XTANDI® (enzalutamide)
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免费版 |
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31.43 Kb |
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软件语言: |
简体中文 |
更新时间: |
2013-04-17 |
版本号: |
1.0 |
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Win2000/WinXP/Win2003 |
软件类别: |
国产软件 |
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★★★★★ |
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admin |
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3(今日:1,本周:1,本月:2) |
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XTANDI® (enzalutamide)胶囊为口服使用
美国初次批准:2012 一般描述 Enzalutamide是一种雄激素受体抑制剂。化学名是 4-{3-[4-cyano-3-(trifluoromethyl)phenyl]-5,5dimethyl-4-oxo-2-sulfanylideneimidazolidin-1-yl}-2-fluoro-N-methylbenzamide. 分子量为464.44和分子式为 C21H16F4N4O2S。结构式为: Enzalutamide是一种白色结晶非吸湿性固体。实际上不溶于水。 XTANDI以为口服给药液体充填明胶胶囊供应。每粒胶囊含40 mg的enzalutamide在辛酰己酰聚氧甘油酯[caprylocaproyl polyoxylglycerides]中为溶液。无活性成分是辛酰己酰聚氧甘油酯,丁基羟基茴香醚,二丁基羟基甲苯,明胶,山梨糖醇山梨糖醇液,甘油,纯水,二氧化钛,和黑色氧化铁。
临床药理学 作用机制 Enzalutamide是一种雄激素受体抑制剂作用在雄激素受体信号通路不同步骤。曾证明Enzalutamide与雄激素竞争性抑制结合至雄激素受体和抑制雄激素受体核易位和与DNA相互作用。一个主要代谢物,N-去甲基enzalutamide,表现出与enzalutamide相似体外活性。在体外Enzalutamide减低增殖和诱发前列腺癌细胞的细胞死亡,和在小鼠前列腺癌异种移植模型中减小肿瘤体积。.
适应证和用途 XTANDI是一种雄激素受体抑制剂适用于治疗有转移去势耐受前列腺癌既往曾接受多西他奇[docetaxel]患者。
剂量和给药方法 XTANDI 160 mg(四40 mg胶囊)口服给药每天1次。吞服整个胶囊。XTANDI可与或无食物服用。
剂型和规格 胶囊40 mg
禁忌证 妊娠
警告和注意事项 接受XTANDI患者0.9%发生癫痫发作。没有曾有癫痫发作患者,在有癫痫发作诱发因素患者,或同时使用药物可能降低癫痫发作阈患者中使用XTANDI的临床试验经验。
不良反应 最常见不良反应(≥ 5%)是虚弱/疲劳,背痛,腹泻,关节痛,潮热,外周血水肿,肌肉骨骼痛,头痛,上呼吸道感染,肌肉无力,眩晕,失眠,下呼吸道感染,脊髓压迫症和马尾神经综合征,血尿,感觉异常,焦虑,和高血压。
药物相互作用 (1)避免强CYP2C8抑制剂,因为它们可能增加对XTANDI血浆暴露。如需要共同给药,减低XTANDI剂量。 (2)避免强或中度CYP3A4或CYP2C8 诱导剂因它们可能改变对XTANDI血浆暴露。 (3)避免CYP3A4,CYP2C9和CYP2C19底物有狭窄治疗指数,因XTANDI可能减低这些药物的血浆暴露。如XTANDI是与华法林(CYP2C9底物)共同给药,进行附加的INR监测。.
如何供应/贮存和处置 (1)XTANDI(enzalutamide)40 mg胶囊供应为白色至灰白色椭圆形软明胶胶囊用黑墨汁印有MDV。可得到以下包装大小的XTANDI胶囊: (2)120胶囊瓶(NDC 0469-0125-99) 推荐贮存:在干处贮存XTANDI胶囊在20°C至25°C(68°F至77°F)和保持容器密闭。外出允许从15°C至30°C (59°F至86°F)。 Xtandi Approved for Metastatic Castration-Resistant Prostate Cancer Previously Treated With Docetaxel Medivation and Astellas announced that the FDA has approved Xtandi (enzalutamide) capsules for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) who have previously received docetaxel (Taxotere; Sanofi Aventis).
The efficacy and safety of Xtandi were assessed in a randomized, placebo-controlled, multicenter Phase 3 clinical trial. A total of 1,199 patients with mCRPC who had previously received docetaxel were randomized 2:1 to receive either Xtandi orally at a dose of 160mg once daily (N=800) or placebo (N=399). The primary endpoint of the trial was overall survival. Xtandi-treated patients had a statistically-significant improvement in median overall survival compared to the placebo group: 18.4 months in the Xtandi group vs. 13.6 months in the placebo group (P<0.0001). Xtandi provided a 37% reduction in risk of death compared to placebo (hazard ratio=0.631).
Enzalutamide is an androgen receptor inhibitor that acts on different steps in the androgen receptor signaling pathway. Xtandi will be supplied as 40mg capsules. Medivation and Astellas expect to make Xtandi available in mid-September 2012.
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