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
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
| 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.
CNS Activity
Approval Year
Targets
| Primary Target | Pharmacology | Condition | Potency |
|---|---|---|---|
| 0.4 nM [IC50] | |||
| 35.0 nM [IC50] | |||
| 0.4 nM [IC50] | |||
Target ID: CHEMBL2971 Sources: https://pubmed.ncbi.nlm.nih.gov/34058344 |
2.0 nM [IC50] |
Conditions
| Condition | Modality | Targets | Highest Phase | Product |
|---|---|---|---|---|
| Primary | GAVRETO Approved UseIndicated 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 Date2020 |
Cmax
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
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
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
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
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
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
| Value | Dose | Co-administered | Analyte | Population |
|---|---|---|---|---|
2.9% |
PRALSETINIB plasma | Homo sapiens |
Doses
| Dose | Population | Adverse 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%) Sources: Pneumonia (1.4%) Pneumonitis (1.1%) Anaemia (3 patients) Dyspnea (1.1%) Sepsis (1.1%) |
AEs
| AE | Significance | Dose | Population |
|---|---|---|---|
| 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: |
Overview
| CYP3A4 | CYP2C9 | CYP2D6 | hERG |
|---|---|---|---|
OverviewOther
| Other Inhibitor | Other Substrate | Other Inducer |
|---|---|---|
Drug as perpetrator
Drug as victim
Tox targets
| Target | Modality | Activity | Metabolite | Clinical evidence |
|---|---|---|---|---|
Sources: https://www.accessdata.fda.gov/drugsatfda_docs/nda/2020/213721Orig1s000MultidisciplineR.pdf Page: 42 | 51 |
PubMed
| Title | Date | PubMed |
|---|---|---|
| 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 |
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
Sources: https://pubmed.ncbi.nlm.nih.gov/29657135
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
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1WPE73O1WV
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840321
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Pralsetinib
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Pralsetinib
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| 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 | ||
|---|---|---|---|---|
|
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ACTIVE MOIETY |
|
| Name | Property Type | Amount | Referenced Substance | Defining | Parameters | References |
|---|---|---|---|---|---|---|
| blood-to-plasma ratio | PHARMACOKINETIC |
|
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| Volume of Distribution | PHARMACOKINETIC |
|
|
|||
| Biological Half-life | PHARMACOKINETIC |
|
MULTIPLE DOSES |
|
||
| Tmax | PHARMACOKINETIC |
|
SINGLE DOSE |
|
||
| Biological Half-life | PHARMACOKINETIC |
|
SINGLE DOSE |
|
||