The FDA has granted approval to nilotinib (Danziten) for the treatment of adult patients with newly diagnosed Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML) in chronic phase (CP) and accelerated phase (AP). This approval is significant as it marks the first and only nilotinib formulation that does not require mealtime restrictions, offering a more convenient treatment option for patients. The drug is also indicated for patients resistant or intolerant to prior therapy, including imatinib.
Key Benefits of Danziten
Danziten, developed by Azurity Pharmaceuticals, is a re-engineered formulation of nilotinib designed to improve bioavailability. Unlike the standard nilotinib (Tasigna), which requires patients to avoid food for two hours before and one hour after administration, Danziten provides consistent nilotinib exposure regardless of whether it is taken with food or on an empty stomach. This eliminates the mealtime restrictions associated with Tasigna, which can significantly impact a patient's quality of life.
Clinical Implications
According to Richard Blackburn, CEO of Azurity Pharmaceuticals, "Danziten offers a new nilotinib treatment option with equivalent efficacy to Tasigna, but without the fasting requirements." The elimination of mealtime restrictions addresses a critical unmet need for CML patients, as the variable bioavailability of Tasigna, which increases when taken with food, can prolong the QT interval, posing potential safety concerns.
Dosage and Administration
The prescribing information for Danziten specifies that it is indicated for adult patients with newly diagnosed Ph-positive CML-CP or CML-AP who are resistant or intolerant to prior therapy that included imatinib. The recommended dose for newly diagnosed patients with Ph-positive CML-CP is 142 mg orally twice daily. For those resistant or intolerant with Ph-positive CML-CP and CML-AP, the dose is 190 mg orally twice daily. Dosage adjustments are necessary for patients with baseline hepatic impairment. Furthermore, treatment discontinuation may be considered in eligible patients who have received nilotinib tablets for at least three years and achieved a sustained molecular response.
