Copanlisib Explained

Width:275
Tradename:Aliqopa
Dailymedid:Copanlisib
Licence Us:209936
Routes Of Administration:Intravenous
Class:PI3-Kinase inhibitor
Atc Prefix:L01
Atc Suffix:EM02
Legal Us:Rx-only
Legal Us Comment:[1]
Protein Bound:84.2%
Metabolism:CYP3A4/5 (≈90%), CYP1A1 (≈10%)
Elimination Half-Life:39.1 hours (range: 14.6 to 82.4)
Excretion:Feces (64%), Urine (22%); 14% were not recovered
Cas Number:1032568-63-0
Pubchem:24989044
Drugbank:DB12483
Chemspiderid:25069683
Unii:WI6V529FZ9
Kegg:D10867
Chebi:173077
Chembl:3218576
Synonyms:BAY 80-6946
Iupac Name:2-Amino-N-[7-methoxy-8-(3-morpholin-4-ylpropoxy)-2,3-dihydroimidazo[1,2-c]quinazolin-5-yl]pyrimidine-5-carboxamide
C:23
H:28
N:8
O:4
Smiles:COC1=C(C=CC2=C1N=C(N3C2=NCC3)NC(=O)C4=CN=C(N=C4)N)OCCCN5CCOCC5
Stdinchi:1S/C23H28N8O4/c1-33-19-17(35-10-2-6-30-8-11-34-12-9-30)4-3-16-18(19)28-23(31-7-5-25-20(16)31)29-21(32)15-13-26-22(24)27-14-15/h3-4,13-14H,2,5-12H2,1H3,(H2,24,26,27)(H,28,29,32)
Stdinchikey:PZBCKZWLPGJMAO-UHFFFAOYSA-N

Copanlisib, sold under the brand name Aliqopa, is a medication used for the treatment of adults experiencing relapsed follicular lymphoma who have received at least two prior systemic therapies.[2]

Adverse effects

Data for safety and efficacy of copanlisib are described in the consumer-targeted FDA Drug Trial Snapshot. Copanlisib can cause serious side effects including infections, hyperglycemia, hypertension, pneumonitis, neutropenia and skin rashes. The most common side effects of copanlisib are hyperglycemia, diarrhea, decreased general strength and energy, hypertension, leukopenia, neutropenia, nausea, lower respiratory tract infections and thrombocytopenia.Copanlisib can cause harm to unborn babies.

Mechanism of action

Copanlisib is an inhibitor of phosphatidylinositol-3-kinase (PI3K) with inhibitory activity predominantly against PI3K-α and PI3K-δ isoforms expressed in malignant B-cells. It has been shown to induce tumor cell death by apoptosis and inhibition of proliferation of primary malignant B cell lines.

History

Efficacy resulting in the approval of copanlisib was based on the subgroup of 104 patients with follicular lymphoma from a Phase 2 clinical trial. Of these, 59 percent had a complete or partial shrinkage of their tumors that lasted about 12 months.

To assess the safety of the drug, data from 168 adults with follicular lymphoma and other hematologic malignancies treated with copanlisib were evaluated.[3]

Clinical trials

Phase II clinical trials are in progress for treatment of endometrial cancer, diffuse large B-cell lymphoma, cholangiocarcinoma, and non-Hodgkin lymphoma. Copanlisib in combination with R-CHOP or R-B (rituximab and bendamustine) is in a phase III trial for relapsed indolent non-Hodgkin lymphoma (NHL). Two separate phase III trials are investigating the use of copanlisib in combination with rituximab for indolent NHL and the other using copanlisib alone in cases of rituximab-refractory indolent NHL.

In a preclinical study, copanlisib was effective in inhibiting HER2+ breast cancer cells with acquired resistance to the HER2-inhibitors trastuzumab and/or lapatinib. This effect was increased when copanlisib was administered along with the aforementioned HER2-inhibitors.[4] Consequently, treatments of copanlisib with trastuzumab are being clinically trialled in HER2-positive breast cancer patients.

Society and culture

Legal status

For follicular lymphoma, the U.S. Food and Drug Administration (FDA) awarded copanlisib orphan drug designation in February 2015, and fast track designation in February 2016.[5] The New drug application for follicular lymphoma was granted priority review in May 2017.

In September 2017, it received accelerated approval for the treatment of adults experiencing relapsed follicular lymphoma who have received at least two prior systemic therapies. Further clinical trials are to be performed as a post-marketing requirement to verify the clinical benefit.[6]

Copanlisib was granted orphan drug status for the treatment of splenic, nodal and extranodal subtypes of marginal zone lymphoma.[7]

External links

Notes and References

  1. Web site: Aliqopa- copanlisib injection, powder, lyophilized, for solution . DailyMed . 23 February 2022 . 1 April 2023.
  2. FDA approves new treatment for adults with relapsed follicular lymphoma . U.S. Food and Drug Administration (FDA) . 24 March 2020 . 1 April 2023 .
  3. Web site: Drug Trials Snapshots Aliqopa. 30 June 2020 . U.S. Food and Drug Administration (FDA) .
  4. Elster N, Cremona M, Morgan C, Toomey S, Carr A, O'Grady A, Hennessy BT, Eustace AJ . 25568678 . 6 . A preclinical evaluation of the PI3K alpha/delta dominant inhibitor BAY 80-6946 in HER2-positive breast cancer models with acquired resistance to the HER2-targeted therapies trastuzumab and lapatinib . Breast Cancer Research and Treatment . 149 . 2 . 373–83 . January 2015 . 25528022 . 10.1007/s10549-014-3239-5 .
  5. Web site: NDA 209936, Multisciplinary Review document, chapter 3. U.S. Food and Drug Administration (FDA) .
  6. Web site: NDA 209936, Approval Letter. U.S. Food and Drug Administration (FDA) .
  7. Bayer receives FDA approval for Copanlisib in adults with relapsed follicular lymphoma after two prior systemic therapies. Bayer AG . 14 September 2017.