U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry ABSOLUTE
Molecular Formula C27H32FN9O2
Molecular Weight 533.6005
Optical Activity UNSPECIFIED
Defined Stereocenters 3 / 3
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of Pralsetinib

SMILES

CO[C@@]1(CC[C@@H](CC1)C2=NC(NC3=NNC(C)=C3)=CC(C)=N2)C(=O)N[C@@H](C)C4=CC=C(N=C4)N5C=C(F)C=N5

InChI

InChIKey=GBLBJPZSROAGMF-RWYJCYHVSA-N
InChI=1S/C27H32FN9O2/c1-16-11-22(33-23-12-17(2)35-36-23)34-25(31-16)19-7-9-27(39-4,10-8-19)26(38)32-18(3)20-5-6-24(29-13-20)37-15-21(28)14-30-37/h5-6,11-15,18-19H,7-10H2,1-4H3,(H,32,38)(H2,31,33,34,35,36)/t18-,19-,27+/m0/s1

HIDE SMILES / InChI

Molecular Formula C27H32FN9O2
Molecular Weight 533.6005
Charge 0
Count
Stereochemistry ABSOLUTE
Additional Stereochemistry No
Defined Stereocenters 3 / 3
E/Z Centers 0
Optical Activity UNSPECIFIED

Pralsetinib (GAVRETO™, Blueprint Medicines Corporation) is an orally-administered, next-generation, small-molecule selective rearranged during transfection (RET) inhibitor being developed for the treatment of various solid tumours. RET is a well described proto-oncogene present in multiple cancers including non-small cell lung cancer (NSCLC), papillary thyroid cancer, and medullary thyroid carcinoma. Pralsetinib is a kinase inhibitor of wild-type RET and oncogenic RET fusions (CCDC6-RET) and mutations (RET V804L, RET V804M and RET M918T) with half maximal inhibitory concentrations (IC50s) less than 0.5 nM. In purified enzyme assays, pralsetinib inhibited DDR1, TRKC, FLT3, JAK1-2, TRKA, VEGFR2, PDGFRb, and FGFR1 at higher concentrations that were still clinically achievable at Cmax. In cellular assays, pralsetinib inhibited RET at approximately 14-, 40-, and 12-fold lower concentrations than VEGFR2, FGFR2, and JAK2, respectively. Pralsetinib is approved for the treatment of RET fusion-positive metastatic NSCLC. In the pivotal phase I/II ARROW trial, pralsetinib demonstrated rapid and durable anti-tumour activity in patients with advanced RET fusion-positive NSCLC who were previously treated with platinum-based chemotherapy or were treatment-naïve. Pralsetinib also showed clinical activity against intracranial metastases arising from NSCLC. Pralsetinib had a manageable tolerability profile, with the most common grade 3 treatment-related adverse events being neutropenia, hypertension, anaemia and decreased white blood cell count.

Approval Year

TargetsConditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
GAVRETO

Approved Use

Indicated for the treatment of adult patients with metastatic rearranged during transfection (RET) fusion- positive nonsmall cell lung cancer (NSCLC) as detected by an FDA approved test.

Launch Date

2020
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
2470 ng/mL
400 mg 1 times / day steady-state, oral
dose: 400 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
PRALSETINIB plasma
Homo sapiens
population: UNKNOWN
age: ADULT
sex: UNKNOWN
food status: FASTED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
36700 ng × h/mL
400 mg 1 times / day steady-state, oral
dose: 400 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
PRALSETINIB plasma
Homo sapiens
population: UNKNOWN
age: ADULT
sex: UNKNOWN
food status: FASTED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
20 h
400 mg 1 times / day steady-state, oral
dose: 400 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
PRALSETINIB plasma
Homo sapiens
population: UNKNOWN
age: ADULT
sex: UNKNOWN
food status: FASTED
15.7 h
single, oral
PRALSETINIB plasma
Homo sapiens
population: UNKNOWN
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
2.9%
PRALSETINIB plasma
Homo sapiens
Doses

