A Pilot Clinical Trial of Vemurafenib and Cobimetinib as a Redifferentiation Strategy in High-Risk, Radioactive Iodine (RAI) Naïve, BRAFV600E Mutated Differentiated Thyroid Carcinoma Patients Undergoing Initial RAI Therapy

This phase II trial tests how well vemurafenib and cobimetinib work in treating patients with high risk differentiated thyroid carcinoma with BRAFV600E mutation, in preparation for radioactive iodine therapy. Vemurafenib and cobimetinib are used in patients whose cancer has a mutated (changed) form of a gene called BRAF. They are in a class of medications called kinase inhibitors. They work by blocking the action of an abnormal protein that signals cancer cells to multiply. This helps slow or stop the spread of cancer cells. Giving vemurafenib and cobimetinib may work better to treat patients with high risk differentiated thyroid carcinoma with BRAFV600E mutation, in preparation for radioactive iodine therapy.

开始日期2024-11-30

申办/合作机构

Hope Medical Center

[+1]

NCT06561360 / Recruiting临床2期IIT

A Randomized, Multi-Center, Phase II Study of Vemurafenib Plus Obinutuzumab Vs. Cladribine Plus Rituximab in Patients with Previously Untreated Hairy Cell Leukemia (HCL)

The researchers are doing this study to compare the safety of vemurafenib in combination with obinutuzumab to the standard of approach of cladribine in combination with rituximab. The researchers will look at which treatment causes fewer or milder side effects. Researchers think vemurafenib and obinutuzumab (non-chemotherapy drugs) may cause fewer side effects compared with the usual approach of chemotherapy drugs. They will also compare the two approaches to see which approach is more effective at eliminating cancer cells.

开始日期2024-09-09

申办/合作机构

Memorial Sloan Kettering Cancer Center

[+1]

NCT06603376 / Recruiting临床2期IIT

A Randomized, Multicenter, Controlled Study of Irinotecan Hydrochloride Liposome Injection (Ⅱ) Combined with Fluorouracil, Folinic Acid, Vermofenib and Cetuximab in First-line Treatment of BRAFV600E Mutated Advanced Colorectal Cancer

Based on the upstream signaling features of BRAFV600E and the bypass feedback mechanisms, considering the pro-apoptotic effects of chemotherapy and the synergistic effects of targeted therapy, previous IMPROVEMENT trial creatively explored a balanced chemotherapy-targeted combination approach (FOLFIRI + Vemurafenib + Cetuximab) in advanced colorectal cancer patients with BRAF V600E mutaiton using a signle-arm study design, demonstrating significant therapeutic efficacy in these patietns . To further validate the effectiveness and safety of this regimen and to solidify its clinical value, it is crucial to conduct a randomized, controlled trial. Investigators plan to use the current standard regimen as a control to compare this strategy (FOLFIRI + Vemurafenib + Cetuximab) on a large cohort of patients with BRAFV600E-mutant advanced colorectal cancer in the first-line setting, focusing on its efficacy and safety.

开始日期2024-09-01

申办/合作机构

上海长征医院

100 项与维莫非尼相关的临床结果

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100 项与维莫非尼相关的转化医学

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100 项与维莫非尼相关的专利（医药）

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2,601

项与维莫非尼相关的文献（医药）

2024-12-31·CNS oncology

Promising response to vemurafenib and cobimetinib treatment for BRAF V600E mutated craniopharyngioma: a case report and literature review

Review

作者: Shahlaie, Kiarash ; Lee, Han Sung ; Raafat, Tarek A ; Fragoso, Ruben ; Theeler, Brett J ; Raslan, Osama A ; Aboud, Orwa ; Yu, Nina

Craniopharyngiomas are tumors that arise from the remnants of Rathke's pouch along the nasopharynx to the diencephalon. Current standard of care includes maximal surgical resection versus adjuvant radiation if a maximal resection is unfeasible. Pharmacological therapy with MAPK targeted agents is an emerging therapeutic option for tumors with BRAF V600E mutations. We report a 45-year-old male with a strictly third ventricle papillary craniopharyngioma with a BRAF V600E mutation. After initial surgery with subtotal resection, the patient demonstrated durable response to targeted BRAF and MEK inhibitor therapy with vemurafenib and cobimetinib. Our report suggests that targeted therapy may reduce the need for radiation and impact surgical interventions in select cases.

2024-12-01·EUROPEAN JOURNAL OF PHARMACEUTICAL SCIENCES

A new cannabigerol derivative, LE-127/2, induces autophagy mediated cell death in human cutaneous melanoma cells

Article

作者: Szabó, Erzsébet ; Lőrincz, Eszter Boglárka ; Vass, Virág ; Herczegh, Pál ; Tánczos, Bence ; Szabó, Zsuzsanna ; Tósaki, Ágnes ; Király, József ; Remenyik, Éva ; Tósaki, Árpád ; Bereczki, Ilona

Despite the targeted- and immunotherapies used in the past decade, survival rate among patients with metastatic melanoma remains low, therefore, melanoma is responsible for the majority of skin cancer-related deaths. The ongoing investigation of natural antitumor agents, the nonpsychoactive cannabinoid, cannabigerol (CBG) found in Cannabis sativa is emerging as a promising candidate. CBG offers a potential therapeutic role in the treatment of melanoma demonstrating cell growth inhibition in some tumors. Its low water solubility and bioavailability hinder the potential effectiveness. To address these challenges, a modified CBG, namely LE-127/2 was synthesized by Mannich-type reaction. The aim was to investigate the effect of this novel compound on cell proliferation as well as the mechanism of cell death with a particular focus on autophagy and apoptosis. Human cutan melanoma cell lines, WM35, A2058 and WM3000 were utilized for the present study. Cell proliferation of the cells after the treatment with LE-127/2, parent CBG or vemurafenib was assessed by Cell Titer Blue Assay. Cells were treated with a 1.25-80 µM of the above-mentioned compounds, and it was found that at 20 μM of all drugs showed a comparable effective inhibition of cell proliferation, however, vemurafenib and CBG proved to be more effective than LE-127/2. In addition, clonogenic cell survival assays were performed to examine the inhibitory effect of LE-127/2 on the colony formation ability of melanoma cell lines. Cells treated with 20 µM of LE-127/2 for 14 days showed about a 50% suppression of clonogenic cell survival. LE-127/2 exerted the most intensive inhibition on A2058 cell colonies. Furthermore, notably, LDH cytotoxicity assay performed on HaCaT cell line, proved LE-127/2 to be cytotoxic only at higher concentration, such as 80 μM, while the parent CBG was cytotoxic at concentration as low as 5 μM, suggesting that the new CBG derivative as a drug candidate may be applied in human pharmacotherapy without causing a substantial damage in intact epidermal cells. Analysis of protein expression revealed the impact of LE-127/2 on the expression of basic proteins (LC-3, Beclin-1 and p62) involved in the process of autophagy in the three different melanoma cell lines studied. Elevated expression of these proteins was detected as a result of LE-127/2 (20 µM) treatment. LE-127/2 also induced the expression of some proteins involved in apoptosis, and it is particularly noteworthy the increased level of cleaved PARP. Based on the results obtained, it can be concluded that LE-127/2 induced autophagy could lead to the inhibition of cell proliferation and death in melanoma cells.

