General Information of Drug (ID: DM7W94S)

Drug Name
Brigatinib
Synonyms
1197953-54-0; UNII-HYW8DB273J; Brigatinib [USAN]; ALUNBRIG; HYW8DB273J; Brigatinib (USAN); Brigatiib; Alunbrig (TN); Brigatinib [USAN:INN]; Brigatinib (AP26113); SCHEMBL11916361; KS-00000TSQ; EX-A775; MolPort-044-561-640; BDBM50185140; ZINC148723177; AKOS030257612; CS-4278; DB12267; HY-12857; AC-29958
Indication
Disease Entry ICD 11 Status REF
Anaplastic large cell lymphoma 2A90.A Approved [1]
Non-small-cell lung cancer 2C25.Y Approved [2]
Drug Type
Small molecular drug
Structure
3D MOL 2D MOL
#Ro5 Violations (Lipinski): 1 Molecular Weight (mw) 584.1
Topological Polar Surface Area (xlogp) 4.6
Rotatable Bond Count (rotbonds) 8
Hydrogen Bond Donor Count (hbonddonor) 2
Hydrogen Bond Acceptor Count (hbondacc) 9
ADMET Property
Absorption AUC
The area under the plot of plasma concentration (AUC) of drug is 8165 mcgh/L [3]
Absorption Cmax
The maximum plasma concentration (Cmax) of drug is 552 mcg/L [3]
Clearance
The apparent oral clearance of drug is 12.7 L/h [4]
Elimination
The elimination of brigatinib is divided in 65% in feces and 25% in urine [4]
Half-life
The concentration or amount of drug in body reduced by one-half in 25 hours [4]
Metabolism
The drug is metabolized via the CYP2C8 [4]
Vd
The volume of distribution (Vd) of drug is 153 L [3]
Chemical Identifiers
Formula
C29H39ClN7O2P
IUPAC Name
5-chloro-4-N-(2-dimethylphosphorylphenyl)-2-N-[2-methoxy-4-[4-(4-methylpiperazin-1-yl)piperidin-1-yl]phenyl]pyrimidine-2,4-diamine
Canonical SMILES
CN1CCN(CC1)C2CCN(CC2)C3=CC(=C(C=C3)NC4=NC=C(C(=N4)NC5=CC=CC=C5P(=O)(C)C)Cl)OC
InChI
InChI=1S/C29H39ClN7O2P/c1-35-15-17-37(18-16-35)21-11-13-36(14-12-21)22-9-10-24(26(19-22)39-2)33-29-31-20-23(30)28(34-29)32-25-7-5-6-8-27(25)40(3,4)38/h5-10,19-21H,11-18H2,1-4H3,(H2,31,32,33,34)
InChIKey
AILRADAXUVEEIR-UHFFFAOYSA-N
Cross-matching ID
PubChem CID
68165256
CAS Number
1197953-54-0
DrugBank ID
DB12267
TTD ID
D08PIE
VARIDT ID
DR00368
INTEDE ID
DR0228
ACDINA ID
D00077

Molecular Interaction Atlas of This Drug


Drug Therapeutic Target (DTT)
DTT Name DTT ID UniProt ID MOA REF
ALK tyrosine kinase receptor (ALK) TTPMQSO ALK_HUMAN Inhibitor [1]

Drug Transporter (DTP)
DTP Name DTP ID UniProt ID MOA REF
ATP-binding cassette sub-family B member 5 (ABCB5) DTKVEXO ABCB5_HUMAN Substrate [5]
Breast cancer resistance protein (ABCG2) DTI7UX6 ABCG2_HUMAN Substrate [5]

Drug-Metabolizing Enzyme (DME)
DME Name DME ID UniProt ID MOA REF
Cytochrome P450 2C8 (CYP2C8)
Main DME
DES5XRU CP2C8_HUMAN Substrate [6]
Molecular Interaction Atlas (MIA) Jump to Detail Molecular Interaction Atlas of This Drug

