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Alpelisib HCl (BLY-719; trade name: Piqray) is a novel, potent, newly approved, orally bioavailable phosphatidylinositol 3-kinase (PI3K) inhibitor with antineoplastic activity. As of May 2019, it has been approved by FDA as the first PI3K inhibitor to treat postmenopausal women, and men, with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, PIK3CA-mutated, advanced or metastatic breast cancer (as detected by an FDA-approved test) following progression on or after an endocrine-based regimen. PI3K inhibitor BYL719 specifically inhibits PIK3 in the PI3K/AKT kinase (or protein kinase B) signaling pathway, thereby inhibiting the activation of the PI3K signaling pathway. This may result in inhibition of tumor cell growth and survival in susceptible tumor cell populations. Activation of the PI3K signaling pathway is frequently associated with tumorigenesis. Dysregulated PI3K signaling may contribute to tumor resistance to a variety of antineoplastic agents. Clinical data suggests a disable safety profile with manageable side effects for BYL719.
Targets |
p110α (IC50 = 5 nM); p110γ (IC50 = 250 nM); p110δ (IC50 = 290 nM); p110β (IC50 = 1200 nM); p110α-H1047R (IC50 = 4 nM); p110α-E545K (IC50 = 4 nM)
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ln Vitro |
Alpelisib (BYL-719) effectively suppresses the 2 most prevalent PIK3CA somatic mutations (H1047R, E545K; IC50s~4 nM). Alpelisib potently suppresses Akt phosphorylation in PI3Kα-transformed cells (IC50=74±15 nM) and demonstrates significantly lower inhibitory efficacy (≥15-fold relative to PI3Kα) in PI3Kβ or PI3Kδ isoform-transformed cells [2] . Alpelisib (BYL-719, 0-50 μM; 72 hours) suppresses cell proliferation in the osteosarcoma cell lines MG63, HOS, POS-1 and MOS-J in a dose-dependent manner [3]. Alpelisib (BYL-719) drastically affects the distribution of cell cycle phases. Alpelisib (BYL-719, 25 μM; 18 hours) promotes cell cycle arrest in the G0/G1 phase in human and murine osteosarcoma cell lines [3].
We investigated the therapeutic value of BYL719, a new specific PI3Kα inhibitor that blocks the ATP site, on osteosarcoma and bone cells. The in vitro effects of BYL719 on proliferation, apoptosis, and cell cycle were assessed in human and murine osteosarcoma cell. Its impact on bone cells was determined using human mesenchymal stem cells (hMSC) and human CD14+ osteoclast precursors. Two different murine preclinical models of osteosarcoma were used to analyze the in vivo biological activities of BYL719. BYL719 decreased cell proliferation by blocking cell cycle in G0/G1 phase with no outstanding effects on apoptosis cell death in HOS and MOS-J tumor cells. BYL719 inhibited cell migration and can thus be considered as a cytostatic drug for osteosarcoma.[3] BYL719/Alpelisib inhibits the proliferation of breast cancer cell lines harboring PIK3CA mutations, correlating with inhibition of various downstream signaling components of the PI3K/Akt pathway. NVP-BYL719 potently and selectively inhibits PI3Kα in vitro [2] PI3Kα, β, δ, and γ enzymes share significant amino acid residue homology with particularly high conservation in the catalytic kinase domain. The 2-aminothiazole scaffold was selected as a starting point for the development of potent and selective PI3K inhibitors based on its binding mode, indicating the potential to use substituents at the amino group to develop interactions with nonconserved amino acids at the ATP pocket entrance (21). Consequently, systematic modification of key moieties and optimization of the drug-like properties led to the identification of NVP-BYL719. As previously described in ref. 18, in biochemical assays NVP-BYL719/Alpelisib inhibits wild-type PI3Kα (IC50 = 4.6 nmol/L) more potently than the PI3Kδ (IC50 = 290 nmol/L) and PI3Kγ (IC50 = 250 nmol/L) isoforms and shows significantly reduced activity against PI3Kβ (IC50 = 1,156 nmol/L). Here, in addition, we show that NVP-BYL719 potently inhibits the 2 most common PIK3CA somatic mutations (H1047R, E545K; IC50∼4 nmol/L). The compound also lacked activity against the class III family member Vps34 and the related class IV PIKK protein kinases mTOR, DNA-PK, and ATR and was significantly less potent against the distinct lipid kinase PIK4β (Table 1). The kinase selectivity profile of NVP-BYL719 was further examined in in vitro kinase assay panels. Among all the kinases tested (excluding class I PI3K and PI4Kβ) their respective IC50 or Kd values were at least 50-fold higher when compared with PI3Kα (Supplementary Fig. 1, Supplementary Tables 1–4). To determine the potency and selectivity