2024-12-01·Blood Research

Advancements in the understanding and management of histiocytic neoplasms

Review

作者: Kang, Sung Han ; Yoon, Su Hyun ; Koh, Kyung-Nam ; Kim, Hyery ; Im, Ho Joon

Abstract:

Histiocytic neoplasms are rare diseases involving macrophages, dendritic cells, and monocytes. They include Langerhans cell histiocytosis (LCH), Erdheim-Chester disease (ECD), Rosai-Dorfman disease (RDD), juvenile xanthogranuloma (JXG), and histiocytic sarcoma. Histiocytic neoplasms are characterized by varied clinical courses and prognoses, necessitating a nuanced understanding of their classification, epidemiology, and clinical manifestations. Genetic studies have revealed somatic mutations, predominantly in the MAPK pathway, suggesting a clonal neoplastic nature. This review covers the current understanding of histiocytic neoplasms, molecular pathophysiology, with a particular focus on mutations in genes such as BRAF, MAP2K1, and the PI3K-AKT signaling pathways, and evolving treatment strategies, especially focusing on LCH, ECD, RDD, and JXG. The treatment landscape has evolved with advancements in targeted therapies. BRAF inhibitors, such as vemurafenib and dabrafenib, have shown efficacy, especially in high-risk LCH cases; however, challenges remain, including relapse post-treatment discontinuation, and adverse effects. MEK inhibitors have also demonstrated effectiveness, and cobimetinib has recently been approved for use in adults. Further research is required to determine the optimal treatment duration and strategies for managing therapy interruptions. Advancements in molecular genetics and targeted therapies have revolutionized the management of histiocytic neoplasms. However, ongoing research is crucial for optimizing patient outcomes.

