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Selumetinib

Generic Name
Selumetinib
Brand Names
Koselugo
Drug Type
Small Molecule
Chemical Formula
C17H15BrClFN4O3
CAS Number
606143-52-6
Unique Ingredient Identifier
6UH91I579U
Background

Activation of the Raf-MEK-ERK signaling pathway is known to be implemented in several types of malignancies, thus, mitogen-activated protein kinase kinase (MEK) inhibitors such as selumetinib are important tools that can target the problematic overactivity of this pathway.

Results from clinical trials investigating earlier developed MEK inhibitors were underwhelming. However, selumetinib demonstrated impressive efficacy and tolerability in Phase I trials, leading to its continued investigation for the treatment of various types of tumors in Phase II trials.

Currently, the novel MEK 1 / 2 inhibitor, selumetinib, is approved solely for the treatment of Neurofibromatosis type 1 (NF-1) in a limited age group. NF-1 is considered rare with an estimated incidence of 1/3000 individuals. It is a genetic, autosomal dominant condition resulting from mutations of the NF1 gene, which can lead to various complications including the development of multiple tumors in the nervous system. Some patients with this disorder develop plexiform neurofibromas (PN); however, this is considered to be relatively uncommon compared to other variants of NF-1. Luckily, the use of selumetinib in patients with NF-1 has shown efficacy in shrinking associated tumors and is linked to other positive clinical outcomes.

Indication

Although selumetinib has been investigated for the treatment of several types of cancer, it is currently only indicated for the treatment of neurofibromatosis type 1 (NF1) in patients ≥2 years who have symptomatic, inoperable plexiform neurofibromas (PN).

Associated Conditions
Neurofibromatosis, type 1 (von Recklinghausen's disease)

Trial of Selumetinib and Bromodomain Inhibitor With Durvalumab for Sarcomas

Phase 2
Not yet recruiting
Conditions
MPNST
NF1
Sarcoma
Interventions
First Posted Date
2022-02-23
Last Posted Date
2024-12-27
Lead Sponsor
University of Alabama at Birmingham
Target Recruit Count
41
Registration Number
NCT05253131
Locations
🇺🇸

National Cancer Institute (NCI), Bethesda, Maryland, United States

🇺🇸

Washington University - St. Louis, Saint Louis, Missouri, United States

🇺🇸

New York University Medical Center, New York, New York, United States

and more 11 locations

Phase I Study to Assess the Effect of Food on the PK and Gastrointestinal Tolerability of Selumetinib in Adolescent Children With Neurofibromatosis Type 1 Related Plexiform Neurofibromas

Phase 1
Active, not recruiting
Conditions
Neurofibromatosis Type 1
Interventions
First Posted Date
2021-11-01
Last Posted Date
2025-04-09
Lead Sponsor
AstraZeneca
Target Recruit Count
24
Registration Number
NCT05101148
Locations
🇪🇸

Research Site, Madrid, Spain

Efficacy and Safety of Selumetinib in Adults With NF1 Who Have Symptomatic, Inoperable Plexiform Neurofibromas

Phase 3
Active, not recruiting
Conditions
Neurofibromatosis 1
Plexiform Neurofibroma (PN)
Interventions
Other: Placebo
First Posted Date
2021-06-14
Last Posted Date
2024-12-09
Lead Sponsor
AstraZeneca
Target Recruit Count
146
Registration Number
NCT04924608
Locations
🇬🇧

Research Site, Manchester, United Kingdom

A Study of Selumetinib in Chinese Paediatric and Adult Subjects With Neurofibromatosis Type 1 (NF1) and Inoperable Plexiform Neurofibromas (PN)

Phase 1
Active, not recruiting
Conditions
Neurofibroma Plexiform
Neurofibromatosis 1
Interventions
First Posted Date
2020-10-19
Last Posted Date
2025-02-27
Lead Sponsor
AstraZeneca
Target Recruit Count
32
Registration Number
NCT04590235
Locations
🇨🇳

Research Site, Shanghai, China

A Study to Compare Treatment With the Drug Selumetinib Alone Versus Selumetinib and Vinblastine in Patients With Recurrent or Progressive Low-Grade Glioma

