Ibrutinib

Gefahreninformationscode (GHS)

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• Alarmwort

  Achtung

• Gefahrenhinweise

  H302：Gesundheitsschädlich bei Verschlucken.

  H315：Verursacht Hautreizungen.

  H319：Verursacht schwere Augenreizung.

  H335：Kann die Atemwege reizen.

  H360：Kann die Fruchtbarkeit beeinträchtigen oder das Kind im Mutterleib schädigen.

• Sicherheit

  P264：Nach Gebrauch gründlich waschen.

  P264：Nach Gebrauch gründlich waschen.

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  P302+P352：BEI BERÜHRUNG MIT DER HAUT: Mit viel Wasser/... (Hersteller kann, falls zweckmäßig, ein Reinigungsmittel angeben oder, wenn Wasser eindeutig ungeeignet ist, ein alternatives Mittel empfehlen) waschen.

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Ibrutinib Chemische Eigenschaften,Einsatz,Produktion Methoden

• Beschreibung

  Ibrutinib (CAS: 936563-96-1) is a first-in-class,potent, orally administered covalently-binding inhibitor of BTK. In November 2013, the US FDA approved ibrutinib (also referred to as PCI-32765), for the treatment of patients with mantle cell lymphoma (MCL) who had received at least one prior therapy. Ibrutinib is a potent inhibitor of BTK that binds covalently to Cys-481 in the active site of BTK, resulting in inhibition of kinase activity. Ibrutinib does have significant activity against 19 other kinases, including seven with a cognate cysteine residue. These include BLK, BMX, ITK, TEC, EGFR, ERBB2, and JAK3.

• Originator

  Celera/Pharmacyclics (United States)

• Verwenden

  Ibrutinib is a highly selective Bruton’s tyrosine kinase (Btk) irreversible inhibitor.

• Indications

  Ibrutinib is a non-receptor Bruton's tyrosine kinase inhibitor approved for the treatment of relapsed chronic lymphocytic leukemia(CLL), mantle cell lymphoma (MCL) and WaldenstrÖm's Macroglobulinemia (WM).

• Definition

  ChEBI: Ibrutinib is a member of the class of acrylamides that is (3R)-3-[4-amino-3-(4-phenoxyphenyl)pyrazolo[3,4-d]pyrimidin-1-yl]piperidine in which the piperidine nitrogen is replaced by an acryloyl group. A selective and covalent inhibitor of the enzyme Bruton's tyrosine kinase, it is used for treatment of B-cell malignancies. It has a role as an EC 2.7.10.2 (non-specific protein-tyrosine kinase) inhibitor and an antineoplastic agent. It is a pyrazolopyrimidine, an aromatic amine, an aromatic ether, a member of acrylamides, a N-acylpiperidine and a tertiary carboxamide.

• Trademarks

  Imbruvica

• Allgemeine Beschreibung

  Class: non-receptor tyrosine kinase
  Treatment: CLL, MCL
  Oral bioavailability = 4% (fasted), 8% (fed)
  Elimination half-life = 3.2 h
  Protein binding = 97.3%

• Nebenwirkungen

  The more common side effects of Ibrutinib are diarrhoea and bleeding. Therefore, you should drink plenty of water during treatment, in order to reduce the risk of dehydration using diarrhoea. Bleeding problems can be serious and may even lead to death. This may be manifested by blood or black stools (that look like tar); pink or brown urine; accidental bleeding, or severe or uncontrollable bleeding; spitting up blood or vomit that looks like coffee grounds; coughing up blood; bruising or small red or purple spots on the skin; dizziness; confusing changes in speech; or a headache that lasts for a long time or is severe. Prompt medical attention is needed if a serious condition develops.
  Other possible side effects are: increased risk of infection, fever, chills, weakness, confusion, or other signs or symptoms of infection; increased risk of heart disease, rapid and irregular heartbeat; dizziness; lightheadedness; shortness of breath; swelling of the feet, ankles, or legs; discomfort in the chest; or feeling lightheaded. High blood pressure, reduced blood counts, second primary cancer and tumour lysis syndrome (TLS). Different disease treatments exhibit different adverse effects, so the above side effects may not occur in full.

• Synthese

  Condensation of commercially available 4-phenoxybenzoyl chloride (88) with malononitrile followed by acidic quench and O-methylation with dimethyl sulfate furnished vinyl dinitrile 89 in 84% yield over the three-step sequence. Next, treatment with hydrazine hydrate in refluxing ethanol secured aminopyrazole 90 and this was followed by treatment with neat formamide at elevated temperature to furnish pyrimidopyrazole 91 in excellent conversion. Selective alkylation of the pyrazole nitrogen with commercially- available (S)-piperidinyl tosylate (92) proceeded in 32% yield. Finally, liberation of the amide followed by pH adjustment and amide bond formation with acrolyl chloride furnished ibrutinib (XI) in 50% over the three-step sequence.

