My father was diagnosed with GBM a few months ago and a recent molecular screening suggests that CDK4/6 inhibitors may be of use as a form of therapy due to evidence of 'CDK4 amplification'.
Following my own research, there seem to be three CDK4/6 inhibitor drugs available:
1) ribociclib (Kisqali)
1) ribociclib (Kisqali)
2) palbociclib (lbrance)
3) abemaciclib
Does anyone have any experience with the above drugs in terms of toxicity, side effects, dose etc?
Are there any drugs that are known to, or have some evidence to suggest that they may work synergistically (or to have negative interactions) with these three?
Apart from the three drugs above, does anyone know of any other CDK4/6 inhibitors?
Any inputs would be much appreciated! Thanks!
Are there any drugs that are known to, or have some evidence to suggest that they may work synergistically (or to have negative interactions) with these three?
Apart from the three drugs above, does anyone know of any other CDK4/6 inhibitors?
Any inputs would be much appreciated! Thanks!
Abemaciclib appears to be better than palbociclib in terms of pharmacokinetics and access to the central nervous system
ReplyDeletehttps://www.ncbi.nlm.nih.gov/pubmed/26149830
The three drugs you mentioned are the only CDK inhibitors that have FDA approval.
Abemaciclib also has clinical trial evidence for GBM
http://cancerdiscovery.aacrjournals.org/content/candisc/early/2016/05/31/2159-8290.CD-16-0095.full.pdf#
The results aren't spectacular, but at least this shows it can penetrate into the tumor and be effective in tumors that are sensitive to it.
Abemaciclib or Verzenio has been suggested by my son's NO for possible start in December if he can get it approved by insurance. My son is currently on biweekly Avastin/bevacicumab with CCNU every 8 weeks Plus a small cocktail(as much as I could get him to take) . Went almost 6 months without appreciable growth & now it's started back progressing somewhat. Without insurance it is very expensive $10-12,000 per month. One thing I'm wondering - Perhaps Stephen or someone could comment - In papers I've seen the typical dosing of CCNU every 6 weeks vs my son's 8 weeks. Do you think it would be worth going to 6wks? Also - we got his NO to prescribe Valcyte due to past indicated CMV -but he's prescribing 450mg / 1/day vs 2/day as shown in some papers. Any suggestions? Dan is Unmethylated IDH Wildtype
ReplyDeleteDave Smith