of NVP-BYL719 in cellular assay systems, Rat1 cells transformed using the activated forms of PI3Kα, PI3Kβ, or PI3Kδ were tested and RPPAs were used to quantify the phosphorylation of Akt (S473) as a marker of PI3K pathway activity (17). As described in ref. 18, NVP-BYL719 potently inhibited Akt phosphorylation in cells transformed with PI3Kα (IC50 = 74 ± 15 nmol/L) and showed significant reduced inhibitory activity in PI3Kβ or PI3Kδ isoforms transformed cells (≥15-fold compared with PI3Kα). Here, we report NVP-BYL719 full dose–response curves as well as its IC80 values on S473P-Akt in Rat1 cells (Supplementary Fig. S2). In addition, treatment of TSC1-null MEF cells with NVP-BYL719 was not associated with a reduction in phosphorylation of RPS6 (S235/236) when compared with the positive control RAD001 (IC50 value < 0.5 nmol/L), suggesting that NVP-BYL719 does not inhibit mTORC1 (Supplementary Fig. S3A and S3B). Similarly, NVP-BYL719 does not seem to interfere with the PIKKs involved in DNA-damage repair (ATM and ATR) processes as determined in ATM- and ATR-dependent assay systems (Supplementary Fig. S3C and S3D). Together, these data strongly support the notion that NVP-BYL719 has the relevant in vitro properties of a selective PI3Kα inhibitor. PIK3CA mutant cell lines are selectively sensitive to NVP-BYL719/Alpelisib [2] The above-mentioned approach was useful in defining what tumors were responsive to PI3Kα inhibition. An independent question is asked when one considers, which therapeutic modality is most selective and hence likely to have the best therapeutic index in a specific cancer genotype. Here, using a novel analytical approach to define the selectivity index of small molecule inhibitors across the CCLE, we compared the selectivity profiles across different compound treatments (∼1,000) encompassing more than 200 mechanisms of actions in PIK3CA mutant versus wild-type cell lines and ranked the compounds based on the magnitude of their effects in these 2 groups (Fig. 6). NVP-BYL719, together with 3 close analogs, showed markedly selective efficacy in PIK3CA mutants when compared with wild-type cell line populations and when compared with pan-PI3K inhibitors. Conversely, MEK inhibitors were differentially more selectively effective in PIK3CA wild-type cell lines compared with mutants. BYL719/Alpelisib inhibits osteosarcoma cell proliferation [3] As expected, Figure 1b shows that BYL719 (chemical structure in Fig. 1a) rapidly inhibited the levels of P-AKT and P-mTOR in all cell lines assessed, confirming the functional activity of BYL719 on osteosarcoma cells (Fig. 1b). XTT assays were then performed to analyze the effects of BYL719 on osteosarcoma cell growth (human: MG63, HOS MNNG; mouse: POS-1, MOS-J and rat: OSRGA) (Fig. 1c). After 72 hr of treatment, BYL719 significantly inhibited the cell growth of all osteosarcoma cell lines tested in a dose-dependent manner (Figs. 1c and 1d) with an IC50 ranging from 6 to 15 µM and with the IC90 from 24 to 42 µM (Fig. 1e) at 72 hr. To determine whether or not the decreased cell viability induced by BYL719 was associated with a cell cycle alteration, flow cytometry of cell DNA content was performed after addition of BYL719 (Supporting Information data 3). The results showed that BYL719 significantly altered the distribution of cell cycle phases and, more specifically, increased cell numbers in the G0/G1 phase from 57 to 70% in MG-63, 44 to 73% in HOS (Supporting Information Data 3A), 45–70% in MOS-J and from 58 to 70% in POS-1 cells (Supporting Information Data 3B). These observations were concomitant with a decrease in cells in the S-G2/M phases. Similar results were obtained on a rat osteosarcoma cell line, OSRGA (Supporting Information Data 4). BYL719/Alpelisib acts as a cytostatic drug for osteosarcoma cells [3] To determine whether these effects were due to inhibition of cell proliferation and/or induction of cell death, the effects of BYL719 were assessed by manual counting of viable cells after trypan blue exclusion staining. BYL719 significantly decreases the number of alive HOS and MOS-J cells in a dose- and a time-dependent manner without affecting the number of dead cells, supporting the idea that BYL719 exerts a cytostatic activity in osteosarcoma cells (Fig. 1d and Supporting Information Data 5A, respectively). In addition, BYL719 failed to induce apoptosis as shown by caspase-3/7 activity assessed in HOS and MOS-J cells (Fig. 1e, left panel and Supporting Information 5B, respectively) and confirming by the absence of cleaved-PARP expression after BYL719 treatment in HOS osteosarcoma cells (Fig. 1e, right panel). Similar data were obtained with MG-63, POS-1 (data not shown) and OSRGA cell lines (Supporting Information Data 4D). Migration assays were also performed on HOS and MOS-J cells to determine the effect of BYL719 on cell motility and demonstrated that BYL719 decreased cell motility (Supporting Information Data 6A and B). We then performed a recovery assay. Surprisingly, the treated cells are able to recovery in the same manner than in the control condition, suggesting that BYL719 as a cytostatic effect only when the drug is present (Fig. 4c). All these data suggest that BYL719 has cytostatic activity in osteosarcoma cells. |