项与维莫非尼相关的新闻（医药）

2024-10-25

·精准药物

胶质瘤NCCN指南更新及分子标志物相关靶免药物总结

导语在过去20多年，胶质瘤治疗领域的突破性进展寥寥无几。然而，今年似乎按了加速器，先后有3款药物：Tovorafenib、伯瑞替尼、Vorasidenib，获得突破性成功，成为对应靶点在胶质瘤中的首款获批药物。这些新药的获批共同开启了脑胶质瘤精准诊疗的新篇章。Vorasidenib也于9月30日纳入NCCN指南。本期就指南更新内容进行介绍，同时对胶质瘤分子标志物相关的靶免药物进行汇总分享，以便读者全面了解。一、NCCN指南更新 2024年8月6日，FDA批准Vorasidenib用于治疗手术后（包括活检、次全切或全切）携带IDH1/2突变的2级星形细胞瘤或少突胶质细胞瘤的12岁及以上患者。2024年9月30日，中枢神经系统癌症NCCN指南从2024V2版更新升级为2024V3版，纳入Vorasidenib并扩大其适应症范围，具体更新内容如下：在GLIO-A 2/9和GLIO-A 4/9页面中的以下4个临床场景中添加靶向IDH1或IDH2突变的Vorasidenib作为治疗选择： 01 作为手术/活检后的辅助治疗方案，用于RT和化疗不是首选、WHO2级、KPS≥60的患者： ►少突胶质细胞瘤（1类），首选 ►IDH突变的星形细胞瘤（1类），首选 ►注脚修改：Vorasidenib是IDH1和IDH2突变的双重抑制剂。在一项Vorasidenib对比安慰剂的3期研究中（Mellinghoff IK, et al.N Engl J Med 2023;389:589-601），在病灶残留或复发的2级IDH突变胶质瘤患者（手术后且未接受治疗）中，与安慰剂相比，Vorasidenib改善了中位PFS（27.7个月vs 11.1个月）。虽然Vorasidenib的FDA批准程序仍在进行中，但符合条件的新诊断的WHO2级疾病患者可以通过扩大准入计划（NCT05592743）获得Vorasidenib。同样适用于GLIO-2A、GLIO-4A页面的脚注k。 02 作为辅助治疗方案，用于KPS <60、WHO2级的患者 ►少突胶质细胞瘤（2A类），在某些情况下适用 ►IDH突变星形细胞瘤（2A类），在某些情况下适用 03 作为RT+化疗后复发或进展性疾病的治疗方案，用于WHO2级、KPS≥60的患者 ►少突胶质细胞瘤（2A类），首选 ►IDH突变星形细胞瘤（2A类），首选 04 作为复发或进展性疾病的治疗方案，用于KPS ≥60的患者 ►少突胶质细胞瘤，WHO3级（2B类），首选 ►IDH突变型星形细胞瘤，WHO3级或4级（2B类），首选 ▼IDH突变、1p19q共缺失的少突胶质细胞瘤：系统治疗方案选择 ▼IDH突变的星形细胞瘤：系统治疗方案选择二、胶质瘤分子标志物相关的靶免药物汇总 2.1 获批或指南推荐检测的分子标志物及其药物 1 靶向药物分子标志物：IDH1/2 异柠檬酸脱氢酶（IDH）是三羧酸循环中的一种关键性限速酶，包括IDH1、IDH2和IDH3这3种异构酶，其功能是催化异柠檬酸生成α-酮戊二酸（α-KG）。IDH的特定突变会导致α-KG的代谢异常，D-2-羟戊二酸（D-2-HG）高浓度积累，引起基因的表观修饰异常和氧化还原失衡。超过90%的IDH基因突变为IDH1 R132 突变（常见R132H突变），其余为IDH2 R172突变。 ▼胶质瘤中IDH突变频率、突变类型及其占比 Vorasidenib Vorasidenib（AG-881）是首个获批应用于胶质瘤中的IDH抑制剂。其获批基于INDIGO临床试验（NCT04164901），该试验是一项3期、多中心、随机、双盲、安慰剂对照研究，比较了Vorasidenib与安慰剂在仅接受过手术治疗的IDH1或IDH2突变的2级胶质瘤（少突胶质瘤、星形细胞瘤）残余或复发性患者中的疗效。试验数据显示，Vorasidenib的客观缓解率（ORR）为18%，包括1例部分缓解（PR）和3例轻微缓解（MR）。使用该药物观察到的无强化低级别胶质瘤患者的中位无瘤生存期为36.8个月（95%CI：11.2-40.8个月），强化胶质瘤患者的中位无瘤生存期为3.6个月（95%CI：1.8-6.5个月）。此外，在多名患者中观察到持续的肿瘤缩小。研究结论指出：在2级IDH突变胶质瘤患者中，Vorasidenib显著提高了无进展生存期，并延迟了下一次干预的时间。艾伏尼布艾伏尼布是首个获指南推荐应用于胶质瘤的IDH1抑制剂。该推荐基于以下研究结果：在66例晚期胶质瘤患者中，艾伏尼布耐受性良好，无剂量限制性毒性报道。未达到最大耐受剂量；扩大队列选择500毫克，每天一次。≥ 3 级不良事件发生率为19.7%；3% （n= 2）被认为与治疗有关。非增强型胶质瘤患者（n = 35），客观缓解率为2.9%，部分缓解1例。35例非增强型胶质瘤患者中有30例（85.7%）病情稳定，而31例增强型胶质瘤患者中有14例（45.2%）病情稳定。非增强型和增强型胶质瘤组的中位无进展生存期分别为13.6个月（95% Cl：9.2-33.2个月）和1.4个月（95% Cl：1.0-1.9个月）。在探索性分析中，艾伏尼布降低了非增强性肿瘤的体积和生长速度。结论：在mIDH1晚期胶质瘤患者中，艾伏尼布 500 mg /天1次具有良好的安全性、延长疾病控制时间和减少非增强性肿瘤的生长。目前，还有多款在研的IDH抑制剂，如Olutasidenib、DS-1001（AB-218）的初步研究已表明其在胶质瘤中具有较好的临床应用前景。 2 靶向药物分子标志物：BRAF突变/融合、NF1突变 BRAF基因变异会导致下游MEK/ERK信号通路持续激活，促进肿瘤的生长增殖和侵袭转移。在不同的脑胶质瘤中，BRAF变异的形式不同，主要包括BRAF融合和BRAF V600E。在毛细胞星形细胞瘤（PA，WHO 1级）中高发KIAA1549-BRAF融合（约60%-70%），被认为是PA的诊断标志物。在各个级别的胶质瘤中均检测到BRAF V600E突变，在多形性黄色星形细胞瘤（PXA，WHO 2/3级）中约为70%，在上皮样胶质母细胞瘤中约为50%，在胚胎发育不良性神经上皮瘤（DNET）中约为30%，在节细胞胶质瘤（WHO 1级）中约50%，在PA中约为10%。BRAF基因变异是儿童低级别胶质瘤（LGG）中最常见的致癌驱动因素。神经纤维瘤病1型（NF1）是最常见的常染色体显性肿瘤易感性综合征，由NF1基因胚系突变导致。高达30%的NF1患者会在20岁前患脑肿瘤，其中大部分是低级别胶质瘤，最常见于视觉通路，最常见的病理学亚型是PA。 ▼各类型胶质瘤中 BRAF基因变异频率 ▼常见BRAF融合的断点频率针对BRAF基因变异，NCCN指南推荐用于胶质瘤的靶向药物有：达拉非尼+曲美替尼、维莫非尼±考比替尼、司美替尼，已获药监局批准的药物有Tovorafenib、达拉非尼+曲美替尼。针对NF1基因突变，NCCN指南推荐药物有司美替尼。 Tovorafenib 2024年4月23日，FDA加速批准Tovorafenib（RAF抑制剂）用于BRAF基因融合/重排或BRAF V600突变的6个月及以上复发或难治性儿童低级别胶质瘤患者。这是首个获批用于BRAF融合/重排脑胶质瘤适应症的RAF抑制剂，其获批是基于一项多中心、开放标签、单臂临床试验FIREFLY-1（NCT04775485，II期）的研究结果。FIREFLY-1旨在评估Tovorafenib作为每周一次的单药疗法治疗6个月至25岁患有复发或进展性pLGG患者的疗效与安全性，研究共纳入137名患者（第1组：77名患者携带已知的BRAF激活突变，第2组：60名患者携带已知的RAF变异）。研究结果显示，在第1组RAPNO-LGG标准可评估的76例患者中，最佳ORR为51%，其中包括28例PR（37%）和11例MR（14%），中位持续响应时间（DoR）为13.8个月（95%CI：11.3-NE[不可估计]）。目前正在开展全球III期试验LOGGIC/FIREFLY-2（NCT05566795），旨在评估新诊断的LGG患者每周一次的Tovorafenib单药疗法，入组患者均具有已知的激活RAF改变。司美替尼 NCCN指南推荐用于BRAF变异包括BRAF V600E突变或BRAF融合和NF1突变的复发或进展性局限性胶质瘤成人患者。该推荐基于一项多中心 II 期试验（NCT01089101）的第1组和第3组研究结果：司美替尼对复发性、难治性或进展性伴有常见BRAF变异的PA和NF1相关pLGG具有活性。第1组包括患有WHO 1级毛细胞星形细胞瘤（PA）的儿童，25例符合条件且可评估的肿瘤中有18例（72%）具有 KIAA1549-BRAF融合，有7例（28%）具有BRAF V600E 突变。