Molecular Expression Atlas of This Drug

The Studied Disease Anaplastic large cell lymphoma
ICD Disease Classification 2A90.A
Molecule Name Molecule Type Gene Name p-value Fold-Change Z-score
ALK tyrosine kinase receptor (ALK) DTT ALK 7.19E-15 0.18 0.61
ATP-binding cassette sub-family B member 5 (ABCB5) DTP ABCB5 5.60E-01 -1.37E-02 -1.15E-01
Breast cancer resistance protein (ABCG2) DTP BCRP 3.87E-47 -1.28E+00 -1.63E+00
Cytochrome P450 2C8 (CYP2C8) DME CYP2C8 5.28E-05 1.90E-02 1.09E-01
Molecular Expression Atlas (MEA) Jump to Detail Molecular Expression Atlas of This Drug

Drug-Drug Interaction (DDI) Information of This Drug

Coadministration of a Drug Treating the Same Disease as Brigatinib
DDI Drug Name DDI Drug ID Severity Mechanism Disease REF
Selpercatinib DMZR15V Moderate Increased metabolism of Brigatinib caused by Selpercatinib mediated induction of CYP450 enzyme. Lung cancer [2C25] [35]
Coadministration of a Drug Treating the Disease Different from Brigatinib (Comorbidity)
DDI Drug Name DDI Drug ID Severity Mechanism Comorbidity REF
Ivosidenib DM8S6T7 Moderate Increased metabolism of Brigatinib caused by Ivosidenib mediated induction of CYP450 enzyme. Acute myeloid leukaemia [2A60] [36]
Oliceridine DM6MDCF Moderate Increased metabolism of Brigatinib caused by Oliceridine mediated induction of CYP450 enzyme. Acute pain [MG31] [37]
Troleandomycin DMUZNIG Major Decreased metabolism of Brigatinib caused by Troleandomycin mediated inhibition of CYP450 enzyme. Bacterial infection [1A00-1C4Z] [38]
Pexidartinib DMS2J0Z Major Increased metabolism of Brigatinib caused by Pexidartinib mediated induction of CYP450 enzyme. Bone/articular cartilage neoplasm [2F7B] [36]
Eslicarbazepine DMZREFQ Major Increased metabolism of Brigatinib caused by Eslicarbazepine mediated induction of CYP450 enzyme. Epilepsy/seizure [8A61-8A6Z] [36]
Bay 80-6946 DMLOS5R Moderate Increased metabolism of Brigatinib caused by Bay 80-6946 mediated induction of CYP450 enzyme. Follicular lymphoma [2A80] [39]
Tazemetostat DMWP1BH Moderate Increased metabolism of Brigatinib caused by Tazemetostat mediated induction of CYP450 enzyme. Follicular lymphoma [2A80] [36]
Ripretinib DM958QB Moderate Increased metabolism of Brigatinib caused by Ripretinib mediated induction of CYP450 enzyme. Gastrointestinal stromal tumour [2B5B] [36]
Avapritinib DMK2GZX Moderate Increased metabolism of Brigatinib caused by Avapritinib mediated induction of CYP450 enzyme. Gastrointestinal stromal tumour [2B5B] [35]
MK-1439 DM215WE Moderate Increased metabolism of Brigatinib caused by MK-1439 mediated induction of CYP450 enzyme. Human immunodeficiency virus disease [1C60-1C62] [40]
Berotralstat DMWA2DZ Moderate Decreased metabolism of Brigatinib caused by Berotralstat mediated inhibition of CYP450 enzyme. Innate/adaptive immunodeficiency [4A00] [36]
Pemigatinib DM819JF Moderate Increased metabolism of Brigatinib caused by Pemigatinib mediated induction of CYP450 enzyme. Liver cancer [2C12] [35]
Ubrogepant DM749I3 Moderate Increased metabolism of Brigatinib caused by Ubrogepant mediated induction of CYP450 enzyme. Migraine [8A80] [41]
Siponimod DM2R86O Major Additive immunosuppressive effects by the combination of Brigatinib and Siponimod. Multiple sclerosis [8A40] [36]
Ozanimod DMT6AM2 Major Additive immunosuppressive effects by the combination of Brigatinib and Ozanimod. Multiple sclerosis [8A40] [35]
Fedratinib DM4ZBK6 Major Decreased metabolism of Brigatinib caused by Fedratinib mediated inhibition of CYP450 enzyme. Myeloproliferative neoplasm [2A20] [36]
Rucaparib DM9PVX8 Moderate Decreased metabolism of Brigatinib caused by Rucaparib mediated inhibition of CYP450 enzyme. Ovarian cancer [2C73] [36]
Macimorelin DMQYJIR Moderate Increased metabolism of Brigatinib caused by Macimorelin mediated induction of CYP450 enzyme. Pituitary gland disorder [5A60-5A61] [42]
Lefamulin DME6G97 Moderate Increased metabolism of Brigatinib caused by Lefamulin mediated induction of CYP450 enzyme. Pneumonia [CA40] [43]
Darolutamide DMV7YFT Moderate Increased metabolism of Brigatinib caused by Darolutamide mediated induction of CYP450 enzyme. Prostate cancer [2C82] [44]
Voxelotor DMCS6M5 Major Decreased metabolism of Brigatinib caused by Voxelotor mediated inhibition of CYP450 enzyme. Sickle-cell disorder [3A51] [36]
Larotrectinib DM26CQR Moderate Increased metabolism of Brigatinib caused by Larotrectinib mediated induction of CYP450 enzyme. Solid tumour/cancer [2A00-2F9Z] [36]
Betrixaban DM2C4RF Moderate Decreased clearance of Brigatinib due to the transporter inhibition by Betrixaban. Venous thromboembolism [BD72] [45]
⏷ Show the Full List of 23 DDI Information of This Drug