Doses

DosePopulationAdverse events​
600 mg 1 times / day steady, oral
Highest studied dose
Dose: 600 mg, 1 times / day
Route: oral
Route: steady
Dose: 600 mg, 1 times / day
Sources:
unhealthy, ADULT
Health Status: unhealthy
Age Group: ADULT
Sex: M+F
Food Status: UNKNOWN
Sources:
400 mg 1 times / day steady, oral
Recommended|MTD
Dose: 400 mg, 1 times / day
Route: oral
Route: steady
Dose: 400 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Sex: M+F
Food Status: UNKNOWN
Sources:
Disc. AE: Disease progression, Pneumonia...
AEs leading to
discontinuation/dose reduction:
Disease progression (3.4%)
Pneumonia (1.4%)
Pneumonitis (1.1%)
Anaemia (3 patients)
Dyspnea (1.1%)
Sepsis (1.1%)
Sources:
AEs

AEs

AESignificanceDosePopulation
Dyspnea 1.1%
Disc. AE
400 mg 1 times / day steady, oral
Recommended|MTD
Dose: 400 mg, 1 times / day
Route: oral
Route: steady
Dose: 400 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Sex: M+F
Food Status: UNKNOWN
Sources:
Pneumonitis 1.1%
Disc. AE
400 mg 1 times / day steady, oral
Recommended|MTD
Dose: 400 mg, 1 times / day
Route: oral
Route: steady
Dose: 400 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Sex: M+F
Food Status: UNKNOWN
Sources:
Sepsis 1.1%
Disc. AE
400 mg 1 times / day steady, oral
Recommended|MTD
Dose: 400 mg, 1 times / day
Route: oral
Route: steady
Dose: 400 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Sex: M+F
Food Status: UNKNOWN
Sources:
Pneumonia 1.4%
Disc. AE
400 mg 1 times / day steady, oral
Recommended|MTD
Dose: 400 mg, 1 times / day
Route: oral
Route: steady
Dose: 400 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Sex: M+F
Food Status: UNKNOWN
Sources:
Anaemia 3 patients
Disc. AE
400 mg 1 times / day steady, oral
Recommended|MTD
Dose: 400 mg, 1 times / day
Route: oral
Route: steady
Dose: 400 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Sex: M+F
Food Status: UNKNOWN
Sources:
Disease progression 3.4%
Disc. AE
400 mg 1 times / day steady, oral
Recommended|MTD
Dose: 400 mg, 1 times / day
Route: oral
Route: steady
Dose: 400 mg, 1 times / day
Sources:
unhealthy
Health Status: unhealthy
Sex: M+F
Food Status: UNKNOWN
Sources:
OverviewDrug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
yes
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
major
major
yes (co-administration study)
Comment: Itraconazole increased pralsetinib Cmax and AUC by 1.8-fold and 2.5-fold
Page: 52 | 54 | 82 | 90 | 92 | 99
minor
minor
minor
yes
yes
yes (co-administration study)
Comment: Itraconazole increased pralsetinib Cmax and AUC by 1.8-fold and 2.5-fold
Page: 52 | 92 | 99 | 103
Tox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
PubMed

PubMed

TitleDatePubMed
Pralsetinib: A Review in Advanced RET Fusion-Positive NSCLC.
2022-05
Pralsetinib for patients with advanced or metastatic RET-altered thyroid cancer (ARROW): a multi-cohort, open-label, registrational, phase 1/2 study.
2021-08
Pralsetinib for RET fusion-positive non-small-cell lung cancer (ARROW): a multi-cohort, open-label, phase 1/2 study.
2021-07
Pralsetinib: First Approval.
2020-11
Patents