9例（36%）患者达到PR，9例（36%）疾病稳定（SD）和7例（28%）疾病进展（PD）。2年PFS为70%（95%CI：47%−85%）。在具有 KIAA1549-BRAF 融合的肿瘤中7例（38.9%）PR，而在BRAF V600E肿瘤中2例（28.6%）PR 。第3组包括25例患有任何NF1相关pLGG（WHO 1级和2级）的儿童接受治疗。10例（40%）患者达到 PR，15例（60%） SD和1例（4%）PD。2年PFS为96%（95% CI：74%-99.4%）。 3 靶向分子标志物：MET融合脑胶质瘤中MET异常形式主要有MET融合、MET ex14跳突、MET扩增及MET蛋白过表达；约12%脑胶质瘤被发现存在MET融合，其中PTPRZ1-MET（简称ZM）融合通常与MET ex14跳突同时出现在既往有低级别病史的胶质母细胞瘤中，发生率约为14%，并与更差的预后相关。 ▼MET融合断点（A）及其在5个癌种中的情况（B）和伴侣基因染色体分布（C）注：BC：脑癌，LC：肺癌，IC：小肠癌，GC：胃癌，BDC：胆管癌伯瑞替尼伯瑞替尼（Vebreltinib，PLB-1001）是一种高选择性MET抑制剂，于2024年4月23日获得NMPA批准用于既往治疗失败的具有PTPRZ1-MET融合基因的IDH突变型星形细胞瘤（WHO 4级）或有低级别病史的胶质母细胞瘤成人患者。这使其成为我国首个获批治疗脑胶质瘤MET异常患者的靶向药。获批主要是基于一项随机、对照、开放、多中心的II/III期临床研究（FUGEN，NCT06105619），该研究旨在对比伯瑞替尼与TMZ剂量密度方案或依托泊苷+顺铂方案的安全性和有效性。截至2023年12月，该研究共纳入了84例患者。结果显示，相较于TMZ剂量密度方案或顺铂联合依托泊苷方案，伯瑞替尼单药方案mOS为6.31个月，对照组为3.38个月，降低48%的死亡风险，可显著改善ZM融合脑胶质瘤患者生存。整体安全耐受，常见不良反应多为1-2级，可通过临床管理恢复。 4 靶向药物分子标志物：NTRK融合编码TRK融合蛋白（TRKA、TRKB、TRKC）的基因包括NTRK1、NTRK2或NTRK3的基因，这些基因融合蛋白增加了激酶功能，并与许多实体瘤发生有关。大约0.55-2%的胶质瘤/神经上皮肿瘤含有NTRK融合，但在儿童高级别胶质瘤（HGG）中NTRK融合发生率可能高达5.3%，弥漫性内生性脑桥胶质瘤（DIPG）达4%，3岁以下非脑干HGG达40%。 ▼中枢神经系统肿瘤中NTRK融合的发生率及高频的融合基因类型小分子TRK抑制剂拉罗替尼（Larorectinib，FDA/NMPA）、恩曲替尼（Entrectinib，FDA/NMPA）、瑞普替尼（Repotrectinib，FDA）已在成人和儿童各种癌症的多项试验中显示出抗肿瘤活性，并已获得国内外药监局批准用于NTRK融合的实体瘤患者。目前，针对NTRK融合的成人复发或进展性胶质母细胞瘤以及儿童HGG患者，NCCN指南推荐首选拉罗替尼和恩曲替尼；针对成人患者，2024.V2版NCCN指南新增推荐了瑞普替尼。瑞普替尼瑞普替尼获批基于多中心、单臂、开放标签的I/II期临床试验TRIDENT-1（NCT03093116），该研究纳入了3例TKI经治的胶质母细胞瘤患者，ORR为33.3%，DoR为23.5个月。文献研究报道一名2岁的女性婴儿半球型脑胶质瘤，伴有ZBTB43-NTRK2融合和CDKN2A/2B半合子缺失，在左额颞肿瘤首次手术切除后，接受了诱导化疗，自体外周血干细胞移植（aPBSCT）联合卡铂和塞替派，以及质子治疗（55.8 Gy）。第二次手术切除残留肿瘤后，参加了口服瑞普替尼的临床试验，在3年随访期间未发生疾病复发。 ▼瑞普替尼在TKI经治的NTRK融合胶质母细胞瘤患者中的疗效 ▼NTRK融合的婴儿半球型脑胶质瘤的治疗过程 5 免疫药物分子标志物：超突变遗传性癌症易感性综合征CMMRD（结构性错配修复缺陷综合征，由MMR基因[MLH1、PMS2、MSH2、MSH6]的双等位基因突变导致）经常导致儿童弥漫性高级别胶质瘤的发展，其特点是比偶发脑肿瘤或其他实体肿瘤具有更高的突变负荷。由此产生的超突变肿瘤可能对免疫检查点抑制敏感。针对超突变的复发或进展性的儿童中枢神经系统肿瘤患者，NCCN指南推荐首选纳武利尤单抗、帕博利珠单抗。然而，其有效性的证据目前仅限于病例报告和单一机构的经验。 ▼CMMRD和林奇综合征的遗传模式图（林奇综合征为MMR基因杂合突变，CMMD为MMR基因双等位基因突变）一项研究报告了两个患有复发性多灶性GBM的bMMRD（biallelic MMR deficiency syndrome，同CMMRD）的姐弟，存在POLE突变和高肿瘤突变负荷（预测具有较高的新生抗原），接受了抗程序性死亡-1（PD-1）抑制剂纳武利尤单抗的治疗，在几个月的治疗后，这两个孩子的临床和放射学反应都很明显。另一项案例研究报道，一例5岁女孩存在纯合MSH6 c.1883G>A 突变而患有GBM和CMMRD，接受免疫检查点抑制剂（ICI）纳武利尤单抗治疗，肿瘤缩小了60%，临床症状得到改善，响应持续10个月。研究表明，将CMMRD的基因组和/或分子检测纳入常规儿科肿瘤学临床护理可以确定可能从ICI中受益的患者亚群。一项在丹娜-法伯/波士顿儿童医院对11例复发性或难治性中枢神经系统肿瘤儿童患者进行的回顾性研究显示，免疫检查点抑制剂在儿童患者中具有相当好的耐受性，值得进一步的临床试验研究。 2.2 临床试验/案例报道的其他分子标志物及药物 1 靶向药物分子标志物：ALK融合婴儿半球胶质瘤携带 ALK、ROS1、NTRK1/2/3 或MET受体酪氨酸激酶重排，与其他儿科高级别胶质瘤相比，更适合治疗，生存结果更好。一名3岁的婴儿半球胶质瘤患者肿瘤细胞显示ALK 具有弥漫性免疫反应，RNA 测序显示SPECC1L-ALK融合，于是采用ALK抑制剂洛拉替尼治疗，至8个月，仅残余较小的肿瘤，实行探查性手术后未发现肿瘤，停止治疗6 个月后疾病进展，恢复洛拉替尼治疗，治疗一个月实现几乎完全缓解。另一项案例研究报道，一名3岁婴儿型半球胶质瘤，DNA测序检出QKI-ALK融合，经常规放化疗治疗进展后，采用阿来替尼治疗2个月左右，治疗期间发生肺部转移，更换为洛拉替尼治疗，实现脑部和肺部病灶的完全缓解。 2 靶向药物分子标志物：FGFR变异约有8%的胶质瘤患者会发生FGFR基因组改变，尤其是FGFR1和FGFR3，并且在约3%-5%的GBM患者中存在FGFR3-TACC3（F3T3）融合突变。研究表明F3T3融合是染色体4p16上70kb区域串联复制的结果，通常伴有低水平的局灶扩增，存在该基因融合的肿瘤细胞大量表达嵌合蛋白。FGFR1-TACC1（F1T1）融合在特定的低级别胶质瘤(如室外神经细胞瘤)中可达60%。文献报道1例胶质母细胞瘤患者，携带FGFR3扩增和FGFR3-TACC3融合，经安罗替尼和替莫唑胺治疗2个月后实现部分缓解。原发性脊髓胶质母细胞瘤（PSC GBM）检出FGFR3 p.S249C，接受10个周期的安罗替尼联合伊立替康化疗，随访约10个月期间，患者症状明显减轻，疗效得以维持。有文章报道，两例携带有FGFR3-TACC3融合突变的GBM患者，在接受安罗替尼治疗后疾病得到持续缓解。一项在复发性胶质瘤患者（携带FGFR改变）中进行的多中心II期临床研究（NCT01975701）数据显示，26名接受FGFR抑制剂Infigratinib治疗的患者的6个月PFS率为16.0%，中位PFS为1.7个月，客观缓解率为3.8%。但是4名携带FGFR1（K656E，n = 2) 或FGFR3（ K650E; n = 1）点突变或FGFR3-TACC3融合突变的肿瘤患者疾病控制持续时间超过1年。另外一项临床研究（NCT04083976）报道了FGFR抑制剂厄达替尼在具有FGFR改变的14种实体瘤体治疗中的有效性，其中30名高级别胶质瘤患者的ORR为20%。一项佩米替尼的II期临床研究纳入9例为F3T3融合的胶质瘤（共纳入13例FGFR变异），1例完全缓解，1例部分缓解，2例疾病稳定。目前一项旨在评估佩米替尼在先前治疗过的胶质母细胞瘤或其他原发性中枢神经系统肿瘤患者（携带FGFR1-3改变，包括融合/重排，激活突变或框内缺失）中的疗效和安全性的研究（NCT05267106，II期）正在进行招募中。一项关于Zoligratinib（Debio-1347）的单中心研究纳入5例FGFR变异的儿童胶质瘤患者，1例F3T3融合，1例F1T1融合，在融合的患者中1例PR，1例SD。