Difference between revisions of "Midostaurin (Rydapt)"

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(FDA approval)
m (Text replacement - "please refer to your preferred pharmacopeias such as [http://www.thomsonhc.com/home/dispatch Micromedex], [https://online.lexi.com/lco/action/login UpToDate Lexidrug], [http://www.utdol.com/online/content/search.do UpToDate (courtesy of Lexicomp)], or the prescribing information" to "please refer to your preferred pharmacopeias or the prescribing information")
 
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==General information==
 
==General information==
Class/mechanism: FLT3 inhibitor, tyrosine kinase inhibitor (TKI). Midostaurin or its active metabolites CGP62221 and CGP52421 inhibit activity of wild type FLT3, FLT3 mutant kinases (ITD and TKD), KIT (wild type and D816V mutant), PDGFRα/β, VEGFR2, and members of the serine/threonine kinase PKC (protein kinase C) family. Midostaurin induced apoptosis in leukemic cells expressing ITD and TKD mutant FLT3 receptors or overexpressing wild type FLT3 and PDGF receptors.  Midostaurin also causes apoptosis in mast cells and inhibits histamine release, proliferation, and KIT signaling.<ref name=insert>[https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/rydapt.pdf Midostaurin (Rydapt) package insert]</ref><ref>[[Media:Midostaurin.pdf ‎| Midostaurin (Rydapt) package insert (locally hosted backup)]]</ref><ref>[http://rydapt.com/ Rydapt manufacturer's website]</ref>
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Class/mechanism: FLT3 inhibitor, tyrosine kinase inhibitor (TKI). Midostaurin or its active metabolites CGP62221 and CGP52421 inhibit activity of wild type FLT3, FLT3 mutant kinases (ITD and TKD), KIT (wild type and D816V mutant), PDGFRα/β, VEGFR2, and members of the serine/threonine kinase PKC (protein kinase C) family. Midostaurin induced apoptosis in leukemic cells expressing ITD and TKD mutant FLT3 receptors or overexpressing wild type FLT3 and PDGF receptors.  Midostaurin also causes apoptosis in mast cells and inhibits histamine release, proliferation, and KIT signaling.<ref name=insert>[https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/rydapt.pdf Midostaurin (Rydapt) package insert]</ref><ref>[[:File:Midostaurin.pdf ‎| Midostaurin (Rydapt) package insert (locally hosted backup)]]</ref><ref>[http://rydapt.com/ Rydapt 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>
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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 or the prescribing information.<ref name="insert"></ref>
  
 
==Diseases for which it is used==
 
==Diseases for which it is used==
*[[Acute myeloid leukemia]]
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*[[Acute myeloid leukemia, FLT3-positive|Acute myeloid leukemia, FLT3+]]
 +
*[[Myelodysplastic syndrome]]
 
*[[Systemic mastocytosis]]
 
*[[Systemic mastocytosis]]
  
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*[https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/rydapt.pdf Midostaurin (Rydapt) package insert]<ref name="insert"></ref>
 
*[https://www.pharma.us.novartis.com/sites/www.pharma.us.novartis.com/files/rydapt.pdf Midostaurin (Rydapt) package insert]<ref name="insert"></ref>
  