Drug Inactive Ingredient(s) (DIG) and Formulation(s) of This Drug

DIG
DIG Name DIG ID PubChem CID Functional Classification
Lactose monohydrate E00393 104938 Binding agent; Diluent; Dry powder inhaler carrier; Lyophilization aid
Magnesium stearate E00208 11177 lubricant
Silicon dioxide E00670 Not Available Anticaking agent; Opacifying agent; Viscosity-controlling agent
Water E00035 962 Solvent
Pharmaceutical Formulation
Formulation Name Drug Dosage Dosage Form Route
Brigatinib 180 mg tablet 180 mg Oral Tablet Oral
Brigatinib 90 mg tablet 90 mg Oral Tablet Oral
Brigatinib 30 mg tablet 30 mg Oral Tablet Oral
Jump to Detail Pharmaceutical Formulation Page of This Drug

References

1 2017 FDA drug approvals.Nat Rev Drug Discov. 2018 Feb;17(2):81-85.
2 Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2018
3 Markham A: Brigatinib: First Global Approval. Drugs. 2017 Jul;77(10):1131-1135. doi: 10.1007/s40265-017-0776-3.
4 FDA Reports
5 NDA/BLA Multidisciplinary Review and Evaluation of ALUNBRIG (brigatinib) From FDA.
6 Brigatinib: first global approval. Drugs. 2017 Jul;77(10):1131-1135.
7 Roles of cytochromes P450 1A2, 2A6, and 2C8 in 5-fluorouracil formation from tegafur, an anticancer prodrug, in human liver microsomes. Drug Metab Dispos. 2000 Dec;28(12):1457-63.
8 Role of cytochrome P450 2C8 in drug metabolism and interactions. Pharmacol Rev. 2016 Jan;68(1):168-241.
9 Summary of information on human CYP enzymes: human P450 metabolism data. Drug Metab Rev. 2002 Feb-May;34(1-2):83-448.
10 Differential expression and function of CYP2C isoforms in human intestine and liver. Pharmacogenetics. 2003 Sep;13(9):565-75.
11 Analysis of human cytochrome P450 2C8 substrate specificity using a substrate pharmacophore and site-directed mutants. Biochemistry. 2004 Dec 14;43(49):15379-92.
12 Interaction of sorafenib and cytochrome P450 isoenzymes in patients with advanced melanoma: a phase I/II pharmacokinetic interaction study. Cancer Chemother Pharmacol. 2011 Nov;68(5):1111-8.
13 PharmGKB summary: mycophenolic acid pathway. Pharmacogenet Genomics. 2014 Jan;24(1):73-9.
14 Possible involvement of multiple human cytochrome P450 isoforms in the liver metabolism of propofol. Br J Anaesth. 1998 Jun;80(6):788-95.
15 Doxorubicin transport by RALBP1 and ABCG2 in lung and breast cancer. Int J Oncol. 2007 Mar;30(3):717-25.
16 Wild-type breast cancer resistance protein (BCRP/ABCG2) is a methotrexate polyglutamate transporter. Cancer Res. 2003 Sep 1;63(17):5538-43.
17 The effect of low pH on breast cancer resistance protein (ABCG2)-mediated transport of methotrexate, 7-hydroxymethotrexate, methotrexate diglutamate, folic acid, mitoxantrone, topotecan, and resveratrol in in vitro drug transport models. Mol Pharmacol. 2007 Jan;71(1):240-9.
18 Role of BCRP as a biomarker for predicting resistance to 5-fluorouracil in breast cancer. Cancer Chemother Pharmacol. 2009 May;63(6):1103-10.
19 Inhibiting the function of ABCB1 and ABCG2 by the EGFR tyrosine kinase inhibitor AG1478. Biochem Pharmacol. 2009 Mar 1;77(5):781-93.