参考资料【1】 Shen D , Zhang J , Yuan K ,et al.Landscape of IDH1/2 mutations in Chinese patients with solid tumors: A pan-cancer analysis[J].Molecular Genetics & Genomic Medicine, 2021.DOI:10.1002/mgg3.1697. 【2】Watts JM, Baer MR, Yang J, et al. 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Genomic context of NTRK1/2/3 fusion-positive tumours from a large real-world population [published correction appears in NPJ Precis Oncol. 2021 Sep 17;5(1):86]. NPJ Precis Oncol. 2021;5(1):69. Published 2021 Jul 20. doi:10.1038/s41698-021-00206-y 【27】Fangusaro J, Onar-Thomas A, Young Poussaint T, et al. Selumetinib in paediatric patients with BRAF-aberrant or neurofibromatosis type 1-associated recurrent, refractory, or progressive low-grade glioma: a multicentre, phase 2 trial. Lancet Oncol. 2019;20(7):1011-1022. doi:10.1016/S1470-2045(19)30277-3 【28】Brown NF, Carter T, Kitchen N, Mulholland P. Dabrafenib and trametinib in BRAFV600E mutated glioma. CNS Oncol. 2017;6(4):291-296. doi:10.2217/cns-2017-0006 【29】Marks AM, Bindra RS, DiLuna ML, et al. Response to the BRAF/MEK inhibitors dabrafenib/trametinib in an adolescent with a BRAF V600E mutated anaplastic ganglioglioma intolerant to vemurafenib. Pediatr Blood Cancer. 2018;65(5):e26969. doi:10.1002/pbc.26969 【30】Mellinghoff IK, Ellingson BM, Touat M, et al. Ivosidenib in Isocitrate Dehydrogenase 1-Mutated Advanced Glioma. J Clin Oncol. 2020;38(29):3398-3406. doi:10.1200/JCO.19.03327 【31】Hou Z, Wu H, Luo N, et al. Almonertinib Combined with Anlotinib and Temozolomide in a Patient with Recurrent Glioblastoma with EGFR L858R Mutation. Oncologist. 2023;28(5):449-452. doi:10.1093/oncolo/oyac280 【32】Neyns B, Sadones J, Joosens E, et al. Stratified phase II trial of cetuximab in patients with recurrent high-grade glioma. Ann Oncol. 2009;20(9):1596-1603. doi:10.1093/annonc/mdp032 【33】Bagchi A, Orr BA, Campagne O, et al. Lorlatinib in a Child with ALK-Fusion-Positive High-Grade Glioma. N Engl J Med. 2021;385(8):761-763. doi:10.1056/NEJMc2101264 【34】Lai M, Li S, Li H, et al. Lorlatinib for ALK-fused, infant-type hemispheric glioma with lung metastasis: a case report. Ann Clin Transl Neurol. 2023;10(5):836-841. doi:10.1002/acn3.51766 【35】Wen PY, Stein A, van den Bent M, et al. Dabrafenib plus trametinib in patients with BRAFV600E-mutant low-grade and high-grade glioma (ROAR): a multicentre, open-label, single-arm, phase 2, basket trial. Lancet Oncol. 2022;23(1):53-64. doi:10.1016/S1470-2045(21)00578-7 【36】Mellinghoff IK, Ellingson BM, Touat M, et al. Ivosidenib in Isocitrate Dehydrogenase 1-Mutated Advanced Glioma. J Clin Oncol. 2020;38(29):3398-3406. doi:10.1200/JCO.19.03327 【37】Ivosidenib off-label use for IDH mutant gliomas: The MD Anderson Cancer Center real life experience.Meeting Abstract | 2023 ASCO Annual Meeting I.DOI: 10.1200/JCO.2023.41.16_suppl.e14022 Journal of Clinical Oncology 41, no. 16_suppl (June 01, 2023) e14022-e14022. 【38】Miller JJ, Gonzalez Castro LN, McBrayer S, et al. Isocitrate dehydrogenase (IDH) mutant gliomas: A Society for Neuro-Oncology (SNO) consensus review on diagnosis, management, and future directions. Neuro Oncol. 2023;25(1):4-25. doi:10.1093/neuonc/noac207 【39】https://fore.bio/fore-biotherapeutics-to-present-promising-new-data-from-phase-1-2a-trial-evaluating-plixorafenib-fore8394-in-patients-with-braf-altered-advanced-solid-and-central-nervous-system-tumors-at-asco-2023/ 【40】https://fore.bio/fore-biotherapeutics-announces-oral-presentation-at-sno-2023-reporting-updated-phase-1-2a-results-for-plixorafenib-in-braf-v600-advanced-solid-tumors-including-novel-data-for-patients-with-braf-v600/ 声明：发表/转载本文仅仅是出于传播信息的需要，并不意味着代表本公众号观点或证实其内容的真实性。据此内容作出的任何判断，后果自负。若有侵权，告知必删！长按关注本公众号粉丝群/投稿/授权/广告等请联系公众号助手觉得本文好看，请点这里↓