==Preliminary data==
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==History of changes in FDA indication==
===[[Acute myeloid leukemia]]===
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*2017-04-28: [https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm555756.htm FDA approved] for the treatment of adult patients with newly diagnosed [[Acute myeloid leukemia|acute myeloid leukemia (AML)]] who are [[Biomarkers#FLT3|FLT3]] [[Biomarkers#Alterations|mutation-positive]] (FLT3+), as detected by an FDA-approved test, in combination with standard [[Cytarabine (Ara-C)|cytarabine]] and [[Daunorubicin (Cerubidine)|daunorubicin]] induction and cytarabine consolidation. ''(Based on RATIFY)''
# Stone RM, DeAngelo DJ, Klimek V, Galinsky I, Estey E, Nimer SD, Grandin W, Lebwohl D, Wang Y, Cohen P, Fox EA, Neuberg D, Clark J, Gilliland DG, Griffin JD. Patients with acute myeloid leukemia and an activating mutation in FLT3 respond to a small-molecule FLT3 tyrosine kinase inhibitor, PKC412. Blood. 2005 Jan 1;105(1):54-60. Epub 2004 Sep 2. [http://bloodjournal.hematologylibrary.org/content/105/1/54.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/15345597 PubMed]
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*2017-04-28: [https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm555756.htm FDA approved] for the treatment of adults with [[Systemic mastocytosis|aggressive systemic mastocytosis (SM)]], SM with associated hematological neoplasm, or mast cell leukemia. ''(Based on CPKC412D2201 and CEREMAST)''
<!-- Presented in part at the 45th Annual Meeting of the American Society of Hematology, December 6-9, 2003, San Diego, CA. -->
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==History of changes in EMA indication==
# Fischer T, Stone RM, Deangelo DJ, Galinsky I, Estey E, Lanza C, Fox E, Ehninger G, Feldman EJ, Schiller GJ, Klimek VM, Nimer SD, Gilliland DG, Dutreix C, Huntsman-Labed A, Virkus J, Giles FJ. Phase IIB trial of oral Midostaurin (PKC412), the FMS-like tyrosine kinase 3 receptor (FLT3) and multi-targeted kinase inhibitor, in patients with acute myeloid leukemia and high-risk myelodysplastic syndrome with either wild-type or mutated FLT3. J Clin Oncol. 2010 Oct 1;28(28):4339-45. Epub 2010 Aug 23. [http://jco.ascopubs.org/content/28/28/4339.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/20733134 PubMed]
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*2017-09-18: Initial authorization in combination with standard daunorubicin and cytarabine induction and high dose cytarabine consolidation chemotherapy, and for patients in complete response followed by Rydapt single agent maintenance therapy, for adult patients with newly diagnosed [[acute myeloid leukemia|acute myeloid leukaemia (AML)]] who are FLT3 mutation positive.
 +
*2017-09-18: Initial authorization as monotherapy for the treatment of adult patients with [[systemic mastocytosis|aggressive systemic mastocytosis (ASM)]], systemic mastocytosis with associated haematological neoplasm (SM AHN), or mast cell leukaemia (MCL).
  
===[[Myelodysplastic syndrome]]===
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==Other information==
<!-- Presented in part at the 45th Annual Meeting of the American Society of Hematology, December 6-9, 2003, San Diego, CA. -->
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# Heidel F, Solem FK, Breitenbuecher F, Lipka DB, Kasper S, Thiede MH, Brandts C, Serve H, Roesel J, Giles F, Feldman E, Ehninger G, Schiller GJ, Nimer S, Stone RM, Wang Y, Kindler T, Cohen PS, Huber C, Fischer T. Clinical resistance to the kinase inhibitor PKC412 in acute myeloid leukemia by mutation of Asn-676 in the FLT3 tyrosine kinase domain. Blood. 2006 Jan 1;107(1):293-300. Epub 2005 Sep 8. [https://doi.org/10.1182/blood-2005-06-2469 link to original article] [https://pubmed.ncbi.nlm.nih.gov/16150941/ PubMed]
# Fischer T, Stone RM, Deangelo DJ, Galinsky I, Estey E, Lanza C, Fox E, Ehninger G, Feldman EJ, Schiller GJ, Klimek VM, Nimer SD, Gilliland DG, Dutreix C, Huntsman-Labed A, Virkus J, Giles FJ. Phase IIB trial of oral Midostaurin (PKC412), the FMS-like tyrosine kinase 3 receptor (FLT3) and multi-targeted kinase inhibitor, in patients with acute myeloid leukemia and high-risk myelodysplastic syndrome with either wild-type or mutated FLT3. J Clin Oncol. 2010 Oct 1;28(28):4339-45. Epub 2010 Aug 23. [http://jco.ascopubs.org/content/28/28/4339.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/20733134 PubMed]
 
 
 
===[[Systemic mastocytosis]]===
 
# Gotlib J, Berubé C, Growney JD, Chen CC, George TI, Williams C, Kajiguchi T, Ruan J, Lilleberg SL, Durocher JA, Lichy JH, Wang Y, Cohen PS, Arber DA, Heinrich MC, Neckers L, Galli SJ, Gilliland DG, Coutré SE. Activity of the tyrosine kinase inhibitor PKC412 in a patient with mast cell leukemia with the D816V KIT mutation. Blood. 2005 Oct 15;106(8):2865-70. Epub 2005 Jun 21. [http://www.bloodjournal.org/content/106/8/2865.long link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/15972446 PubMed]
 