20 Sterol transport by the human breast cancer resistance protein (ABCG2) expressed in Lactococcus lactis. J Biol Chem. 2003 Jun 6;278(23):20645-51.
21 The phytoestrogen genistein enhances multidrug resistance in breast cancer cell lines by translational regulation of ABC transporters. Cancer Lett. 2016 Jun 28;376(1):165-72.
22 Curcumin inhibits the activity of ABCG2/BCRP1, a multidrug resistance-linked ABC drug transporter in mice. Pharm Res. 2009 Feb;26(2):480-7.
23 Imatinib mesylate (STI571) is a substrate for the breast cancer resistance protein (BCRP)/ABCG2 drug pump. Blood. 2004 Nov 1;104(9):2940-2.
24 ABCB5-mediated doxorubicin transport and chemoresistance in human malignant melanoma. Cancer Res. 2005 May 15;65(10):4320-33.
25 DrugBank 5.0: a major update to the DrugBank database for 2018. Nucleic Acids Res. 2018 Jan 4;46(D1):D1074-D1082. (ID: DB12010)
26 Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health & Human Services. 2015
27 2018 FDA drug approvals.Nat Rev Drug Discov. 2019 Feb;18(2):85-89.
28 Drugs@FDA. U.S. Food and Drug Administration. U.S. Department of Health Human Services. 2019
29 URL: http://www.guidetopharmacology.org Nucleic Acids Res. 2015 Oct 12. pii: gkv1037. The IUPHAR/BPS Guide to PHARMACOLOGY in 2016: towards curated quantitative interactions between 1300 protein targets and 6000 ligands. (Ligand id: 7397).
30 CH5424802, a selective ALK inhibitor capable of blocking the resistant gatekeeper mutant. Cancer Cell. 2011 May 17;19(5):679-90.
31 Clinical pipeline report, company report or official report of the Pharmaceutical Research and Manufacturers of America (PhRMA)
32 PF-06463922, an ALK/ROS1 Inhibitor, Overcomes Resistance to First and Second Generation ALK Inhibitors in Preclinical Models. Cancer Cell. 2015 Jul 13;28(1):70-81.
33 Interpreting expression profiles of cancers by genome-wide survey of breadth of expression in normal tissues. Genomics 2005 Aug;86(2):127-41.
34 Treatment of ALK-positive non-small cell lung cancer. Arch Pathol Lab Med. 2012 Oct;136(10):1201-4.
35 Cerner Multum, Inc. "UK Summary of Product Characteristics.".
36 Cerner Multum, Inc. "Australian Product Information.".
37 Altice FL, Friedland GH, Cooney EL "Nevirapine induced opiate withdrawal among injection drug users with HIV infection receiving methadone." AIDS 13 (1999): 957-62. [PMID: 10371177]
38 Product Information. Alunbrig (brigatinib). Ariad Pharmaceuticals Inc, Cambridge, MA.
39 Product Information. Aliqopa (copanlisib). Bayer Pharmaceutical Inc, West Haven, CT.
40 Product Information. Pifeltro (doravirine). Merck & Company Inc, Whitehouse Station, NJ.
41 Product Information. Ubrelvy (ubrogepant). Allergan Inc, Irvine, CA.
42 Product Information. Macrilen (macimorelin). Aeterna Zentaris, Charleston, SC.
43 Product Information. Xenleta (lefamulin). Nabriva Therapeutics US, Inc., King of Prussia, PA.
44 Product Information. Nubeqa (darolutamide). Bayer HealthCare Pharmaceuticals Inc., Whippany, NJ.
45 Product Information. Bevyxxa (betrixaban). Portola Pharmaceuticals, South San Francisco, CA.