临床3期临床结果临床2期免疫疗法

2024-10-15

·BioSpace

CuraSen Therapeutics Appoints Kathleen Sereda Glaub Chief Executive Officer

Expands Adrenergic Pipeline to Address Neurogenic Orthostatic Hypotension and Major Depressive Disorder in Older Adults SAN CARLOS, Calif.--(BUSINESS WIRE)--CuraSen Therapeutics, Inc., a clinical-stage biopharmaceutical company developing oral, rapid onset, small molecule drugs to treat psychiatric and neurodegenerative diseases, announced today that it has appointed Kathleen Sereda Glaub, MBA, formerly executive chair, as chief executive officer. Dr. Anthony Ford will move to the role of president and chief scientific officer, and continue to lead research and development. Patrick Enright, managing director of Longitude Capital, will become chair of the board. Along with these executive changes, the company announced clinical program updates for its drug candidates that are each designed to restore adrenergic stimulus that declines with age or disease. CuraSen’s most recent development candidate is CuraAX (CST-3056), an alpha-1A adrenoceptor (α 1A -AR) agonist being developed as a treatment for neurogenic orthostatic hypotension (nOH). The company is planning to submit an investigational new drug (IND) application this quarter. A significant orphan indication affecting approximately 120,000-150,000 patients in the U.S., nOH is a dysfunction in the autonomic nervous system common in Parkinson’s disease (PD) and related diseases that causes sudden drops in blood pressure upon standing. This can lead to debilitating dizziness, weakness, cognitive decline and dangerous falls. CuraAX is a selective, CNS-penetrant, α 1A -AR agonist designed to provide cognitive benefit as well as control harmful blood pressure deviations. CuraCN (formerly known as CST-103/CST-107), a beta2 adrenoceptor (β 2 -AR) agonist combination, is targeted for a Phase 2b study in major depressive disorder in adults 65 and older, many of whom also suffer from cognitive decline. These plans are based on the company’s previous Phase 2 clinical study in patients that revealed compelling evidence of anti-depressant efficacy and improvements in cognition tests. CuraXN (formerly known as CST-2032/CST-107), a second β 2 -AR agonist combination, is in development for Alzheimer’s disease (AD) to address both cognitive symptoms and disease progression. All three drug candidates work by restoring adrenergic function that declines with age and, in particular, is lost early in neurodegenerative diseases such as AD & PD. CuraSen’s development candidates have strong potential to improve cognitive function and mood, in addition to addressing specific aspects of disease pathobiology. “We are thrilled to have Ms. Glaub assume the role of chief executive officer as CuraSen seeks to capitalize on the company’s adrenergic platform and clinical data to develop a broad pipeline of drugs for psychiatric and neurodegenerative diseases. These include opportunities for a significant, fast-to-market, orphan opportunity in neurogenic orthostatic hypotension,” said Mr. Enright, board chair. “CuraSen will benefit from the collective and complementary executive experience of both Ms. Glaub and Dr. Ford, both co-founders of the company.” Ms. Glaub brings more than 30 years of experience in biopharmaceutical corporate development, strategy, financing and company-building. She serves on the board of directors of IO Biotech, and previously served on the boards of Codexis, Aligos Pharmaceuticals and Escient Pharmaceuticals. Ms. Glaub was previously chief executive officer of Afferent Pharmaceuticals, which was acquired by Merck in 2016 for $1.25 billion. Under her leadership, the company advanced gefapixant to Phase 3 readiness for the treatment of chronic cough and raised $80 million in additional private funding for Afferent. Previously, she served as president of Plexxikon, and helped develop two FDA-approved drugs, Zelboraf® for metastatic melanoma and Turalio® for tenosynovial giant cell tumor (TGCT). She led Plexxikon’s business and financing strategy, negotiated multimillion-dollar partnerships, and led the sale of the company to Daiichi Sankyo for nearly $1 billion. She previously held positions as senior vice president and chief financial officer of Cell Genesys, treasurer of Genentech, and various finance and treasury roles with Intel Corporation. Ms. Glaub received her BA from the University of California, Berkeley, and her MBA from Northwestern University. “CuraSen’s expertise in adrenergic pharmacology, chemistry and clinical development has led to the discovery of three promising drug candidates focused on some of the most debilitating and common neurodegenerative and psychiatric diseases affecting patients and their families. Our adrenergic target mechanisms are already validated by approved drugs in a range of indications, and we have confirmed the ability to develop CNS-penetrant compounds with a unique approach to safety,” said Glaub. “Given the strong and rapid-onset efficacy signals pointing to an anti-depressant effect in our past studies and our understanding of adrenergic deficits in older adults, we believe there is a unique opportunity to address depression in these patients with CuraCN. With CuraXN, we hope to deliver a transformational treatment for Alzheimer’s disease with our holistic approach to restoring brain functionality and health. Lastly, with CuraAX, we believe we can offer major advantages over current treatments for nOH, including durability of efficacy and cognitive benefit, dosing convenience and improved safety.” About CuraSen Therapeutics CuraSen is focused on the development of new treatments for psychiatric and neurodegenerative diseases, including neurogenic orthostatic hypotension, major depressive disorder and Alzheimer’s disease. CuraSen’s drugs are small molecule, oral tablets designed to activate certain receptor populations in the brain to compensate for decline of the adrenergic system driven by aging and disease. The company has evaluated two β 2 -AR agonist candidates, CuraCN and CuraXN, in multiple Phase 2 clinical studies for effects on memory, attention, executive function and mood, as well as safety and tolerability. CuraSen is planning to submit an IND application by the end of 2024 for its third drug candidate CuraAX, an α 1A -AR agonist, for the treatment of nOH. For more information, please visit . Contacts Susan Kinkead Kinkead Communications susan@kinkeadcomm.com 415-509-3610