ln Vivo |
Alpelisib (BYL-719) decreases tumor volume and ectopic bone matrix deposition considerably when administered orally once a day (12.5 mg/kg and 50 mg/kg in C57Bl/6J mice; 50 mg/kg in female Rj:NMRI nude mice)[3]. In rats, alpelisib (1 mg/kg, intravenous administration) has an intermediate terminal elimination half-life (t1/2=2.9±0.2 h)[1].
In PIK3CA mutant xenograft models in rodents, BYL719 (>270 mg/d) demonstrates statistically significant dose-dependent anti-tumor efficacy. BYL719 has a low half-life of 8.5 hours, a low inter-individual variability in Cmax, and an exposure that increases dose proportionally between 30 mg/d and 450 mg/d in humans. First indications of clinical efficacy for BYL719 (270 mg/d) include 1 confirmed partial response in a patient with ER+ breast cancer and significant PET responses (PMR) and/or tumor shrinkage in 8 of the 17 patients evaluated. NVP-BYL719/Alpelisib shows robust PK/PD/Efficacy relationship in PI3Kα-driven tumors [2] To examine NVP-BYL719 ability to inhibit the PI3K/Akt pathway in a PI3Kα-dependent in vivo model, its pharmacokinetic/pharmacodynamic (PK/PD) relationship was assessed in a Rat1-myr-p110α mechanistic tumor-bearing mouse model. Each female athymic mouse received single or repeated doses of NVP-BYL719 (12.5, 25, or 50 mg/kg, p.o.) and plasma and tumors samples were collected for PK and PD analysis at different time points. Here NVP-BYL719 treatment was associated with dose and time-dependent inhibition of the PI3K/Akt pathway, which notably paralleled time-dependent drug exposure in tumor and plasma (Fig. 1A). To determine whether dose- and time-dependent pathway inhibition was linked to antitumor activity, Rat1-myr-p110α tumor-bearing nude mice were treated orally every day with the compound for up to 8 consecutive days (Fig. 1B). Treatments of 12.5, 25, and 50 mg/kg were well tolerated and resulted in a dose-dependent and statistically significant antitumor effect with a T/C of 14.1% and regressions of 9.6% and 65.2%, respectively. To assess the relative PI3K selectivity in vivo, we further tested NVP-BYL719 in a corresponding Rat1-myr-p110δ model. NVP-BYL719, when tested at the optimal dose of 50 mg/kg p.o., every day, showed only a modest antitumor effect (T/C of 30%; Fig. 1C). We next sought to better understand the degree of PI3Kα inhibition that is required for antitumor efficacy. To this end, we first determined the tumor concentrations giving 50% (in vivo IC50) and 80% (in vivo IC80) S473P-Akt inhibition (0.4 and 4 μmol/L, respectively) by measuring the extent of Akt phosphorylation using RPPA and the specific tumor drug concentration in matched samples from multiple animals and at multiple time points (Fig. 1D). Interestingly, when corrected for plasma protein binding of NVP-BYL719 in mouse (PPB = 91.2%), the in vivo IC50 (35 nmol/L) and IC80 (352 nmol/L) values roughly approximate the in vitro cellular IC50 and IC80 of 74 and 301 nmol/L, respectively. We next sought to determine the relationship between exposure, as measured by time over the in vivo IC80, and antitumor efficacy. Here, we found a nearly linear relationship between the antitumor efficacy magnitude and duration of drug exposure over the IC80 (R2 = 0.80, P < 0.001, n = 11; Fig. 1E). From this relationship it seems that 80% inhibition of Akt phosphorylation for at least 29% of the dosing interval is required for NVP-BYL719 to induce tumor stasis, and that this level of pathway inhibition must be sustained for at least 45% of the dosing interval to produce 30% tumor regression in the Rat1-myr-p110α tumor-bearing nude mice. In contrast, in the Rat1-myr-p110δ tumor-bearing nude mice NVP-BYL719 exposure levels did not achieve 80% inhibition of Akt phosphorylation (in vivo IC80 = 29 μmol/L; corrected for NVP-BYL719 plasma protein binding in mouse IC80 = 2,552 μmol/L) most likely explaining the modest antitumor effect observed and in line with the modest activity of the compound on p110δ. To exclude the possibility that