Ceritinib (Zykadia)

==General information==
Class/mechanism: Tyrosine kinase inhibitor; inhibits anaplastic lymphoma kinase (ALK). Ceritinib prevents growth of ALK-rearranged cancer cells by inhibiting autophosphorylation of ALK and subsequent ALK-mediated phosphorylation of the downstream signaling protein STAT3. In vitro, ceritinib is 20 times as potent against ALK as compared to Crizotinib (Xalkori) and inhibits growth of cells expressing EML4-ALK and NPM-ALK fusion proteins. Ceritinib has been observed in EML4-ALK-rearranged non-small cell lung cancer xenograft models to have activity against crizotinib-sensitive and crizotinib-resistant tumors. Ceritinib also inhibits the insulin-like growth factor 1 receptor (IGF-1R), insulin receptor (InsR), and ROS1. It does not inhibit MET.Ceritinib (Zykadia) package insert Ceritinib (Zykadia) package insert (locally hosted backup)Zykadia manufacturer's websiteShaw AT, Kim DW, Mehra R, Tan DS, Felip E, Chow LQ, Camidge DR, Vansteenkiste J, Sharma S, De Pas T, Riely GJ, Solomon BJ, Wolf J, Thomas M, Schuler M, Liu G, Santoro A, Lau YY, Goldwasser M, Boral AL, Engelman JA. Ceritinib in ALK-rearranged non-small-cell lung cancer. N Engl J Med. 2014 Mar 27;370(13):1189-97. link to original article link to PMC article EuroPMC
Route: PO
Extravasation: n/a
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias or the prescribing information.
==Diseases for which it is used==
*ALK+ non-small cell lung cancer
==Patient drug information==
*Ceritinib (Zykadia) package insert
*Ceritinib (Zykadia) patient drug information (Chemocare)Ceritinib (Zykadia) patient drug information (Chemocare)
*Ceritinib (Zykadia) patient drug information (UpToDate)Ceritinib (Zykadia) patient drug information (UpToDate)
==History of changes in FDA indication==
*2014-04-29: Accelerated approval for the treatment of patients with anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer (NSCLC) who have progressed on or are intolerant to crizotinib. (Based on ASCEND-1)
*2017-05-26: Granted regular FDA approval for patients with metastatic non-small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK)-positive as detected by an FDA-approved test. (Based on ASCEND-4)
==History of changes in EMA indication==
*2015-05-06: Initial marketing authorization as Zykadia.
==History of changes in Health Canada indication==
*2015-03-27: Initial notice of compliance with conditions as monotherapy for use in patients with anaplastic lymphoma kinase (ALK)-positive locally advanced (not amenable to curative therapy) or metastatic non-small cell lung cancer (NSCLC) who have progressed on or who were intolerant to crizotinib.
*2018-06-06: New indication for previously untreated adult patients with anaplastic lymphoma kinase (ALK)-positive locally advanced or metastatic non-small cell lung cancer.
==History of changes in PMDA indication==
*2016-03-28: Initial approval for the treatment of unresectable advanced/relapsed anaplastic lymphoma kinase (ALK)-positive non-small cell lung cancer with resistance or intolerance to crizotinib.
*2017-09-22: Revised indication for the treatment of unresectable advanced/relapsed ALK fusion gene-positive non-small cell lung cancer.
==Also known as==
*Code name: LDK-378
*Brand names: Erinlar, Lucicer, Noxalk, Spexib, Zykadia
==References==
Category:Drugs
Category:Oral medications
Category:Mutation-specific medications
Category:ALK inhibitors
Category:IGFR inhibitors
Category:ROS1 inhibitors
Category:Non-small cell lung cancer medications
Category:EMA approved in 2015
Category:FDA approved in 2014
Category:PMDA approved in 2016