通用中文 | 依维莫司片 | 通用外文 | Everolimus |
品牌中文 | 飞尼妥 | 品牌外文 | Afinitor |
其他名称 | Afinitor 靶点mTOR | ||
公司 | 诺华(Novartis) | 产地 | 美国(USA) |
含量 | 10mg | 包装 | 30片/盒 |
剂型给药 | 储存 | 室温 | |
适用范围 | 肾癌 肾肿瘤 肾细胞癌 |
通用中文 | 依维莫司片 |
通用外文 | Everolimus |
品牌中文 | 飞尼妥 |
品牌外文 | Afinitor |
其他名称 | Afinitor 靶点mTOR |
公司 | 诺华(Novartis) |
产地 | 美国(USA) |
含量 | 10mg |
包装 | 30片/盒 |
剂型给药 | |
储存 | 室温 |
适用范围 | 肾癌 肾肿瘤 肾细胞癌 |
【商品名】Afinito
【通用名】依维莫司
【英文名】Everolimus
【成份】依维莫司
【适应症】适用于用舒尼替尼[sunitinib]或索拉非尼[sorafenib]治疗失败后晚期肾细胞癌患者的治疗。
【剂量和给药方法】
1、5mg每天1次有或无食物。
2、治疗中断和/或剂量减低至5mg每天1次可能需要处理不良药物反应。
3、对有Child-Pugh类别B肝损伤患者,减低剂量至5mg每天1次。
4、如需要中度CYP3A4或P-糖蛋白(PgP)抑制剂,减低AFINITOR剂量至2.5mg每天1次;如耐受考虑增加至5mg每天1次。
5、如需要CYP3A4的强诱导剂,增加AFINITOR剂量5mg增量至最大20mg每天1次。
【禁忌】对活性物质,对其它雷帕霉素衍生物,或对任何辅料超敏性。超敏性反应比阿姆纤维症状包括,单不限于,过敏,呼吸困难,脸红,胸痛,或胸血管水肿(如,气道或舌肿胀,有或无呼吸损伤)用依维莫司和其它雷帕霉素衍生物曾观察到。
【注意事项】
1、非-感染性肺炎:监查临床症状或放射学变化;曾发生致命性病例.用剂量减低或停药处理直至症状解决,和考虑皮质甾体。
2、感染:增加的风险感染,某些致命性。监视征象和症状,和及时治疗。
3、口腔溃疡:口溃疡,口炎,和口粘膜炎是常见处理包括口腔洗涤(无酒精或过氧化物)和局部治疗。
4、实验室检验改变:可能发生血清肌酐,血糖,和脂质的升高。还可能发生血红蛋白,嗜中性,和血小板减低。治疗前和以后定期监测肾功能,血糖,脂质,和血液学参数。
5、免疫接种:避免活疫苗和密切接触曾接受活疫苗者。
6、妊娠中使用:当给予妊娠妇女时可能发生胎儿危害。告知妇女对胎儿潜在危害。
【不良反应】最常见不良反应(发生率 ≥30%)是口炎,感染,虚弱,疲乏,咳嗽,和腹泻。
【药物相互作用】
1、强CYP3A4或PgP抑制剂:避免同时使用。
2、中度CYP3A4或PgP抑制剂:如需要联用,谨慎使用和减低AFINITOR剂量。
3、强CYP3A4诱导剂:避免同时使用。如不能避免联用,增加AFINITOR剂量。
【在特殊人群中的使用】
1、哺乳母亲:停止药物或哺乳,考虑药物对母亲的重要性。
2、肝损伤:有Child-Pugh类别C肝损伤患者中不应使用AFINITOR。对有Child-Pugh类别B肝损伤患者减低剂量至5mg每天。
【FDA妊娠分级】妊娠类别D
【药 理作用】依维莫司是一种mTOR的抑制剂(雷帕霉素哺乳动物靶点),PI3K/AKT通路下游的一种丝氨酸苏氨酸激酶。在几种人癌中mTOR失调控。依维 莫司结合至细胞内蛋白,FKBP-12,导致一种抑制剂性复合物形成和mTOR激酶活性的抑制。依维莫司减低S6核糖体蛋白激酶(S6K1)的活性和真核 生物延伸因子4E-结合蛋白(4E-BP), mTOR的下游效应器,涉及蛋白质合成。此外,依维莫司抑制缺氧-可诱导因子的表达(如,HIF-1)和减低血管内皮生长因子(VEGF)的表达。在体外 和/或体内研究中通过依维莫司mTOR的抑制作用曾显示减低细胞增殖,血管生成和葡萄糖摄取。
【储藏】密封保存
Brand Name :Afinito
Active Ingredients : Everolimus
Manufactured by:BIOCON
Form: Tablets
Strength: 10 mg
Tablets in one Pack: 20 Tablets
Afinitor(R) Approved In US As First Treatment For Patients With Advanced Kidney Cancer After Failure Of Either Sunitinib Or Sorafenib
Novartis announced that Afinitor® (everolimus) tablets has been approved by the US Food and Drug Administration (FDA) for patients with advanced renal cell carcinoma (RCC) after failure of treatment with Sutent® (sunitinib)* or Nexavar® (sorafenib)**. Prior to Afinitor, no other therapy has been studied in a Phase III trial in this patient population where there is an important unmet medical need1. Sutent and Nexavar are commonly used as initial treatments for advanced RCC2. The approval is based on data that showed Afinitor, when compared with placebo, more than doubled the time without tumor growth or death in patients with advanced kidney cancer (4.9 vs. 1.9 months) and reduced the risk
of disease progression or death by 67% (hazard ratio=0.33 with 95% confidence interval 0.25 to 0.43; P<0.0001)3. Furthermore, additional data show that after 10 months of treatment with Afinitor, approximately 25% of patients still had no tumor growth1, ***. "This approval provides a new and useful tool for treating advanced renal cell cancer, representing an important step forward in managing this disease," said Robert J. Motzer, MD, attending physician, Memorial