临床2期高管变更并购

2024-09-21

·药通社

【施老师的PV小讲堂】药品安全对临床试验的影响

药物警戒是确保药品安全的重要环节，它涵盖了药品的全生命周期，包括药品上市前和上市后的监测、识别、评估和控制药品不良反应及其他有害反应。这个过程从药品的非临床实验开始，经过严格的审评审批，到人体临床试验，最终到药品上市及广泛使用。本期药通社直播间邀请到【施海坤-杭州坤煜生物医药有限公司创始人 CEO/CMO；苏州科林利康医学研究公司高级副总裁临床研究和药品安全首席专家】为医药同行进行分享！本次直播还会创建直播交流群为您提供互动交流的机会。欢迎点击下方预约 2024年9月24日 19:00药通社直播间! 嘉宾简介-施海坤报告主题：《施老师的PV小讲堂-药品安全的前世今生》个人简介：北京大学医学部临床外科学博士，以色列魏兹曼研究所博士后，获得美国医生资格认证，并在美国接受住院医生培训，拥有中美双向的临床经验。师从国际知名免疫学家，欧洲科学院院士，Prof，Irun Cohn 和以色列国家科学院院长，Prof.Haim Garty 从事肿瘤和疫苗的基础研究和治疗药物的研发 20 余年在美国罗氏+瑞士罗氏+Express Scripts 等跨国医药公司担任临床研究副总监总监和资深总监，并作为项目的核心成员先后参与了世界级的重磅药物AVASTIN，VEMURAFENIB，OCRELIZUMAB和TAGRESSA的临床研发并成功地推动了药物的研发成功和后期获得FDA的批准上市。 2017年做为联合创始人在美国创立了Teclison Limited，并担任公司的CMO，领导团队先后成功的与FDA，EMA和NMPA的举行了Pre-IND 和 EOP1会议，成功地开发了一个全球新的被FDA授予了孤儿药的资格的，治疗肝细胞癌的小分子药物，并在美国，中国完成了药物I期和u期临床试验，目前在中国进行m期临床试验。【施老师的PV小讲堂】直播预告：

疫苗孤儿药临床申请临床1期

100 项与维莫非尼相关的药物交易

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外链

KEGG	Wiki	ATC	Drug Bank
D09996	维莫非尼	L01XE15	DB08881

研发状态

批准上市

10 条最早获批的记录,

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适应症	国家/地区	公司	日期
BRAF突变阳性黑色素瘤	日本	Chugai Pharmaceutical Co., Ltd.	2014-12-26
BRAF V600 突变阳性黑色素瘤	欧盟	Roche Registration GmbH	2012-02-17
BRAF V600 突变阳性黑色素瘤	冰岛	Roche Registration GmbH	2012-02-17
BRAF V600 突变阳性黑色素瘤	列支敦士登	Roche Registration GmbH	2012-02-17
BRAF V600 突变阳性黑色素瘤	挪威	Roche Registration GmbH	2012-02-17
黑色素瘤	美国	Hoffmann-La Roche, Inc.	2011-08-17

未上市

10 条进展最快的记录,

后查看更多信息

适应症	最高研发状态	国家/地区	公司	日期
BRAF V600E突变结直肠癌	临床3期	-	上海科州药物股份有限公司初创企业	2023-11-24
甲状腺未分化癌	临床3期	英国	Hoffmann-La Roche Ltd.	2023-03-01
BRAF V600 突变阳性肿瘤	临床3期	英国	Hoffmann-La Roche Ltd.	2023-03-01
结直肠癌	临床3期	英国	Hoffmann-La Roche Ltd.	2023-03-01
Erdheim-Chester病	临床3期	英国	Hoffmann-La Roche Ltd.	2023-03-01
胶质瘤	临床3期	英国	Hoffmann-La Roche Ltd.	2023-03-01
喉肿瘤	临床3期	英国	Hoffmann-La Roche Ltd.	2023-03-01
多发性骨髓瘤	临床3期	英国	Hoffmann-La Roche Ltd.	2023-03-01
非小细胞肺癌	临床3期	英国	Hoffmann-La Roche Ltd.	2023-03-01
卵巢癌	临床3期	英国	Hoffmann-La Roche Ltd.	2023-03-01

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临床结果

适应症

分期

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研究	分期	人群特征	评价人数	分组	结果	评价	发布日期