our finding could be Rat1 mouse tumor models specific, NVP-BYL719 was administered in vivo at different doses to nude mice and nude rats bearing a diverse range of cancer cell lines–derived tumor xenografts. Here as well, we found a nearly linear relationship between the antitumor efficacy magnitude and duration of drug exposure over the IC80 (R2 = 0.77, P < 0.001, n = 27, Supplementary Fig. S4 and Table S5). These data suggest that sustained inhibition of the PI3K/Akt pathway for a fraction of the dosing interval is required for NVP-BYL719 to produce a robust antitumor effect. NVP-BYL719/Alpelisib shows an improved safety profile compared with pan-class I inhibition [2] The expected on target side effects of anti-PI3K therapy are insulin resistance and hyperglycemia. To assess whether NVP-BYL719 perturbs glucose homeostasis, plasma insulin and glucose blood levels were measured and compared with plasma drug concentrations in matched samples from multiple animals and at multiple time points. The data here revealed that insulin plasma levels increased proportionally with NVP-BYL719 plasma concentrations, whereas blood glucose levels were maintained close to normal up to 20 μmol/L of NVP-BYL719 (Fig. 2A and B). However, above 20 μmol/L, we observed a compound concentration-dependent glucose increase which led to hyperglycemia despite insulin plasma level elevation. Thus, we defined 20 μmol/L as NVP-BYL719-related hyperglycemic threshold in mice. Genetic alterations in PIK3CA predict NVP-BYL719/Alpelisib in vivo efficacy [2] Next, NVP-BYL719 was administered in vivo at the dose of 50 mg/kg (every day, p.o.) to mice bearing a diverse range of cancer cell lines–derived tumor xenografts (Fig. 5A and Supplementary Table S5) with different genetic backgrounds, including the predictive features of the decision tree described previously. Most of the tumor models that carried a PIK3CA mutation or amplification responded to NVP-BYL719 (response defined as T/C < 20%). In contrast, in most of the tumor models that carried a PTEN mutation or were PIK3CA wild type, we observed progressive disease. In vivo, the predictor also significantly enriched for responders (positive predictive value = 89%). These data demonstrate that the NVP-BYL719 predictive features derived from the in vitro profiling and analysis of the CCLE seem relevant for predicting response in vivo (P = 0.01, Fisher test). BYL719/Alpelisib simultaneously reduces tumor growth and tumor ectopic bone formations in two murine models of osteosarcoma and slightly modulates systemic bone parameters [3] We next tested the effects of BYL719 in the murine MOS-J syngenic model of osteosarcoma. BYL719 significantly reduced tumor volumes in a dose-dependent manner compared to a vehicle group (Fig. 2a; p < 0.01 and p < 0.001, respectively for 12.5 and 50 mg/kg BYL719). Indeed, the mean tumor volume decreased from 1747 mm3 in the control group to 938 mm3 for the group treated with 50 mg/kg BYL719 (Fig. 2a, p < 0.001). In addition, µCT analyses were performed on the tibias with the tumors and the contralateral tibias (normal bone) of each mouse. MicroCT analyses of the tibias bearing tumor showed the ectopic bone formation deposited by the tumor cells and clearly demonstrated that BYL719 significantly reduced this tumor ectopic bone (Fig. 2b, left panel). The benefit of BYL719 was confirmed with the calcified tissue parameters measured (Fig. 2b, right panel). The bone volume (BV) was significantly decreased with 50 mg/kg BYL719, 7.08 ± 0.6 to 4.37 ± 0.21 mm3 (p < 0.001) as was the bone surface (BS) from 99.65 ± 5.74 mm2 to 63.91 ± 2.3 mm2 (p < 0.001). Histomorphometric parameters of contralateral tibias were studied to determine the systemic effect of BYL719 on normal bone remodeling without any tumor (Supporting Information Data 7). BYL719 at 50 mg/(kg day−1) did not affect any of the studied trabecular bone parameters (Supporting Information Data 7). However, it significantly reduced several cortical bone parameters including TV (tissue volume), BV, BV/TV, BS/TV, and CTh (p < 0.01) (Supporting Information Data 7). Histological investigations revealed that BYL719 decreased the surface of TRAP+ osteoclasts without affecting the number of osterix+ cells (Figs. 3a and 3b). In addition, the therapeutic benefit of BYL719 was strengthened by the decrease of KI67+ cell number (Fig. 3c) and by a reduction of the tumor vascularization (Fig. 3d). Based on these results, the therapeutic potential of BYL719 was analyzed in a xenogenic model of osteosarcoma. Nude mice with human HOS tumors were treated with 50 mg/(kg day−1) of BYL719. As with