Dasatinib [BMS 354825] is an orally active, small molecule, dual inhibitor of both SRC and ABL kinases that is under development with Bristol-Myers Squibb for the treatment of patients with chronic myelogenous leukaemia (CML) and imatinib-acquired resistance/intolerance. While imatinib remains a frontline therapy for CML, patients with advanced disease frequently develop resistance to imatinib therapy through multiple mechanisms. These mechanisms include insufficient potency at therapeutic doses, activation of alternate oncogenic pathways, and overexpression of the multidrug-resistant gene. One of the possible causes of imatinib-acquired resistance is associated with increased expression of the SRC-related kinase Lyn and loss of BCR-ABL dependence arising from sequence mutations. In December 2005, Bristol-Myers Squibb announced that it has completed the rolling NDA submission to the US FDA for dasatinib in the treatment of CML in chronic, accelerated or blast phases, as well as Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukaemia (ALL) in patients with resistance or intolerance to prior treatment. At the Bristol-Myers Squibb R&D Day in May 2005, the company stated that it plans to evaluate dasatinib in solid tumours. In in vitro assays, dasatinib induced apoptosis and had potent activity in the imatinib-resistant tumour cells lines and CML patient specimens. It effectively inhibited the proliferation of cells expressing nearly all imatinib-resistant isoforms. In vivo, dasatinib has shown efficacy, with no apparent toxicity, when administered orally in SCID mice with xenografts of imatinib-sensitive and resistant human CML cells lines. Dasatinib is also undergoing preclinical evaluation for its potential as a therapy against multiple myeloma. Bristol-Myers Squibb has a composition-of-matter patent covering this research approach that will expire in 2020.
达沙替尼[BMS 354825]是一种口服活性小分子,是SRC和ABL激酶的双重抑制剂,百时美施贵宝公司正在对其进行开发,用于治疗慢性粒细胞白血病(CML)患者以及对伊马替尼产生耐药性/不耐受的患者。虽然伊马替尼仍是CML的一线治疗药物,但晚期疾病患者经常通过多种机制对伊马替尼治疗产生耐药性。这些机制包括治疗剂量下效力不足、替代致癌途径的激活以及多药耐药基因的过表达。伊马替尼获得性耐药的可能原因之一与SRC相关激酶Lyn的表达增加以及序列突变导致的BCR-ABL依赖性丧失有关。2005年12月,百时美施贵宝宣布已完成向美国食品药品监督管理局滚动提交达沙替尼的新药申请,用于治疗慢性期、加速期或急变期的CML患者,以及对先前治疗耐药或不耐受的费城染色体阳性(Ph+)急性淋巴细胞白血病(ALL)患者。在2005年5月的百时美施贵宝研发日,该公司表示计划评估达沙替尼在实体瘤中的作用。在体外试验中,达沙替尼可诱导凋亡,并且在伊马替尼耐药的肿瘤细胞系和CML患者标本中具有强效活性。它能有效抑制表达几乎所有伊马替尼耐药异构体的细胞的增殖。在体内,当对移植有伊马替尼敏感和耐药的人CML细胞系的SCID小鼠口服给药时,达沙替尼已显示出疗效,且无明显毒性。达沙替尼作为一种治疗多发性骨髓瘤的潜在药物也正在进行临床前评估。百时美施贵宝拥有一项涵盖该研究方法的物质成分专利,该专利将于2020年到期。