Erlotinib: Difference between revisions

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<applet  load="" size="480" color="" frame="true"  spin="on" Scene ="Erlotinib/Erlotinib/1" align="right" caption="Erlotinib, also known as Tarceva"/>
<StructureSection load='' size='450' side='right' scene='Erlotinib/Erlotinib/1' caption='Erlotinib, also known as Tarceva'>
__TOC__
===Better Known as: Tarceva===
===Better Known as: Tarceva===
* Marketed By: Genentech, OSI Pharmaceutials, & Roche
* Marketed By: Genentech, OSI Pharmaceutials, & Roche
* Major Indication: Pancreatic & Small Cel Lung [[Cancer]]
* Major Indication: Pancreatic & Small Cell Lung [[Cancer]]
* Drug Class: [[EGFR]] Inhibitor
* Drug Class: [[EGFR]] Inhibitor
* Date of FDA Approval (Expiration): 2005 (2020)
* Date of FDA Approval (Expiration): 2005 (2020)
* 2009 Sales: $1.2 Billion
* 2009 Sales: $1.2 Billion
* Importance: It is one of the best selling and most effective treatments for several types of cancer. It is an improved version of [[Iressa]].
* Importance: It is one of the best selling and most effective treatments for several types of cancer. It is an improved version of [[Iressa]].
* The following is a list of Pharmacokinetic Parameters. See: [[Pharmaceutical Drugs]] for more information
* See [[Pharmaceutical Drugs]] for more information about other drugs and disorders
 
* See also [[Journal:JBSD:26|Investigation on the Site-Selective Binding of Bovine Serum Albumin by Erlotinib Hydrochloride]]
===Mechanism of Action===
===Mechanism of Action===
[[EGFR|Epidermal Growth Factor Receptors]] are overexpressed in many types of human [[Cancer|carcinomas]] including lung, pancreatic, and breast cancer, and are often mutated. This overexpression leads to excessive activation of the anti-apoptotic [[Ras]] signalling cascade, resulting in uncontrolled [[DNA_Replication|DNA synthesis]] and cell proliferation. Studies have revealed that the <scene name='Erlotinib/Kinase/1'>EGFR tyrosine kinase domain</scene> is responsible for activating this Ras signaling cascade. Upon binding ligands like Epidermal Growth Factor, EGFR dimerizes and autophosphorylates several tyrosine residues at its C-terminal domain. Upon phosphorylation, EGFR undergoes a conformational change, revealing an additional binding site capable of eliciting downstream activation of other signaling proteins.<ref>PMID:6090945</ref><ref>PMID:16729045</ref> Erlotinib inhibits the EGFR tyrosine kinase by <scene name='Erlotinib/Bound/1'>binding to the ATP-binding site</scene> located within the kinase domain. Residues _ to tightly bind the inhibitor. Unable to bind ATP, EGFR is incapable of autophosphorylating its C-terminal tyrosines, and the uncontrolled cell-proliferation signal is terminated.<ref>PMID:15284455</ref>
[[EGFR|Epidermal Growth Factor Receptors]] are overexpressed in many types of human [[Cancer|carcinomas]] including lung, pancreatic, and breast cancer, and are often mutated. This overexpression leads to excessive activation of the anti-apoptotic [[Ras]] signalling cascade, resulting in uncontrolled [[DNA_Replication|DNA synthesis]] and cell proliferation. Studies have revealed that the <scene name='Erlotinib/Kinase/1'>EGFR tyrosine kinase domain</scene> is responsible for activating this Ras signaling cascade. Upon binding ligands like Epidermal Growth Factor, EGFR dimerizes and autophosphorylates several tyrosine residues at its C-terminal domain. Upon phosphorylation, EGFR undergoes a conformational change, revealing an additional binding site capable of eliciting downstream activation of other signaling proteins.<ref>PMID:6090945</ref><ref>PMID:16729045</ref> Erlotinib inhibits the EGFR tyrosine kinase by <scene name='Erlotinib/Bound/1'>binding to the ATP-binding site</scene> located within the kinase domain. EGFR uses residues Asp 831, Lys 721, Thr 766, Leu 820, Gly 772, Phe 771, Leu 694, Pro 770, Met 769, Leu 768, Gln 767 & Ala 719 to tightly bind the inhibitor. Unable to bind ATP, EGFR is incapable of autophosphorylating its C-terminal tyrosines, and the uncontrolled cell-proliferation signal is terminated.<ref>PMID:15284455</ref><ref>PMID:11129168</ref>


===Pharmacokinetics===
===Pharmacokinetics===
{| class="wikitable" border="1" width="55%" style="text-align:center"
<table style="background: cellspacing="0px"  align="" cellpadding="0px" width="50%">
|-
<tr>
!  colspan="4" align="center"| EGFR Inhibitor [[Pharmaceutical_Drugs#Pharmacokinetics_Translated|Pharmacokinetics]] Comparison at Equivalent Dosages <ref>PMID:16609030</ref><ref>PMID:17482782</ref><ref>D. Smith et al. Br J Clin Pharmacol. 2009 April; 67(4): 421–426.</ref>
<td style="width:auto; vertical-align:top;border-width:0px; border-style:inset">
|-
<div style="height:100%; width: 100%">
! Parameter
{{:Tyrosine Kinase Inhibitor Pharmacokinetics}}
! [[Erlotinib]] <br/>(Tarceva)
</div>
! [[Gefitinib]] <br/>(Iressa)
</td>
! [[Lapatinib]] <br/>(Tykerb)
</tr>
|-
</table>
! [[Pharmaceutical_Drugs#Tmax|T<sub>max</sub>]] (hr)
</StructureSection>
! 2.0
! 5.4
! 4
|-
! [[Pharmaceutical_Drugs#Cmax|C<sub>max</sub>]] (ng/ml)
! 69.6
! 130
! 115
|-
! [[Pharmaceutical_Drugs#Bioavailability_.28F.29|Bioavailability]] (%)
! 99
! 59
! Variable
|-
! [[Pharmaceutical_Drugs#Protein_Binding|Protein Binding]] (%)
! 93
! 90
! 99
|-
! [[Pharmaceutical_Drugs#Half_Life_.28T1.2F2.29|T<sub>1/2</sub>]] (hr)
! 9.4
! 26.9
! 9.6
|-
! [[Pharmaceutical_Drugs#Area_Under_the_Curve_.28AUC.29|AUC]] (ng/ml/hr)
! 20577
! 3850
! 1429
|-
! Typical Dosage (mg)
! 150
! 250
! 100
|-
! Metabolism
! Hepatic - (CYP3A4)
! Hepatic - (CYP3A4)
! Hepatic - (CYP3A4)
|}
 
===References===
===References===
<references/>
<references/>
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Proteopedia Page Contributors and Editors (what is this?)Proteopedia Page Contributors and Editors (what is this?)

David Canner, Michal Harel, Joel L. Sussman, Alexander Berchansky