Dasatinib
 | |
| Clinical data | |
|---|---|
| Routes of administration | Oral |
| Legal status | |
| Legal status |
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| Pharmacokinetic data | |
| Protein binding | 96% |
| Metabolism | hepatic |
| Elimination half-life | 1.3–5 hours |
| Excretion | Fecal (85%), renal (4%) |
| Identifiers | |
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| CAS Number | |
| PubChem CID | |
| CompTox Dashboard (EPA) | |
| ECHA InfoCard | 100.228.321 |
| Chemical and physical data | |
| Formula | C22H26ClN7O2S |
| Molar mass | 488.01 g/mol g·mol−1 |
Dasatinib is a drug produced by Bristol-Myers Squibb and sold under the trade name Sprycel®. Dasatinib is an oral BCR/ABL tyrosine kinase inhibitor approved for use in patients with chronic myelogenous leukemia (CML) and Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL).
Efficacy
In a Phase I dose escalation study published in June 2006, dasatinib was tested in patients who were resistant to or who could not tolerate imatinib (Gleevec).[1] Complete hematological responses[1] were seen in 37 of 40 patients with chronic-phase CML. Major hematologic responses[2] were seen in 31 of 44 patients with accelerated-phase CML, CML in blast crisis, or Ph+ ALL.
Duration of benefit
Responses were maintained in 95% of patients with chronic-phase CML, with a median follow-up time of >12 months. In patients with accelerated-phase CML, 82% remained in remission, although with a median follow-up of only 5 months. Nearly all patients with CML in blast crisis or Ph+ ALL relapsed within 6 months.
Susceptible genotypes
Responses were seen in patients with all BCR/ABL genotypes, with the exception of T315I mutation, which confers resistance to both dasatinib and imatinib in vitro.
Toxicities
Neutropenia and myelosuppression were common toxic effects. Fifteen patients in the above-mentioned study developed pleural effusions, which were felt to be a side effect of dasatinib. Some of these patients required thoracentesis or pleurodesis to treat the effusions. Other adverse events included mild to moderate diarrhea, peripheral edema, and headache. A small number of patients developed abnormal liver function tests which returned to normal without dose adjustments. Mild hypocalcemia was also noted, but did not appear to cause any significant problems.
Notes
- ^ Complete hematologic response was defined as normal white blood cell and platelet counts, no blasts in the peripheral blood, <5% myelocytes plus metamyelocytes in the peripheral blood, <20% basophils in the peripheral blood, and no extramedullary disease.
- ^ The definition of a major hematologic response was sufficiently abstruse that the reader is referred to the original article (Talpaz et al., 2006) for details.
Reference
- Talpaz M, Shah N, Kantarjian H, Donato N, Nicoll J, Paquette R, Cortes J, O'Brien S, Nicaise C, Bleickardt E, Blackwood-Chirchir M, Iyer V, Chen T, Huang F, Decillis A, Sawyers C (2006). "Dasatinib in imatinib-resistant Philadelphia chromosome-positive leukemias". N Engl J Med. 354 (24): 2531–41. PMID 16775234.
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External links
- Summary Basis for Approval from the U.S. Food and Drug Administration Freedom of Information homepage
- Abstract of the Talpaz phase 1 article in the New England Journal of Medicine
- Prescribing information from Bristol-Myers Squibb
- Diary of a CML patient involved in the clinical trials for dasatinib
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