Sloan-Kettering Cancer Center, New York and principal investigator of the RECORD-1 trial, the basis for FDA approval of Afinitor. "New treatment options are vital to help us continue to offer patients with advanced kidney cancer new ways to battle their difficult-to-treat disease. Based on clinical trial data, this option should be considered when sunitinib or sorafenib fail." In 2008, the FDA granted priority review status to Afinitor, previously known as RAD001, based on its potential to fill an unmet medical need for patients with advanced kidney cancer. Novartis has filed regulatory submissions in the European Union, Switzerland and Japan, as well as with other regulatory agencies globally1. Afinitor inhibits mTOR, a protein in the cancer cell that controls tumor cell division and blood vessel growth. Preclinical and clinical data have established the important role of mTOR in the development and progression of several types of tumors1.
"With this approval, we can now offer patients a targeted therapy proven to fulfill an important unmet need in the treatment of advanced kidney cancer," said David Epstein, President and CEO, Novartis Oncology, Novartis Molecular Diagnostics. "We continue to study Afinitor in kidney cancer, and through a broad clinical program to explore its potential in many other tumor types."
About renal cell carcinoma
Renal cell carcinoma is often referred to as kidney cancer. Kidney cancer accounts for approximately 2% of all new cancers4. RCC is the most common type of kidney cancer, with occurrence rates rising steadily around the world due in part to smoking and obesity5,6. It is estimated that about 54,000 new cases of RCC developed in the US in 2008 and more than 13,000 people died from the disease7. In RCC, cancer cells develop in the lining of the kidney's tubes and grow into a tumor8. If left untreated, the tumor can spread to neighboring lymph nodes and eventually other organs9.
RECORD-1 trial
The FDA regulatory filing for Afinitor was based on data from RECORD-1 (REnal Cell cancer treatment with Oral RAD001 given Daily), the largest Phase III clinical trial to study the effects of an oral mTOR inhibitor in advanced RCC patients whose cancer progressed despite prior treatment with sunitinib, sorafenib or both sequentially. In February 2008, based on a recommendation from an independent data monitoring committee, Novartis stopped the trial after interim results showed that patients receiving Afinitor experienced a significant delay in cancer progressing or death compared with patients receiving placebo1. This international, multi-center, randomized, double-blind trial involved 416 patients with advanced RCC whose cancer progressed despite prior treatment with sunitinib, sorafenib or both sequentially. In addition, prior therapy with bevacizumab, interferon alfa and interleukin-2 was allowed. Patients were randomized to receive Afinitor (10 mg) daily or placebo, in conjunction with best supportive care. The
primary endpoint of the study was progression-free survival, which was assessed via a blinded independent, central radiological review10.