ACTRN12620000861954 (MoST, ESMO2024) 人工标引	临床2期	BRAF突变实体瘤 \| BRAF V600突变阳性非小细胞肺癌一线 BRAF V600M	64	vemurafenib+cobimetinib (solid tumor)	願醖憲鹹構糧廠壓網鹽(鹹築蓋選糧積蓋壓齋願) = 顧範衊鹹淵窪鹽繭遞醖餘淵蓋糧選廠糧醖淵選 (範憲鑰願窪網積壓憲蓋 ) 更多	积极	2024-09-14
				vemurafenib+cobimetinib (NSCLC)	願醖憲鹹構糧廠壓網鹽(鹹築蓋選糧積蓋壓齋願) = 築齋網糧簾範鬱鏇膚鬱餘淵蓋糧選廠糧醖淵選 (範憲鑰願窪網積壓憲蓋 ) 更多
NCT02091141 (MyPathway, CTgov)	临床2期	晚期恶性实体瘤 \| 膀胱癌 \| 胆道癌 ... 更多	673	Trastuzumab+Pertuzumab (Trastuzumab Plus Pertuzumab)	醖繭窪糧壓積膚積鏇窪(鏇廠衊繭鹽廠願齋窪積) = 醖範餘醖構蓋鏇選鏇憲淵衊鹹壓蓋遞選築遞構 (襯壓夢餘憲築顧夢餘憲, 觸糧簾糧醖製壓鬱壓鹹 ~ 壓網襯艱衊選鹽壓簾膚) 更多	-	2024-07-23
				atezolizumab (Atezolizumab)	醖繭窪糧壓積膚積鏇窪(鏇廠衊繭鹽廠願齋窪積) = 窪醖齋淵餘艱壓醖積觸淵衊鹹壓蓋遞選築遞構 (襯壓夢餘憲築顧夢餘憲, 願獵憲窪觸鏇窪製壓構 ~ 蓋壓願選淵衊鬱積製衊) 更多
NCT03781219 (Pubmed) 人工标引	临床1期	BRAF突变实体瘤 BRAF V600	72	Tunlametinib plus Vemurafenib (NSCLC)	窪顧憲願選鏇艱簾夢積(鏇齋膚網築顧鑰構窪淵) = All 72 patients had treatment-related adverse events (TRAEs) 齋獵齋壓範夢願築鹽繭 (顧獵製鏇願觸鑰艱窪膚 ) 更多	积极	2024-06-12
				Tunlametinib 9 mg plus Vemurafenib 720 mg (RP2D)
NCT05263453 (ASCO2024) 人工标引	临床2期	BRAF V600 突变阳性黑色素瘤 BRAF V600-mutant	17	Tunlametinib + vemurafenib	醖膚糧鹹衊窪壓壓憲鹹(繭獵觸獵鬱衊鬱膚獵製) = 襯觸窪觸蓋鹹齋遞淵鹹襯獵醖簾憲簾鏇膚構鏇 (夢鏇膚憲觸築餘選顧衊, 44.0 ~ 89.7) 更多	积极	2024-05-24
				Tunlametinib + vemurafenib (pre-treated pts)	醖膚糧鹹衊窪壓壓憲鹹(繭獵觸獵鬱衊鬱膚獵製) = 構淵鬱築糧製淵鑰襯網襯獵醖簾憲簾鏇膚構鏇 (夢鏇膚憲觸築餘選顧衊, 46.2 ~ 95.0) 更多
NCT03625141 (TRICOTEL, ASCO2024) 人工标引	临床2期	BRAF V600 突变阳性黑色素瘤 BRAF V600 mutation	65	Atezolizumab (A) + cobimetinib (C) + vemurafenib (V)	壓鏇襯製艱夢願積簾蓋(範顧獵壓糧衊憲衊憲積) = 選選鏇網襯鹽簾憲醖淵簾醖範鹽艱顧獵範窪遞 (築鬱憲餘積鑰製鏇築壓, 27 ~ 51) 更多	积极	2024-05-24
HCL-PG04 (EHA2024) 人工标引	临床2期	毛细胞白血病 BRAF V600E	26	Obinutuzumab +/- VEMURAFENIB	簾壓構製範觸築範窪繭(獵淵蓋製願觸鏇窪壓構) = 餘鏇鹽鹽憲觸簾糧鹽鹽觸醖繭廠夢窪壓窪網繭 (築顧遞製顧獵範鬱艱構 ) 更多	积极	2024-05-14
NCT03625141 (TRICOTEL, CTgov)	临床2期	肿瘤转移 \| 转移性黑色素瘤 \| BRAF V600 突变阳性黑色素瘤	80	Atezolizumab+Cobimetinib+Vemurafenib (Cohort 2 - Cobimetinib, Atezolizumab and Vemurafenib)	窪簾蓋鑰壓艱齋襯積糧(網鹹選範顧夢繭簾觸鹹) = 憲齋製鹹鹹鏇膚襯鏇願簾襯積網鑰廠廠鹹膚構 (願淵鑰淵窪鏇餘鑰網範, 範顧選齋範構鹹鹹遞選 ~ 獵簾遞鹹夢製蓋願範醖) 更多	-	2024-02-08
				Atezolizumab+Cobimetinib (Cohort 1- Cobimetinib and Atezolizumab)	顧餘繭鹽餘積鑰範鹽窪(壓構繭夢醖積範製鏇顧) = 觸範廠觸觸積衊艱襯蓋廠襯簾壓廠窪齋範簾壓 (願衊鹹簾繭蓋夢蓋鑰構, 醖糧鏇遞窪鑰鏇鏇製遞 ~ 餘膚醖淵製衊窪壓築觸) 更多
HCL-PG03R (ASH2023)	N/A	毛细胞白血病	35	Vemurafenib Plus Rituximab (V+R)	遞繭積淵蓋廠糧積壓窪(選糧醖餘網襯構獵鹽繭) = 襯夢淵獵醖艱鑰鏇淵繭醖範鹽憲窪願齋鑰顧範 (憲衊齋夢遞獵鹽窪觸蓋 ) 更多	积极	2023-12-10
NCT03781219 (ESMO2023) 人工标引	临床1期	晚期恶性实体瘤 BRAF V600 mutation	72	tunlametinib 9mg + vemurafenib 720mg	製淵積壓憲廠壓蓋憲壓(選醖顧膚鬱鏇艱膚蓋窪) = The most common AE were CK elevation, anemia and rash which were predominantly grade 1/2. 獵遞衊餘艱構廠壓鹽選 (遞顧窪觸願繭襯夢遞選 )	积极	2023-10-23
				Tunlametinib + Vemurafenib (NSCLC)
NCT05019534 (ESMO2023) 人工标引	临床1期	BRAF V600E突变结直肠癌 Microsatellite Stable (MSS) \| BRAF V600E mutation	12	Vemurafenib+Camrelizumab+cetuximab	窪鹽製廠築淵獵齋衊顧(遞築夢憲衊製醖製廠築) = grade 1-2 treatment-related AEs occurred in 12 patients (100.0%). Grade 1-2 AEs included drug-related rash (75.0%), articular pain (75.0%), reactive capillary proliferation disease (66.7%), anemia (53.3%), muscular pain (41.7%), mucosal hemorrhage (41.7%), fatigue (25.0%), and mouth ulcers (16.7%) 網憲醖範鏇選衊餘鏇觸 (簾鹽衊衊積艱壓齋襯艱 ) 更多	积极	2023-10-22