Dinutuximab
Target | GD2 |
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Clinical data | |
Trade names | Unituxin, Qarziba, others |
Other names | Ch14.18, APN-311 |
AHFS/Drugs.com | Monograph |
MedlinePlus | a615022 |
License data |
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Pregnancy category |
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Intravenous | |
ATC code | |
Legal status | |
Legal status | |
Identifiers | |
CAS Number | |
IUPHAR/BPS | |
DrugBank | |
ChemSpider |
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UNII | |
KEGG | |
ChEMBL | |
Chemical and physical data | |
Formula | C6422H9982N1722O2008S48 |
Molar mass | 144981.42 g·mol−1 |
Dinutuximab (Ch14.18, tradename Unituxin) and dinutuximab beta (tradename Qarziba) are monoclonal antibodies used as a second-line treatment for children with high-risk
They both cause severe side effects, including severe pain that must be controlled with
Dinutuximab received marketing approval in the US and in the European Union in March 2015;[7][8] the marketing approval was withdrawn in 2017.[8] Dinutuximab beta received marketing approval in Europe in 2017.[6] The antibody was originally called Ch14.18 and was discovered by a group at University of California San Diego led by Alice Yu; this antibody and several others were brought into clinical trials funded by the National Cancer Institute.
Medical use
Dinutuximab is used as post-consolidation therapy for children with high-risk
Dinutuximab beta is also used as a second line treatment for children with high-risk neuroblastoma; it was tested and is used with a longer and slower dosing regime, and is given on its own, although it may be combined with IL-2 if a stronger immune response is needed.[9]
Women who are pregnant or who might become pregnant should not take dinutuximab or dinutuximab beta, because it is very likely to cause harm to a fetus.[5][9]
Adverse effects
The US label for dinutuximab carries black box warnings for life-threatening
More than 25% of children taking these drugs experienced pain, fever, hives, vomiting, diarrhea, bone marrow suppression causing loss of platelets, red blood cells, white blood cells, and albumin, hypotension, electrolyte imbalance including low sodium, potassium, and calcium, elevated transaminases, infusion reactions, and capillary leak syndrome.[5][9]
Other common adverse effects include retention or urine for weeks to months after receiving the drugs, protein in urine, blurred vision or dilated pupils, infections, edema, high blood pressure, bleeding that won't stop, tachycardia, and weight gain.[5][9]
Pharmacology
Dinutuximab and dinutuximab beta each work by binding to
In clinical trials of dinutuximab, the maximum plasma concentration was 11.5 mcg/mL; the mean steady state volume distribution was 5.4 L; the clearance rate was 0.21 L/day; and the average half-life was 10 days.[5]
Chemistry
Ch14.18 is a chimeric monoclonal antibody in which the variable heavy and light chain regions come from a mouse, with a human constant region for the heavy chain IgG1 and light chain kappa.[5][10]
The version of dinutuximab made by United Therapeutics, and marketed under the brand name Unituxin, is manufactured via industrial fermentation using a murine myeloma cell line, SP2/0.[5] The version marketed by EUSA for Apeiron is called generically dinutuximab beta and is marketed under the brand name Isquette, and is manufactured in Chinese hamster ovary cells.[11][12]
History
Dinutuximab (originally called Ch14.18) was discovered by a group at University of California San Diego led by Alice Yu; this antibody and several others were brought into clinical trials funded by the National Cancer Institute.[10][13] The NCI manufactured the mAbs for the Phase III trial[13] of Ch14.18 in combination with GM-CSF and IL-2, which was halted due to clear efficacy; the results published in 2009.[14] No company had offered by that time to get FDA approval and commercialize the drug, so the NCI kept manufacturing it and making it available under compassionate use.[13] In 2010, the NCI signed an agreement with United Therapeutics under which the company took over manufacturing and would bring the drug to market.[13]
In the meantime in Europe, oncologists and patient advocates wanted to have the drug available in Europe, and made efforts to obtain the cell line used to make it from United Therapeutics and the originating lab at the NCI itself; when those efforts failed they reached out to a group at
The FDA approved United Therapeutics application in March 2015,[18] as did the European Medicines Agency.[19]
In 2017, United Therapeutics withdrew the European marketing authorization, and said that it was having trouble making enough of the drug to sell in Europe.[19]
In October 2016, Apeiron licensed the rights to Ch14.18 to the UK biotech company, EUSA,[20] and in May 2017, Apeiron and EUSA obtained EMA approval to market Ch14.18, by then called dinutuximab beta.[9][6]
References
- ^ a b "Qarziba Australian prescription medicine decision summary". Therapeutic Goods Administration (TGA). 11 April 2020. Retrieved 16 August 2020.
- FDA. Retrieved 22 Oct 2023.
- ^ "Summary Basis of Decision (SBD) for Unituxin". Health Canada. 23 October 2014. Retrieved 29 May 2022.
- ^ "Qarziba (Dinutuximab beta) 4.5 mg/mL concentrate for solution for infusion - Summary of Product Characteristics (SmPC)". (emc). 27 November 2019. Retrieved 16 August 2020.
- ^ a b c d e f g h i j k "Unituxin- dinutuximab injection". DailyMed. 19 April 2019. Retrieved 16 August 2020.
- ^ a b c "Qarziba EPAR". European Medicines Agency. 17 September 2018. Retrieved 16 August 2020.
- ^ "Unituxin (dinutuximab)". U.S. Food and Drug Administration (FDA). 8 April 2015. Retrieved 16 August 2020.
- ^ a b "Unituxin EPAR". European Medicines Agency (EMA). 17 September 2018. Retrieved 16 August 2020.
- ^ a b c d e f g "Summary of product characteristics:: Dinutuximab beta EUSA (formerly Dinutuximab beta Aperion)" (PDF). EMA. 8 May 2017. Archived from the original (PDF) on 18 March 2018. Retrieved 28 January 2018.
- ^ PMID 22589483.
- ^ "Assessment report: Dinutuximab beta Apeiron" (PDF). EMA. 23 March 2017. Archived from the original (PDF) on 18 March 2018. Retrieved 28 January 2018.
- ^ "Dinutuximab beta - Apeiron Biologics -". AdisInsight. Retrieved 28 January 2018.
- ^ a b c d "Dinutuximab (Unituxin)". NCI Technology Transfer Center. Archived from the original on 18 November 2016. Retrieved 28 January 2018.
- PMID 19947897.
- ^ "Anti-GD2 for the treatment of neuroblastoma". Cinderella Therapeutics. 15 January 2013. Archived from the original on 30 June 2016.
- ^ "Apeiron Gains Rights to Phase III-Stage Neuroblastoma Treatment". GEN. 22 June 2011.
- ^ "Press release: Oncology Alliance: Apeiron, CCRI and SIOPEN join forces against neuroblastoma". Bionity. 27 June 2011. Archived from the original on 20 November 2011. Retrieved 28 January 2018.
- ^ "Unituxin New FDA Drug Approval". CenterWatch. Retrieved 28 January 2018.
- ^ a b "Unituxin: Withdrawal of the marketing authorisation in the European Union" (PDF). EMA. 21 April 2017. Archived from the original (PDF) on 28 January 2018.
- ^ "Apeiron licences neuroblastoma antibody". Biocom AG. 4 October 2016.
External links
- "Dinutuximab". Drug Information Portal. U.S. National Library of Medicine.
- "Dinutuximab beta". Drug Information Portal. U.S. National Library of Medicine.