About Afinitor
Afinitor is the first oral, daily therapy (5 mg and 10 mg tablets) to treat advanced kidney cancer after failure of treatment with sunitinib or sorafenib. In cancer cells, Afinitor continuously targets mTOR, a protein that acts as a central regulator of tumor cell division, blood vessel growth and cell metabolism. Afinitor is also being studied in multiple cancer types, including neuroendocrine, breast, gastric and hepatocellular carcinoma (HCC), as well as tuberous sclerosis complex (TSC) and non-Hodgkin's lymphoma11. The active ingredient in Afinitor is everolimus, which is available in different dosage strengths under the trade name Certican® for the prevention of organ rejection in heart and kidney transplant recipients. Certican was first approved in the EU in 2003. Certican is not approved for use in the US1.
Important safety information
Afinitor is contraindicated in patients with hypersensitivity to everolimus, to other rapamycin derivatives or to any of the excipients. Potentially serious adverse reactions include non infectious pneumonitis and infections for which patients should be monitored carefully and treated as needed. In addition, non-infectious pneumonitis may require temporary dose reduction and/or interruption or discontinuation. Patients with systemic invasive fungal infections should not receive Afinitor. Oral ulceration is a common side effect with Afinitor. Renal function, blood glucose, lipids and hematological parameters should be evaluated prior to the start of therapy with Afinitor and periodically thereafter. Strong or moderate CYP3A4 or P-glycoprotein inhibitors should be avoided. An increase in the dose of Afinitor is recommended when co-administered with a strong CYP3A4 inducer. Live vaccinations and close contact with those who have received live vaccines should be avoided. Afinitor should not be used in patients with severe hepatic impairment. Afinitor may cause fetal harm in pregnant women. The most common adverse reactions (incidence ≥30%) were stomatitis, infections, asthenia, fatigue, cough and diarrhea. The most common grade 3/4 adverse reactions (incidence ≥3%) were infections, dyspnea, fatigue, stomatitis, dehydration, pneumonitis, abdominal pain and asthenia. The most common laboratory abnormalities (incidence ≥50%) were anemia, hypercholesterolemia, hypertriglyceridemia, hyperglycemia, lymphopenia and increased creatinine. The most common grade 3/4 laboratory abnormalities (incidence ≥3%) were lymphopenia, hyperglycemia, anemia, hypophosphatemia and hypercholesterolemia. Deaths due to acute respiratory failure (0.7%), infection (0.7%) and acute renal failure (0.4%) were observed for patients receiving Afinitor.
Disclaimer
The foregoing release contains forward-looking statements that can be identified by terminology such as "risk," "options," "potential," "continue to study," "explore," "estimated," "can" or similar expressions, or by express or implied discussions regarding potential new indications or labeling for Afinitor, potential approvals of Afinitor in additional markets, or regarding potential future revenues from Afinitor. You should not place undue reliance on these statements. Such forward-looking statements reflect the
current views of the Company regarding future events, and involve known and unknown risks, uncertainties and other factors that may cause actual results with Afinitor to be materially different from any future results, performance or achievements expressed or implied by such statements. There can be no guarantee that Afinitor will be approved for sale in any additional markets. Neither can there be any guarantee that Afinitor will be approved for any additional indications or labeling in any market. Nor can there be any guarantee that Afinitor will achieve any particular levels of revenue in the future. In particular, management's expectations regarding Afinitor could be affected by, among other things, unexpected regulatory actions or delays or government regulation generally; unexpected clinical trial results, including unexpected new clinical data and unexpected additional analysis of existing clinical data; the company's ability to obtain or maintain patent or other proprietary intellectual property protection; competition in general; government, industry and general public pricing pressures; the impact that the foregoing factors could have on the values attributed to the Group's assets and liabilities as recorded in the Group's consolidated balance sheet, and other risks and factors referred to in Novartis AG's current Form 20-F on file with the US Securities and Exchange Commission. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those anticipated, believed, estimated or expected. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of new information, future events or otherwise.
About Novartis
Located in East Hanover, New Jersey, Novartis Pharmaceuticals Corporation is an affiliate of Novartis AG which provides healthcare solutions that address the evolving needs of patients and societies. Focused solely on healthcare, Novartis offers a diversified portfolio to best meet these needs: innovative medicines, preventive vaccines, diagnostic tools, cost-saving generic pharmaceuticals and consumer health products. Novartis is the only company with leading positions in these areas. In 2008, the Group's continuing operations achieved net sales of USD 41.5 billion and net income of USD 8.2 billion. Approximately USD 7.2 billion was invested in R&D activities throughout the Group. Headquartered in Basel, Switzerland, Novartis Group companies employ approximately 96,700 full-time-equivalent associates and operate in more than 140 countries around the world.