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Bosutinib

Generic Name
Bosutinib
Brand Names
Bosulif
Drug Type
Small Molecule
Chemical Formula
C26H29Cl2N5O3
CAS Number
380843-75-4
Unique Ingredient Identifier
5018V4AEZ0
Background

Bosutinib is a 7-alkoxy-3-quinolinecarbonitrile that functions as a potent, dual SRC and ABL tyrosine kinase inhibitor indicated for chronic myelogenous leukemia (CML), specifically Philadelphia chromosome-positive (Ph+) CML. Philadelphia chromosome is a hallmark of CML due to the reciprocal translocation t(9;22)(q34;q11), resulting in a BCR-ABL fusion protein. The first BCR-ABL inhibitor, imatinib, was introduced over a decade ago as a breakthrough in CML management; however, emerging resistance to imatinib poses challenges in achieving remission. Second-generation BCR-ABL inhibitors like bosutinib inhibit most resistance-conferring BCR-ABL mutations except V299L and T315, thus providing more therapeutic options for patients.

Bosutinib was first approved by the FDA in 2012 for the treatment of adult chronic, accelerated, or blast-phase Ph+ CML with resistance or intolerance to prior therapy. On September 26, 2023, bosutinib was also approved by the FDA for the treatment of pediatric CML that is newly diagnosed or resistant/intolerant to prior therapy. This approval was based on favorable results obtained from the open-label, randomized, multicenter trial BFORE that showed a significant improvement in major molecular response, defined as a ≤0.1% BCR ABL ratio on an international scale, with bosutinib treatment.

Indication

用于治疗对既往治疗无效的慢性、加速期或急变期Ph+的慢性粒细胞白血病(CML)患者。

Associated Conditions
Accelerated Phase Chronic Myelogenous Leukemia (CML), Chronic Phase Chronic Myeloid Leukemia, Blast phase Chronic myeloid leukemia

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Novartis has secured FDA approval for Scemblix, a novel STAMP inhibitor, offering new hope for patients with previously-treated chronic myeloid leukaemia (CML). The drug has shown promising results in clinical trials, particularly for patients with the T315I mutation, and could significantly impact Novartis' CML portfolio.

Non-ABL1 Mutations Impact Outcomes in Chronic Myeloid Leukemia

• Analysis of CML patients reveals that non-ABL1 mutations, such as ASXL1 and RUNX1, can influence disease progression and treatment response. • The study used next-generation sequencing to assess the impact of these mutations on overall survival, event-free survival, and failure-free survival in CML patients. • Findings suggest that identifying non-ABL1 mutations could help personalize treatment strategies and improve long-term outcomes for CML patients. • The research highlights the importance of continuous monitoring and understanding of factors affecting treatment outcomes in CML.

FDA Approves Scemblix as First-Line Treatment for Chronic Myeloid Leukemia

• The FDA has granted accelerated approval to Novartis' Scemblix (asciminib) for newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia in chronic phase (Ph+ CML-CP). • Scemblix, a STAMP inhibitor, demonstrated superior major molecular response rates compared to traditional tyrosine kinase inhibitors (TKIs) in the ASC4FIRST trial. • This approval expands the eligible patient population for Scemblix and offers a potentially safer and more effective alternative to existing first-line CML treatments. • Novartis is conducting further trials to confirm Scemblix's benefits, with potential for blockbuster sales and global market expansion.

FDA Approves Scemblix (asciminib) for Newly Diagnosed Chronic Myeloid Leukemia

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Tailored TKI Dosing Strategies Improve Outcomes in Chronic Myeloid Leukemia

• Tailored dosing of tyrosine kinase inhibitors (TKIs) in chronic myeloid leukemia (CML) improves safety without compromising efficacy, according to Elias Jabbour, MD. • The phase 4 BYOND trial demonstrated that bosutinib is effective with sustained responses and manageable adverse effects in TKI-pretreated CML patients. • Treatment-free remission is achievable with bosutinib, similar to other TKIs, when patients achieve a sustained deep molecular response. • Novel agents and strategies are being explored to induce higher rates of sustained deep molecular response, improve long-term safety, and reduce the financial burden of CML treatment.

Novartis' Scemblix Demonstrates Superior Efficacy in Newly Diagnosed CML Patients

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Scemblix Receives European Commission Approval for CML Treatment After TKI Failure

• The European Commission has approved Scemblix (asciminib) for adult patients with Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML-CP). • Scemblix is intended for patients previously treated with two or more tyrosine kinase inhibitors (TKIs) who have experienced resistance or intolerance. • Phase III ASCEMBL trial results showed Scemblix nearly doubled the major molecular response rate compared to bosutinib (25.5% vs. 13.2%) at 24 weeks. • Scemblix offers a novel mechanism of action as a STAMP inhibitor, targeting the ABL myristoyl pocket, providing a new therapeutic option.

Scemblix Receives Positive CHMP Opinion for CML Treatment After TKI Failure

• The CHMP has recommended marketing authorization for Scemblix (asciminib) for Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML-CP). • The recommendation targets adult patients who have previously been treated with two or more tyrosine kinase inhibitors (TKIs). • Phase III ASCEMBL study data showed Scemblix nearly doubled major molecular response rates compared to Bosulif, with lower discontinuation rates. • Scemblix, if approved, will be the first CML treatment specifically targeting the ABL myristoyl pocket, offering a new option for TKI-resistant patients.

FDA Approves Novartis' Scemblix for Resistant Philadelphia Chromosome-Positive CML

• The FDA has approved Scemblix (asciminib) for Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML-CP) in adults after two or more tyrosine kinase inhibitors (TKIs). • Scemblix, a first-in-class ABL myristoyl pocket binder, offers a novel approach for patients with resistance or intolerance to existing TKI therapies. • Clinical trials demonstrated Scemblix nearly doubled the molecular response rate compared to bosutinib, with a lower rate of treatment discontinuation due to adverse reactions. • The approval also includes patients with the T315I mutation, who typically have limited treatment options and face significantly worse outcomes.
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