  

• Arzneimittelwechselwirkung

  Potentially hazardous interactions with other drugs
  Anti-arrhythmics: concentration possibly increased by amiodarone and dronedarone - avoid or reduce dose of ibrutinib.
  Antibacterials: concentration possibly increased by ciprofloxacin, clarithromycin, erythromycin and telithromycin - avoid or reduce dose of ibrutinib; concentration reduced by rifampicin - avoid.
  Antidepressants: concentration possibly reduced by St John’s wort - avoid.
  Antiepileptics: concentration possibly reduced by carbamazepine, fosphenytoin, phenobarbital and phenytoin - avoid.
  Antifungals: concentration possibly increased by fluconazole, itraconazole, ketoconazole and voriconazole - avoid or reduce dose of ibrutinib
  . Antipsychotics: avoid with clozapine, increased risk of agranulocytosis.
  Antivirals: concentration possibly increased by atazanavir, darunavir, fosamprenavir, indinavir, ritonavir and saquinavir - avoid or reduce dose of ibrutinib.
  Aprepitant: concentration possibly increased - avoid or reduce dose of ibrutinib.
  Calcium channel blockers: concentration possibly increased by diltiazem or verapamil - avoid or reduce dose of ibrutinib.
  Cobicistat: concentration possibly increased, avoid or reduce dose of ibrutinib.
  Cytotoxics: concentration possibly increased by crizotinib - avoid or reduce dose of ibrutinib; concentration possibly increased by imatinib - reduce dose of ibrutinib.
  Grapefruit juice and Seville oranges: avoid.

• Stoffwechsel

  Ibrutinib is metabolised primarily by CYP3A4 to produce a dihydrodiol metabolite with an inhibitory activity towards BTK approximately 15 times lower than that of ibrutinib. Involvement of CYP2D6 in the metabolism of ibrutinib appears to be minimal.
  After a single oral administration of radiolabeled [14C]-ibrutinib in healthy subjects, approximately 90% of radioactivity was excreted within 168 hours, with the majority (80%) excreted in the faeces and <10% in the urine. Unchanged ibrutinib accounted for approximately 1% of the radiolabeled excretion product in faeces and none in urine.

• Lager

  +4°C

• Mode of action

  Ibrutinib is the second oral agent approved for the treatment of MCL. It works by irreversibly inhibiting Bruton’s tyrosine kinase (Btk) leading to the inhibition of B-cell receptor signaling and resulting in the reduction of malignant B-cell proliferation and induction of cell death. Btk plays an important role in the differentiation, development, proliferation, and survival of B cells via activation of cell-cycle regulators and regulating the expression of pro- and antiapoptotic proteins. Aberrant Btk activity results in a variety of B-cell malignancies including MCL. Ibrutinib inhibits Btk by irreversibly binding to cysteine-481 in the active site thereby inhibiting phosphorylation of tyrosine-223 and affecting downstream B-cell signaling pathways.

• Einzelnachweise

  1) Honigberg?et al.?(2010),?The Bruton tyrosine kinase inhibitor PCI-32765 blocks B-cell activation and is efficacious in models of autoimmune disease and B-cell malignancy;?Proc. Natl. Acad. Sci. USA?107?13075 DOI:10.1073/pnas.1004594107
  2) Ponader?et al.?(2012),?The Bruton tyrosine kinase Inhibitor PCI-32765 thwarts chronic lymphocytic leukemia cell survival and tissue homing in vitro and in vivo;?Blood?119?1182
  DOI:10.1182/blood-2011-10-386417
  3) De Rooij?et al.?(2012),?The clinically active BTK inhibitor PCI-32765 targets B-cell receptor- and chemokine-controlled adhesion and migration in chronic lymphocytic leukemia;?Blood?119?2590
  DOI:10.1182/blood-2011-11-390989
  4) Pavlasoca?et al.?(2016),?Ibrutinib inhibits CD20 upregulation on CLL B cells mediated by the CXCR4/SDF-1 axis;?Blood?128?1609 DOI:10.1182/blood-2016-04-709519
  5) Sagiv-Barfi?et al.?(2015),?Therapeutic antitumor immunity by checkpoint blockade is enhanced by ibrutinib, an inhibitor of both BTK and ITK; Proc. Natl. Acad. Sci. USA?112?E966 DOI:10.1073/pnas.1500712112
  6) Weber?et al.?(2017),?Bruton's Tyrosine Kinase: An Emerging Key Player in Innate Immunity,?Front. Immunol.?8?1454 DOI:10.3389/fimmu.2017.01454

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