トラメチニブ

危険有害性情報のコード(GHS)

• 絵表示(GHS)

  

• 注意喚起語

  Danger

• 危険有害性情報

  H317：アレルギー性皮膚反応を起こすおそれ

  H361：生殖能または胎児への悪影響のおそれの疑い

  H372：長期にわたる、または反復暴露により臓器の障 害

• 注意書き

  P201：使用前に取扱説明書を入手すること。

  P202：全ての安全注意を読み理解するまで取り扱わないこ と。

  P260：粉じん/煙/ガス/ミスト/蒸気/スプレーを吸入しないこ と。

  P261：粉じん/煙/ガス/ミスト/蒸気/スプレーの吸入を避ける こと。

  P264：取扱い後は皮膚をよく洗うこと。

  P264：取扱い後は手や顔をよく洗うこと。

  P270：この製品を使用する時に、飲食または喫煙をしないこ と。

  P272：汚染された作業衣は作業場から出さないこと。

  P280：保護手袋/保護衣/保護眼鏡/保護面を着用するこ と。

  P281：指定された個人用保護具を使用すること。

  P302+P352：皮膚に付着した場合：多量の水と石鹸で洗うこと。

  P308+P313：暴露または暴露の懸念がある場合：医師の診断/手当てを 受けること。

  P314：気分が悪い時は、医師の診断/手当てを受けること。

  P321：特別な処置が必要である（このラベルの．．． を見よ）。

  P333+P313：皮膚刺激または発疹が生じた場合：医師の診断/手当てを 受けること。

  P363：汚染された衣類を再使用す場合には洗濯をすること。

  P405：施錠して保管すること。

  P501：内容物/容器を．．．に廃棄すること。

トラメチニブ 化学特性,用途語,生産方法

• 効能

  抗悪性腫瘍薬, マイトジェン活性化細胞外シグナル関連キナーゼ(MEK)阻害薬

• 説明

  Trametinib is an inhibitor of MEK1 and -2. It inhibits B-RAF- and C-RAF-induced phosphorylation of MEK1 (IC₅₀s = 3.4 and 1.8 nM, respectively) and MEK2 (IC₅₀s = 1.6 and 0.92 nM, respectively). Trametinib inhibits the growth of two human colorectal cancer cell lines expressing mutant B-RAF (IC₅₀s = 0.48 and 0.52 nM) and seven cell lines expressing mutant K-Ras (IC₅₀s = 2.2-174 nM) but does not inhibit the growth of wild-type COLO 320DM cells expressing both B-RAF and K-Ras (IC₅₀ = >10,000 nM). It reduces tumor growth in HT-29 and COLO 205 mouse xenograft models when used at doses of 0.3 and 1 mg/kg per day. Trametinib (0.03 and 0.1 mg/kg per day) also decreases M. tuberculosis-induced increases in hind paw volume in a rat model of arthritis. Formulations containing trametinib, in combination with dabrafenib, have been used in the treatment of metastatic mutant B-RAF^V600E melanoma.

• 使用

  Used in the systematic treatment of advanced cutaneous melanoma. An EGFR kinase inhibitor.

• 適応症

  MEK, also known as MAPK, is a dual specificity threonine/tyrosine kinase that is a key node in the Raf–Ras–MEK signaling pathway. Small-molecule MEK inhibitors represent the largest group of type III allosteric inhibitors that do not bind to the ATP binding pocket. As of December 2016, besides the FDA-approved MEK1/2 inhibitors trametinib (Mekinist(R), GlaxoSmithKline) and cobimetinib (Cotellic(R), Roche), over 10 MEK inhibitors are currently in clinical trials. Trametinib was approved by FDA in 2013 for the treatment of patients with either B-Raf V600E or V600K mutated metastatic melanoma. Considering the fact that MEK and Raf are different kinases along the same pathway of Ras–Raf–MEK/ERK signaling cascade, combination strategies using both MEK and B-Raf inhibitors were utilized to overcome the observed progression using single-agent trametinib, which usually occurs within 7months. FDA approved the combination of trametinib and dabrafenib for the treatment of B-Raf V600E/K mutated metastatic melanoma in January 2014 and the combination of cobimetinib and vemurafenib for the same type of indication. Although significant improvement in progression-free survival was observed using MEK/B-Raf combination strategy, the incidence of some common adverse effects, such as vomiting, diarrhea, nausea, rash, and pyrexia, also increased.

• 定義

  ChEBI: A pyridopyrimidine that is used (as its dimethyl sulfoxide addition compound) for the treatment of patients with unresectable or metastatic melanoma with BRAF V600E or V600K mutations, and who have not received prior BRAF inhibitor treatment.

• brand name

  Mekinist

• 薬物動態学

  Trametinib has favorable pharmacokinetic properties: quick oral absorption with tmax of 0.5–1.5 h, long duration of action with effective t1/2 of 4 days, and elimination t1/2 of 10 days, as well as good oral bioavailability (72%). The unusual long half-life and good potency contribute a once-daily administration of just 2 mg, the lowest dosage of all the MEK inhibitors now in use (Table 2). Trametinib is metabolized predominantly via deacetylation to give 6, which subsequently undergoes hydroxylation to give 8 or glucuronidation to afford 7 (Fig. 4).
  

• 臨床応用

  Trametinib (GSK1120212) is an oral MEK inhibitor which has demonstrated excellent results in combination therapy for BRAF-mutated melanoma and is FDA approved in combination with BRAF inhibitors for that indication. Trametinib was evaluated initially as a single agent in KRAS mutant NSCLC in comparison with docetaxel and pemetrexed. Results as a single agent were not impressive, with an ORR of only 12% in these patients.

• IC 50

  In vitro IC50's of MEK inhibitors:
  

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