# Gotlib J, Kluin-Nelemans HC, George TI, Akin C, Sotlar K, Hermine O, Awan FT, Hexner E, Mauro MJ, Sternberg DW, Villeneuve M, Huntsman Labed A, Stanek EJ, Hartmann K, Horny HP, Valent P, Reiter A. Efficacy and Safety of Midostaurin in Advanced Systemic Mastocytosis. N Engl J Med. 2016 Jun 30;374(26):2530-41. [http://www.nejm.org/doi/full/10.1056/NEJMoa1513098 link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/27355533 PubMed]
 
 
 
==History of changes in FDA indication==
 
*4/28/2017: [https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm555756.htm FDA approved] "for the treatment of adult patients with newly diagnosed [[Acute myeloid leukemia|acute myeloid leukemia (AML)]] who are FLT3 mutation-positive (FLT3+), as detected by an FDA-approved test, in combination with standard [[Cytarabine (Cytosar)|cytarabine]] and [[Daunorubicin (Cerubidine)|daunorubicin]] induction and cytarabine consolidation."
 
*4/28/2017: [https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm555756.htm FDA approved] "for the treatment of adults with [[Systemic mastocytosis|aggressive systemic mastocytosis (SM)]], SM with associated hematological neoplasm, or mast cell leukemia."
 
  
 
==Also known as==
 
==Also known as==
PKC412
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*'''Code name:''' PKC-412
 +
*'''Brand names:''' Rydapt, Tauritmo
  
 
==References==
 
==References==
 
<references/>
 
<references/>
  
[[Category:Drug index]]
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[[Category:Drugs]]
[[Category:Chemotherapy]]
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[[Category:Oral medications]]
 +
[[Category:Mutation-specific medications]]
  
[[Category:Kinase inhibitors]]
 
 
[[Category:FLT3 inhibitors]]
 
[[Category:FLT3 inhibitors]]
 
[[Category:KIT inhibitors]]
 
[[Category:KIT inhibitors]]
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[[Category:Myelodysplastic syndrome medications]]
 
[[Category:Myelodysplastic syndrome medications]]
 
[[Category:Systemic mastocytosis medications]]
 
[[Category:Systemic mastocytosis medications]]
[[Category:Drugs FDA approved in 2017]]
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 +
[[Category:EMA approved in 2017]]
 +
[[Category:FDA approved in 2017]]

Latest revision as of 01:02, 29 June 2024

General information

Class/mechanism: FLT3 inhibitor, tyrosine kinase inhibitor (TKI). Midostaurin or its active metabolites CGP62221 and CGP52421 inhibit activity of wild type FLT3, FLT3 mutant kinases (ITD and TKD), KIT (wild type and D816V mutant), PDGFRα/β, VEGFR2, and members of the serine/threonine kinase PKC (protein kinase C) family. Midostaurin induced apoptosis in leukemic cells expressing ITD and TKD mutant FLT3 receptors or overexpressing wild type FLT3 and PDGF receptors. Midostaurin also causes apoptosis in mast cells and inhibits histamine release, proliferation, and KIT signaling.[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 or the prescribing information.[1]

Diseases for which it is used

Patient drug information

History of changes in FDA indication

History of changes in EMA indication

  • 2017-09-18: Initial authorization in combination with standard daunorubicin and cytarabine induction and high dose cytarabine consolidation chemotherapy, and for patients in complete response followed by Rydapt single agent maintenance therapy, for adult patients with newly diagnosed acute myeloid leukaemia (AML) who are FLT3 mutation positive.
  • 2017-09-18: Initial authorization as monotherapy for the treatment of adult patients with aggressive systemic mastocytosis (ASM), systemic mastocytosis with associated haematological neoplasm (SM AHN), or mast cell leukaemia (MCL).

Other information

  1. Heidel F, Solem FK, Breitenbuecher F, Lipka DB, Kasper S, Thiede MH, Brandts C, Serve H, Roesel J, Giles F, Feldman E, Ehninger G, Schiller GJ, Nimer S, Stone RM, Wang Y, Kindler T, Cohen PS, Huber C, Fischer T. Clinical resistance to the kinase inhibitor PKC412 in acute myeloid leukemia by mutation of Asn-676 in the FLT3 tyrosine kinase domain. Blood. 2006 Jan 1;107(1):293-300. Epub 2005 Sep 8. link to original article PubMed

Also known as

  • Code name: PKC-412
  • Brand names: Rydapt, Tauritmo

References