2016-11-29: Granted full approval for the treatment of adult patients with T315I-positive CML (chronic phase, accelerated phase, or blast phase). (Based on PACE)
- 2016-11-29: Granted full approval for the treatment of adult patients with T315I-positive, Philadelphia chromosome-positive ALL. (Based on PACE)
- 2024-03-19: Granted accelerated approval in combination with chemotherapy for adult patients with newly diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). (Based on PhALLCON)
History of changes in EMA indication
- 2013-07-01: Initial authorization
History of changes in Health Canada indication
- 2015-04-02: Initial notice of compliance with conditions
- 2022-10-03: Conditions were met
History of changes in PMDA indication
- 2016-09-28: New approval for the treatment of chronic myelogenous leukemia with resistance or intolerance to prior drug therapies.
- 2016-09-28: New approval for the treatment of recurrent or refractory Philadelphia chromosome-positive acute lymphoblastic leukemia.
Also known as
- Code name: AP-24534
- Generic name: ponatinib hydrochloride
- Brand name: Iclusig
References
Categories:
- Drugs
- Oral medications
- Mutation-specific medications
- Bcr-Abl inhibitors
- FGFR inhibitors
- FLT3 inhibitors
- KIT inhibitors
- RET inhibitors
- SRC inhibitors
- VEGFR inhibitors
- PDGFR inhibitors
- B-cell acute lymphoblastic leukemia medications
- Chronic myeloid leukemia medications
- FDA approved in 2012
- EMA approved in 2013
- Health Canada approved in 2015
- PMDA approved in 2016