the MOS-J model, BYL719 significantly reduced tumor volumes, from 1445 mm3 for the control group to 650 mm3 for the treated group at the end of the treatment period (Fig. 2c; p < 0.01). These results confirmed the inhibitory effect of BYL719 in a second preclinical osteosarcoma model. MicroCT analysis of the tibias bearing tumor revealed that BYL719 reduced deposition of ectopic bone matrix as shown by the bone parameters values from 64.91 ± 5.2 to 36.4 ± 0.70 mm2 (p < 0.001) and from 6.2 ± 0.33 to 4.0 ± 0.08 mm3 (p < 0.001), respectively, for BS and BV (Fig. 2d, right panel). The effect of BYL719 on normal bone was evaluated by µCT of the contralateral tibia without any tumor confirming the results obtained in the syngenic MOS-J model (Supporting Information Data 8). MicroCT confirmed the effect of BYL719 on cortical bone observed in C57Bl5J mice. Therapeutic benefit of combining BYL719/Alpelisib with conventional chemotherapeutic agents [3] As BYL719 shows a cytostatic effect in osteosarcoma cells, we then assessed the therapeutic benefit to combine BYL719 with ifosfamide (mafosfamide for in vitro experiment) a conventional chemotherapy in the treatment of osteosarcoma. To determine whether this effect was additive or synergistic, the dose-dependent effects with constant ratio design and the combination index (CI) values were performed and calculated according to the Chou and Talalay median effect principal. Figures 4a and 4b show the dose–response curve (combination treatment, BYL719 or mafosfamide monotherapy) and the combination index plots, indicating that BYL719 synergistically enhances the effect of mafosfamide on tumor cell growth (Figs. 4a and 4b). Then we performed a colony formation assay to evaluate capabilities to recover after 2 days of BYL719 ± mafosfamide treatment. While BYL719 did not change the number of colonies, mafosfamide decreased the colony formation compared with control (Fig. 4c). However, the combination of BYL719 with mafosfamide significantly induced the highest decrease of colony formation compared with each single drug alone (Fig. 4c). Moreover, BYL719 potentiates the effect of mafosfamide to induce apoptosis as shown by the increase of cleaved-PARP expression (Fig. 4d). We then studied the effect of BYL719 (50 mg/(kg day−1)) combined with a suboptimal dose of ifosfamide (IFOS, 30 mg/(kg day−1) for 3 days) the syngenic murine model previously described (Fig. 4e). As expected, 50 mg/kg BYL719 had a significantly inhibitory effect on tumor development as compared to the control group. In contrast, combined treatment of a suboptimal dose of IFOS with 50 mg/(kg day−1) BYL719 significantly decreased tumor growth (1011 mm3) compared to using IFOS alone (1746 mm3) or BYL719 alone (1421 mm3) (Fig. 4e). MicroCT analysis of tumor bones revealed that the combined treatment did not have an impact on the therapeutic response of BYL719, not even synergistic or additive effects were observed on the ectopic bone formed (Figs. 4f and 4g). These results strongly demonstrate the therapeutic interest to combine BYL719 with a conventional chemotherapeutic drug, in order to markedly delay tumor growth and tumor ectopic bone formation. |
Cell Assay |
Cell proliferation assay[3]
Cell Types: MG63, HOS, POS-1, MOS-J Tested Concentrations: 10, 20, 30, 40, 50 μM Incubation Duration: 72 hrs (hours) Experimental Results: Inhibition of cell growth of all osteosarcoma cell lines tested In a dose-dependent manner, IC50 is 6-15 µM and IC90 is 24-42 µM. Cell cycle analysis [3] Cell Types: MG63, HOS, POS-1, MOS-J Tested Concentrations: 25 μM Incubation Duration: 18 hrs (hours) Experimental Results: The cell cycle of human and mouse osteosarcoma cells was induced to arrest in the G0/G1 phase. |
Animal Protocol |
Animal/Disease Models: 5weeks old female Rj:NMRI nude mice, human HOS-MNNG osteosarcoma cells; 5weeks old male C57Bl/6J mice, mouse MOS-J osteosarcoma cells [3]
Doses: C57Bl/6J mice 12.5 mg/kg and 50 mg/kg; female Rj: NMRI nude mice 50 mg/kg. Route of Administration: oral; daily Experimental Results: tumor volume was Dramatically diminished, and tumor growth was also diminished. Animal/Disease Models: Female Sprague Dawley rats [1] Doses: 1 mg/kg (pharmacokinetic/PK/PK study) Route of Administration: IV Experimental Results: T1/2=2.9±0.2 hrs (hrs (hours)). |
ADME/Pharmacokinetics |
Absorption, Distribution and Excretion