Phase 3
Recruiting
Conditions
Refractory Low Grade Astrocytoma
Refractory Low Grade Glioma
Recurrent Low Grade Astrocytoma
Recurrent WHO Grade 2 Glioma
Refractory WHO Grade 1 Glioma
Interventions
Procedure: Biospecimen Collection
Procedure: Magnetic Resonance Imaging
Other: Quality-of-Life Assessment
Other: Questionnaire Administration
First Posted Date
2020-10-06
Last Posted Date
2025-05-18
Lead Sponsor
National Cancer Institute (NCI)
Target Recruit Count
300
Registration Number
NCT04576117
Locations
🇺🇸

Children's Hospital of Alabama, Birmingham, Alabama, United States

🇺🇸

Arkansas Children's Hospital, Little Rock, Arkansas, United States

🇺🇸

Loma Linda University Medical Center, Loma Linda, California, United States

and more 98 locations

Selumetinib Paediatric NF1 Japan Study

Phase 1
Completed
Conditions
Neurofibromatosis Type 1
Interventions
First Posted Date
2020-07-31
Last Posted Date
2023-04-26
Lead Sponsor
AstraZeneca
Target Recruit Count
12
Registration Number
NCT04495127
Locations
🇯🇵

Research Site, Setagaya-ku, Japan

A Study of the Drugs Selumetinib vs. Carboplatin and Vincristine in Patients With Low-Grade Glioma

Phase 3
Recruiting
Conditions
Low Grade Astrocytoma
Metastatic Low Grade Glioma
Low Grade Glioma
Metastatic Low Grade Astrocytoma
Interventions
Procedure: Biospecimen Collection
Procedure: Magnetic Resonance Imaging
Other: Quality-of-Life Assessment
Other: Questionnaire Administration
First Posted Date
2019-11-18
Last Posted Date
2025-05-18
Lead Sponsor
National Cancer Institute (NCI)
Target Recruit Count
220
Registration Number
NCT04166409
Locations
🇺🇸

Children's Hospital of Alabama, Birmingham, Alabama, United States

🇺🇸

Banner Children's at Desert, Mesa, Arizona, United States

🇺🇸

Phoenix Childrens Hospital, Phoenix, Arizona, United States

and more 127 locations

Phase 2 Platform Study in Patients With Advanced Non-Small Lung Cancer Who Progressed on First-Line Osimertinib Therapy (ORCHARD)

First Posted Date
2019-05-10
Last Posted Date
2025-01-30
Lead Sponsor
AstraZeneca
Target Recruit Count
247
Registration Number
NCT03944772
Locations
🇸🇪

Research Site, Stockholm, Sweden

A Study of the Drugs Selumetinib Versus Carboplatin/Vincristine in Patients With Neurofibromatosis and Low-Grade Glioma

Phase 3
Recruiting
Conditions
Neurofibromatosis Type 1
Visual Pathway Glioma
Low Grade Glioma
Interventions
Procedure: Magnetic Resonance Imaging
Other: Quality-of-Life Assessment
Other: Questionnaire Administration
First Posted Date
2019-03-12
Last Posted Date
2025-05-18
Lead Sponsor
National Cancer Institute (NCI)
Target Recruit Count
165
Registration Number
NCT03871257
Locations
🇺🇸

University of Florida Health Science Center - Gainesville, Gainesville, Florida, United States

🇺🇸

Nemours Children's Hospital, Orlando, Florida, United States

🇺🇸

University of Illinois, Chicago, Illinois, United States

and more 259 locations

Study of Selumetinib (MK-5618) in Combination With Pembrolizumab (MK-3475) in Participants With Advanced/Metastatic Solid Tumors (MK-5618-001)

Phase 1
Terminated
Conditions
Advanced/Metastatic Solid Tumors
Interventions
First Posted Date
2019-02-07
Last Posted Date
2024-11-07
Lead Sponsor
Merck Sharp & Dohme LLC
Target Recruit Count
32
Registration Number
NCT03833427
Locations
🇨🇦

Princess Margaret Cancer Centre ( Site 0014), Toronto, Ontario, Canada

🇺🇸

City of Hope National Medical Center ( Site 0004), Duarte, California, United States

🇺🇸

START Midwest ( Site 0001), Grand Rapids, Michigan, United States

and more 3 locations
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