Difference between revisions of "Omacetaxine (Synribo)"

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'''In clinical trials'''May also be known as homoharringtonine (HHT).
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==General information==
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Class/mechanism: Cephalotaxine ester & natural alkaloid that inhibits protein synthesis/translation/elongation; prepared via a semi-synthetic process from cephalotaxine, an extract of Cephalotaxus species leaves.  Mechanism is not fully understood, but omacetaxine mepesuccinate inhibits protein synthesis and promotes apoptosis in a manner that does not involve direct binding of Bcr-Abl.  Omacetaxine mepesuccinate has been observed to bind to the A-site cleft in the large ribosomal subunit of a type of archaeabacteria.  It reduces levels of Bcr-Abl and human induced myeloid leukemia cell differentiation protein Mcl-1, an anti-apoptotic Bcl-2 family memberOmacetaxine mepesuccinate has been seen to have activity in mouse models with wild-type Bcr-Abl, as well as imatinib-resistant chronic myeloid leukemia (CML) models with the T315I mutation.<ref name="insert">[https://www.synribohcp.com/globalassets/synribo-hcp/downloadable-assets/synribo_pi.pdf Omacetaxine mepesuccinate (Synribo) package insert]</ref><ref>[[:File:Omacetaxine.pdf | Omacetaxine mepesuccinate (Synribo) package insert (locally hosted backup)]]</ref><ref>[http://synribo.com/ Synribo manufacturer's website]</ref><ref>Quintás-Cardama A, Kantarjian H, Cortes J. Homoharringtonine, omacetaxine mepesuccinate, and chronic myeloid leukemia circa 2009. Cancer. 2009 Dec 1;115(23):5382-93. [https://doi.org/10.1002/cncr.24601 link to original article] [https://pubmed.ncbi.nlm.nih.gov/19739234/ PubMed]</ref>
  
==General information==
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Route: IV, SC
Class/mechanism: Semisynthetic form of homoharringtonine (HHT), which is a natural alkaloid that inhibits protein synthesis (such as human induced myeloid leukemia cell differentiation protein MCL1), promotes apoptosis, and is being investigated for its activity in imatinib-resistant chronic myeloid leukemia (CML) patients with the T315I mutation.<ref>Quintás-Cardama A, Kantarjian H, Cortes J. Homoharringtonine, omacetaxine mepesuccinate, and chronic myeloid leukemia circa 2009. Cancer. 2009 Dec 1;115(23):5382-93. [http://onlinelibrary.wiley.com/doi/10.1002/cncr.24601/full link to original article] [http://www.ncbi.nlm.nih.gov/pubmed/19739234 PubMed]</ref>
 
<br>Route: IV, SC
 
 
<br>Extravasation: no information
 
<br>Extravasation: no information
  
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.
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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 Micromedex, Lexicomp, or the prescribing information.<ref name="insert"></ref>
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==Diseases for which it is used==
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*[[Acute myeloid leukemia]]
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*[[Chronic myeloid leukemia]]
  
 
==Patient drug information==
 
==Patient drug information==
No information available.
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*[https://www.synribohcp.com/globalassets/synribo-hcp/downloadable-assets/synribo_pi.pdf Omacetaxine (Synribo) package insert]<ref name="insert"></ref>
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*[https://chemocare.com/druginfo/omacetaxine.aspx Omacetaxine (Synribo) patient drug information (Chemocare)]<ref>[https://chemocare.com/druginfo/omacetaxine.aspx Omacetaxine (Synribo) patient drug information (Chemocare)]</ref>
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*[http://www.uptodate.com/contents/omacetaxine-patient-drug-information Omacetaxine (Synribo) patient drug information (UpToDate)]<ref>[http://www.uptodate.com/contents/omacetaxine-patient-drug-information Omacetaxine (Synribo) patient drug information (UpToDate)]</ref>
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==History of changes in FDA indication==
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*2012-10-26: Accelerated approval for treatment of adult patients with chronic or accelerated phase [[Chronic myeloid leukemia|chronic myeloid leukemia (CML)]] with resistance and/or intolerance to two or more [[Regimen_classes#Tyrosine_kinase_inhibitor_therapy|tyrosine kinase inhibitors (TKI)]]. ''(Based on CGX-635-CML-202 and CGX-635-CML-203)''
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**2014-02-10: Converted to regular approval for treatment of adult patients with chronic or accelerated phase [[Chronic myeloid leukemia|chronic myeloid leukemia (CML)]] with resistance and/or intolerance to two or more [[Regimen_classes#Tyrosine_kinase_inhibitor_therapy|tyrosine kinase inhibitors (TKI)]]. ''(Based on CGX-635-CML-202 and CGX-635-CML-203)''
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==Also known as==
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*'''Generic names:''' HHT, homoharringtonine, omacetaxine mepesuccinate
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*'''Brand names:''' Omapro, Synribo
  
 
==References==
 
==References==
 
<references/>
 
<references/>
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[[Category:Drugs]]
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[[Category:Intravenous medications]]
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[[Category:Subcutaneous medications]]
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[[Category:Cephalotaxine]]
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[[Category:Acute myeloid leukemia medications]]
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[[Category:Chronic myeloid leukemia medications]]
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[[Category:FDA approved in 2012]]

Latest revision as of 00:06, 6 July 2024

General information

Class/mechanism: Cephalotaxine ester & natural alkaloid that inhibits protein synthesis/translation/elongation; prepared via a semi-synthetic process from cephalotaxine, an extract of Cephalotaxus species leaves. Mechanism is not fully understood, but omacetaxine mepesuccinate inhibits protein synthesis and promotes apoptosis in a manner that does not involve direct binding of Bcr-Abl. Omacetaxine mepesuccinate has been observed to bind to the A-site cleft in the large ribosomal subunit of a type of archaeabacteria. It reduces levels of Bcr-Abl and human induced myeloid leukemia cell differentiation protein Mcl-1, an anti-apoptotic Bcl-2 family member. Omacetaxine mepesuccinate has been seen to have activity in mouse models with wild-type Bcr-Abl, as well as imatinib-resistant chronic myeloid leukemia (CML) models with the T315I mutation.[1][2][3][4]

Route: IV, SC
Extravasation: no information

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, or the prescribing information.[1]

Diseases for which it is used

Patient drug information


History of changes in FDA indication

Also known as

  • Generic names: HHT, homoharringtonine, omacetaxine mepesuccinate
  • Brand names: Omapro, Synribo

References