Alpelisib reached a peak concentration in plasma of 1320±912ng/mL after 2 hours. Alpelisib has an AUClast of 11,100±3760h ng/mL and an AUCINF of 11,100±3770h ng/mL. A large, high fat meal increases the AUC by 73% and Cmax by 84% while a small, low fat meal increases the AUC by 77% and Cmax by 145%. 36% of an oral dose is eliminated as unchanged drug in the feces and 32% as the primary metabolite BZG791 in the feces. About 2% of an oral dose is eliminated in the urine as unchanged drug and 7.1% as the primary metabolite BZG791. In total 81% of an oral dose is eliminated in the feces and 14% is eliminated in the urine. The apparent volume of distribution at steady state is 114L. The mean apparent oral clearance was 39.0L/h. The predicted clearance is 9.2L/hr under fed conditions. Metabolism / Metabolites Alpelisib is metabolized by hydrolysis reactions to form the primary metabolite. It is also metabolized by CYP3A4. The full metabolism of Alpelisib has yet to be determined but a series of reactions have been proposed. The main metabolic reaction is the substitution of an amine group on alpelisib for a hydroxyl group to form a metabolite known as M4 or BZG791. Alpelisib can also be glucuronidated to form the M1 and M12 metabolites. Biological Half-Life The mean half life of alprelisib is 8 to 9 hours. |
Toxicity/Toxicokinetics |
Hepatotoxicity
In the prelicensure clinical trials of alpelisib in patients with cancer, liver test abnormalities were frequent although usually transient, asymptomatic, and mild-to-moderate in severity. Some degree of ALT elevation arose in up to 44% of alpelisib- and fulvestrant-treated patients, but were above 5 times the upper limit of normal (ULN) in only 3% to 4%. The aminotransferase elevations rarely necessitated dose modifications or interruptions, and only slightly lower rates of enzyme elevations occurred in patients taking fulvestrant without alpelisib. In these trials that enrolled less than 1000 patients, there were several reports of marked serum aminotransferase elevations that led to early discontinuation. However, the nature and clinical features of the liver injury were not provided and there were no cases of clinically apparent liver injury. Skin rashes were also common with alpelisib therapy, and patients are often given prophylactic antihistamines which appear to result in fewer and milder rashes. However, moderate-to-severe rash can occur and some are accompanied by drug reaction with eosinophilia and systemic signs (DRESS) syndrome, some degree of liver injury (usually anicteric and asymptomatic) being a part of the manifestations. Likelihood score: E* (unproven but suspected rare cause of clinically apparent liver injury). Effects During Pregnancy and Lactation ◉ Summary of Use during Lactation No information is available on alpelisib during breastfeeding. The manufacturer recommends that breastfeeding be discontinued during alpelisib therapy and for 1 week after the final dose. ◉ Effects in Breastfed Infants Relevant published information was not found as of the revision date. ◉ Effects on Lactation and Breastmilk Relevant published information was not found as of the revision date. Protein Binding Alpelisib is 89% protein bound. |
References |
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Additional Infomation |
Phosphatidylinositol-3-kinase α (PI3Kα) is a therapeutic target of high interest in anticancer drug research. On the basis of a binding model rationalizing the high selectivity and potency of a particular series of 2-aminothiazole compounds in inhibiting PI3Kα, a medicinal chemistry program has led to the discovery of the clinical candidate NVP-BYL719.[2]
Somatic PIK3CA mutations are frequently found in solid tumors, raising the hypothesis that selective inhibition of PI3Kα may have robust efficacy in PIK3CA-mutant cancers while sparing patients the side-effects associated with broader inhibition of the class I phosphoinositide 3-kinase (PI3K) family. Here, we report the biologic properties of the 2-aminothiazole derivative NVP-BYL719, a selective inhibitor of PI3Kα and its most common oncogenic mutant forms. The compound selectivity combined with excellent drug-like properties translates to dose- and time-dependent inhibition of PI3Kα signaling in vivo, resulting in robust therapeutic efficacy and tolerability in PIK3CA-dependent tumors. Novel targeted therapeutics such as NVP-BYL719, designed to modulate aberrant functions elicited by cancer-specific genetic alterations upon which the disease depends, require well-defined patient stratification strategies in order to maximize their therapeutic impact and benefit for the patients. Here, we also describe the application of the Cancer Cell Line Encyclopedia as a preclinical platform to refine the patient stratification strategy for NVP-BYL719 and found that PIK3CA mutation was the foremost positive predictor of sensitivity while revealing additional positive and negative associations such as PIK3CA amplification and PTEN mutation, respectively. These patient selection determinants are being assayed in the ongoing NVP-BYL719 clinical trials.