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Details

Stereochemistry ABSOLUTE
Molecular Formula C27H32FN9O2
Molecular Weight 533.6005
Optical Activity UNSPECIFIED
Defined Stereocenters 3 / 3
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of Pralsetinib

SMILES

CO[C@@]1(CC[C@@H](CC1)C2=NC(NC3=NNC(C)=C3)=CC(C)=N2)C(=O)N[C@@H](C)C4=CC=C(N=C4)N5C=C(F)C=N5

InChI

InChIKey=GBLBJPZSROAGMF-RWYJCYHVSA-N
InChI=1S/C27H32FN9O2/c1-16-11-22(33-23-12-17(2)35-36-23)34-25(31-16)19-7-9-27(39-4,10-8-19)26(38)32-18(3)20-5-6-24(29-13-20)37-15-21(28)14-30-37/h5-6,11-15,18-19H,7-10H2,1-4H3,(H,32,38)(H2,31,33,34,35,36)/t18-,19-,27+/m0/s1

HIDE SMILES / InChI

Description

Pralsetinib (GAVRETO™, Blueprint Medicines Corporation) is an orally-administered, next-generation, small-molecule selective rearranged during transfection (RET) inhibitor being developed for the treatment of various solid tumours. RET is a well described proto-oncogene present in multiple cancers including non-small cell lung cancer (NSCLC), papillary thyroid cancer, and medullary thyroid carcinoma. Pralsetinib is a kinase inhibitor of wild-type RET and oncogenic RET fusions (CCDC6-RET) and mutations (RET V804L, RET V804M and RET M918T) with half maximal inhibitory concentrations (IC50s) less than 0.5 nM. In purified enzyme assays, pralsetinib inhibited DDR1, TRKC, FLT3, JAK1-2, TRKA, VEGFR2, PDGFRb, and FGFR1 at higher concentrations that were still clinically achievable at Cmax. In cellular assays, pralsetinib inhibited RET at approximately 14-, 40-, and 12-fold lower concentrations than VEGFR2, FGFR2, and JAK2, respectively. Pralsetinib is approved for the treatment of RET fusion-positive metastatic NSCLC. In the pivotal phase I/II ARROW trial, pralsetinib demonstrated rapid and durable anti-tumour activity in patients with advanced RET fusion-positive NSCLC who were previously treated with platinum-based chemotherapy or were treatment-naïve. Pralsetinib also showed clinical activity against intracranial metastases arising from NSCLC. Pralsetinib had a manageable tolerability profile, with the most common grade 3 treatment-related adverse events being neutropenia, hypertension, anaemia and decreased white blood cell count.

CNS Activity

Approval Year

Targets

Primary TargetPharmacologyConditionPotency
0.4 nM [IC50]
35.0 nM [IC50]
0.4 nM [IC50]
2.0 nM [IC50]

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
GAVRETO

Cmax

ValueDoseCo-administeredAnalytePopulation
2470 ng/mL
400 mg 1 times / day steady-state, oral
PRALSETINIB plasma
Homo sapiens

AUC

ValueDoseCo-administeredAnalytePopulation
36700 ng × h/mL
400 mg 1 times / day steady-state, oral
PRALSETINIB plasma
Homo sapiens

T1/2

ValueDoseCo-administeredAnalytePopulation
20 h
400 mg 1 times / day steady-state, oral
PRALSETINIB plasma
Homo sapiens
15.7 h
single, oral
PRALSETINIB plasma
Homo sapiens

Funbound

ValueDoseCo-administeredAnalytePopulation
2.9%
PRALSETINIB plasma
Homo sapiens

Doses

AEs

Drug as perpetrator​

Drug as victim

Tox targets

PubMed

Sample Use Guides

In Vivo Use Guide
The recommended dosage of GAVRETO is 400 mg orally once daily on an empty stomach (no food intake for at least 2 hours before and at least 1 hour after taking GAVRETO)
Route of Administration: Oral
In Vitro Use Guide
Pralsetinib is a highly potent and selective RET (c-RET) inhibitor with an IC50 of 0.4 nM for WT RET. It also demonstrates potent activity (IC50 0.4 nmol/L) against common oncogenic RET alterations, including RET (M918T).