Sample Use Guides

The recommended dosage of GAVRETO is 400 mg orally once daily on an empty stomach (no food intake for at least 2 hours before and at least 1 hour after taking GAVRETO)
Route of Administration: Oral
In Vitro Use Guide
Pralsetinib is a highly potent and selective RET (c-RET) inhibitor with an IC50 of 0.4 nM for WT RET. It also demonstrates potent activity (IC50 0.4 nmol/L) against common oncogenic RET alterations, including RET (M918T).
Substance Class Chemical
Created
by admin
on Tue Apr 01 20:36:10 GMT 2025
Edited
by admin
on Tue Apr 01 20:36:10 GMT 2025
Record UNII
1WPE73O1WV
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
GAVRETO
Preferred Name English
Pralsetinib
INN   USAN  
Official Name English
cis-N-{(1S)-1-[6-(4-fluoro-1H-pyrazol-1-yl)pyridin-3-yl]ethyl}-1-methoxy-4-{4-methyl-6-[(5-methyl-1H-pyrazol-3-yl)amino]pyrimidin-2-yl}cyclohexane-1-carboxamide
Systematic Name English
Cyclohexanecarboxamide, N-[(1S)-1-[6-(4-fluoro-1H-pyrazol-1-yl)-3-pyridinyl]ethyl]-1-methoxy-4-[4-methyl-6-[(5-methyl-1H-pyrazol-3-yl)amino]-2-pyrimidinyl]-, cis-
Systematic Name English
BLU-123244
Code English
cis-Pralsetinib
Common Name English
Pralsetinib, cis-
Common Name English
Pralsetinib [WHO-DD]
Common Name English
X581238
Code English
Pralsetinib [ORANGE BOOK]
Common Name English
BLU123244
Code English
Pralsetinib [INN]
Common Name English
X-581238
Code English
RG-6396
Code English
Pralsetinib [USAN]
Common Name English
BLU-667
Code English
Classification Tree Code System Code
FDA ORPHAN DRUG 840321
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
FDA ORPHAN DRUG 634318
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
FDA ORPHAN DRUG 728519
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
Code System Code Type Description
CAS
2097132-94-8
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
PRIMARY
NCI_THESAURUS
C132295
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
PRIMARY
USAN
HI-27
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
PRIMARY
RXCUI
2394936
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
PRIMARY
EVMPD
SUB196574
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
PRIMARY
INN
11004
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
PRIMARY
SMS_ID
100000182481
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
PRIMARY
EPA CompTox
DTXSID901336540
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
PRIMARY
LACTMED
Pralsetinib
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
PRIMARY
FDA UNII
1WPE73O1WV
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
PRIMARY
DAILYMED
1WPE73O1WV
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
PRIMARY
WIKIPEDIA
Pralsetinib
Created by admin on Tue Apr 01 20:36:10 GMT 2025 , Edited by admin on Tue Apr 01 20:36:10 GMT 2025
PRIMARY
Related Record Type Details
METABOLIC ENZYME -> INDUCER
METABOLIC ENZYME -> SUBSTRATE
MINOR
SOLVATE->ANHYDROUS
TRANSPORTER -> INHIBITOR
TRANSPORTER -> INHIBITOR
METABOLIC ENZYME -> INHIBITOR
METABOLIC ENZYME -> INHIBITOR
TIME-DEPENDENT INHIBITION
EXCRETED UNCHANGED
FECAL
INHIBITOR -> TARGET
IC50
TRANSPORTER -> INHIBITOR
METABOLIC ENZYME -> INHIBITOR
TIME-DEPENDENT INHIBITION
TRANSPORTER -> INHIBITOR
OFF-TARGET->INHIBITOR
IC50
TRANSPORTER -> INHIBITOR
METABOLIC ENZYME -> SUBSTRATE
MAJOR
TARGET -> INHIBITOR
IC50
METABOLIC ENZYME -> INDUCER
TRANSPORTER -> INHIBITOR
METABOLIC ENZYME -> SUBSTRATE
MINOR
TRANSPORTER -> SUBSTRATE
TRANSPORTER -> SUBSTRATE
SALT/SOLVATE -> PARENT
EXCRETED UNCHANGED
URINE
TRANSPORTER -> INHIBITOR
METABOLIC ENZYME -> INHIBITOR
METABOLIC ENZYME -> INDUCER
METABOLIC ENZYME -> INDUCER
TRANSPORTER -> INHIBITOR
BINDER->LIGAND
Protein binding of pralsetinib is independent of concentration.
BINDING
TARGET -> INHIBITOR
IC50
Related Record Type Details
ACTIVE MOIETY
Name Property Type Amount Referenced Substance Defining Parameters References
blood-to-plasma ratio PHARMACOKINETIC
Volume of Distribution PHARMACOKINETIC
Biological Half-life PHARMACOKINETIC MULTIPLE DOSES

Tmax PHARMACOKINETIC SINGLE DOSE

Biological Half-life PHARMACOKINETIC SINGLE DOSE