[3] It has been established that disturbances in intracellular signaling pathways play a considerable part in the oncologic process. Phosphatidylinositol-3-kinase (PI3K) has become of key interest in cancer therapy because of its high mutation frequency and/or gain in function of its catalytic subunits in cancer cells. We investigated the therapeutic value of BYL719, a new specific PI3Kα inhibitor that blocks the ATP site, on osteosarcoma and bone cells. The in vitro effects of BYL719 on proliferation, apoptosis, and cell cycle were assessed in human and murine osteosarcoma cell. Its impact on bone cells was determined using human mesenchymal stem cells (hMSC) and human CD14+ osteoclast precursors. Two different murine preclinical models of osteosarcoma were used to analyze the in vivo biological activities of BYL719. BYL719 decreased cell proliferation by blocking cell cycle in G0/G1 phase with no outstanding effects on apoptosis cell death in HOS and MOS-J tumor cells. BYL719 inhibited cell migration and can thus be considered as a cytostatic drug for osteosarcoma. In murine preclinical models of osteosarcoma, BYL719 significantly decreased tumor progression and tumor ectopic bone formation as shown by a decrease of Ki67+ cells and tumor vascularization. To explore the maximum therapeutic potential of BYL719, the drug was studied in combination with conventional chemotherapeutic drugs, revealing promising efficacy with ifosfamide. BYL719 also exhibited dual activities on osteoblast and osteoclast differentiation. Overall, the present work shows that BYL719 is a promising drug in either a single or multidrug approach to curing bone sarcoma.[4] |
Molecular Formula |
C19H23CLF3N5O2S
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Molecular Weight |
477.93
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Exact Mass |
477.121
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CAS # |
1584128-91-5
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Related CAS # |
Alpelisib;1217486-61-7
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PubChem CID |
139035009
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Appearance |
Typically exists as solid at room temperature
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Hydrogen Bond Donor Count |
3
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Hydrogen Bond Acceptor Count |
8
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Rotatable Bond Count |
4
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Heavy Atom Count |
31
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Complexity |
663
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Defined Atom Stereocenter Count |
1
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SMILES |
CC1=C(SC(=N1)NC(=O)N2CCC[C@H]2C(=O)N)C3=CC(=NC=C3)C(C)(C)C(F)(F)F.Cl
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InChi Key |
HJNPFZMOUFLFRE-YDALLXLXSA-N
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InChi Code |
InChI=1S/C19H22F3N5O2S.ClH/c1-10-14(11-6-7-24-13(9-11)18(2,3)19(20,21)22)30-16(25-10)26-17(29)27-8-4-5-12(27)15(23)28;/h6-7,9,12H,4-5,8H2,1-3H3,(H2,23,28)(H,25,26,29);1H/t12-;/m0./s1
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Chemical Name |
(2S)-1-N-[4-methyl-5-[2-(1,1,1-trifluoro-2-methylpropan-2-yl)pyridin-4-yl]-1,3-thiazol-2-yl]pyrrolidine-1,2-dicarboxamide;hydrochloride
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Synonyms |
Alpelisib hydrochloride; Alpelisib (hydrochloride); 1584128-91-5;
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HS Tariff Code |
2934.99.9001
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Storage |
Powder -20°C 3 years 4°C 2 years In solvent -80°C 6 months -20°C 1 month |
Shipping Condition |
Room temperature (This product is stable at ambient temperature for a few days during ordinary shipping and time spent in Customs)
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Solubility (In Vitro) |
May dissolve in DMSO (in most cases), if not, try other solvents such as H2O, Ethanol, or DMF with a minute amount of products to avoid loss of samples
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Solubility (In Vivo) |
Note: Listed below are some common formulations that may be used to formulate products with low water solubility (e.g. < 1 mg/mL), you may test these formulations using a minute amount of products to avoid loss of samples.
Injection Formulations
Injection Formulation 1: DMSO : Tween 80: Saline = 10 : 5 : 85 (i.e. 100 μL DMSO stock solution → 50 μL Tween 80 → 850 μL Saline)(e.g. IP/IV/IM/SC) *Preparation of saline: Dissolve 0.9 g of sodium chloride in 100 mL ddH ₂ O to obtain a clear solution. Injection Formulation 2: DMSO : PEG300 :Tween 80 : Saline = 10 : 40 : 5 : 45 (i.e. 100 μL DMSO → 400 μLPEG300 → 50 μL Tween 80 → 450 μL Saline) Injection Formulation 3: DMSO : Corn oil = 10 : 90 (i.e. 100 μL DMSO → 900 μL Corn oil) Example: Take the Injection Formulation 3 (DMSO : Corn oil = 10 : 90) as an example, if 1 mL of 2.5 mg/mL working solution is to be prepared, you can take 100 μL 25 mg/mL DMSO stock solution and add to 900 μL corn oil, mix well to obtain a clear or suspension solution (2.5 mg/mL, ready for use in animals). View More
Injection Formulation 4: DMSO : 20% SBE-β-CD in saline = 10 : 90 [i.e. 100 μL DMSO → 900 μL (20% SBE-β-CD in saline)] Oral Formulations
Oral Formulation 1: Suspend in 0.5% CMC Na (carboxymethylcellulose sodium) Oral Formulation 2: Suspend in 0.5% Carboxymethyl cellulose Example: Take the Oral Formulation 1 (Suspend in 0.5% CMC Na) as an example, if 100 mL of 2.5 mg/mL working solution is to be prepared, you can first prepare 0.5% CMC Na solution by measuring 0.5 g CMC Na and dissolve it in 100 mL ddH2O to obtain a clear solution; then add 250 mg of the product to 100 mL 0.5% CMC Na solution, to make the suspension solution (2.5 mg/mL, ready for use in animals). View More
Oral Formulation 3: Dissolved in PEG400  (Please use freshly prepared in vivo formulations for optimal results.) |
Preparing Stock Solutions | 1 mg | 5 mg | 10 mg | |
1 mM | 2.0924 mL | 10.4618 mL | 20.9236 mL | |
5 mM | 0.4185 mL | 2.0924 mL | 4.1847 mL | |
10 mM | 0.2092 mL | 1.0462 mL | 2.0924 mL |
*Note: Please select an appropriate solvent for the preparation of stock solution based on your experiment needs. For most products, DMSO can be used for preparing stock solutions (e.g. 5 mM, 10 mM, or 20 mM concentration); some products with high aqueous solubility may be dissolved in water directly. Solubility information is available at the above Solubility Data section. Once the stock solution is prepared, aliquot it to routine usage volumes and store at -20°C or -80°C. Avoid repeated freeze and thaw cycles.
Calculation results
Working concentration: mg/mL;
Method for preparing DMSO stock solution: mg drug pre-dissolved in μL DMSO (stock solution concentration mg/mL). Please contact us first if the concentration exceeds the DMSO solubility of the batch of drug.
Method for preparing in vivo formulation::Take μL DMSO stock solution, next add μL PEG300, mix and clarify, next addμL Tween 80, mix and clarify, next add μL ddH2O,mix and clarify.
(1) Please be sure that the solution is clear before the addition of next solvent. Dissolution methods like vortex, ultrasound or warming and heat may be used to aid dissolving.
(2) Be sure to add the solvent(s) in order.
Targeted Therapy Directed by Genetic Testing in Treating Patients With Locally Advanced or Advanced Solid Tumors, The ComboMATCH Screening Trial
CTID: NCT05564377
Phase: Phase 2   Status: Recruiting
Date: 2024-11-21