Binimetinib, sold under the brand name Mektovi, is an anti-cancer medication used to treat various cancers. Binimetinib is a selective inhibitor of MEK, a central kinase in the tumor-promoting MAPK pathway. Inappropriate activation of the pathway has been shown to occur in many cancers. In June 2018 it was approved by the FDA in combination with encorafenib for the treatment of patients with unresectable or metastatic BRAF V600E or V600K mutation-positive melanoma. In October 2023, it was approved by the FDA for treatment of NSCLC with a BRAF V600E mutation in combination with encorafenib. It was developed by Array Biopharma and Pfizer.
Mechanism of action
Binimetinib is an orally available inhibitor of mitogen-activated protein kinase kinase (MEK), or more specifically, a MAP2K inhibitor. MEK is part of the RAS pathway, which is involved in cell proliferation and survival. MEK is upregulated in many forms of cancer. Binimetinib, uncompetitive with ATP, binds to and inhibits the activity of MEK1/2 kinase, which has been shown to regulate several key cellular activities including proliferation, survival, and angiogenesis. MEK1/2 are dual-specificity threonine/tyrosine kinases that play key roles in the activation of the RAS/RAF/MEK/ERK pathway and are often upregulated in a variety of tumor cell types. Inhibition of MEK1/2 prevents the activation of MEK1/2 dependent effector proteins and transcription factors, which may result in the inhibition of growth factor-mediated cell signaling. As demonstrated in preclinical studies, this may eventually lead to an inhibition of tumor cell proliferation and an inhibition in production of various inflammatory cytokines including interleukin-1, -6 and tumor necrosis factor.
In December 2015, the company announced that the mutant-NRAS melanoma trial was successful. In the trial, those receiving binimetinib had a median progression-free survival of 2.8 months versus 1.5 months for those on the standard dacarbazine treatment. NDA submitted Jun 2016, and the FDA should decide by 30 June 2017.
In April 2016, it was reported that the phase III trial for low-grade ovarian cancer was terminated due to lack of efficacy.
In 2017, the FDA informed Array Biopharma that the phase III trial data was not sufficient and the New Drug Application was withdrawn.
In June 2018, it was approved for the treatment of certain melanomas by the U.S. Food and Drug Administration (FDA) in combination with encorafenib. The FDA approved binimetinib based primarily on evidence from one clinical trial (NCT01909453) of 383 patients with BRAF V600 mutation-positive melanoma that was advanced or could not be removed by surgery. The trial was conducted at 162 sites in Europe, North America, and various countries around the world.
The synthesis of Binimetinib was recently reported:
The reaction of 2,3,4-trifluoro-5-nitrobenzoic acid [197520-71-1] (1) with O-(2-tert-butoxyethyl)hydroxylamine [1023742-13-3] (2) was achieved using CDI coupling agent and diisopropylethylamine to give 2,3,4-trifluoro-N-[2-[(2-methylpropan-2-yl)oxy]ethoxy]-5-nitrobenzamide, PC141452301 (3). Both of the activated fluorine atoms were displaced using ammonium hydroxide requiring the pressurized conditions of a steel bomb to furnish 2,4-diamino-3-fluoro-N-[2-[(2-methylpropan-2-yl)oxy]ethoxy]-5-nitrobenzamide, PC141452304 (4). Formation of the benzimidazole with formic acid with a catalytic amount of palladium hydroxide on carbon gave PC141452305 (5). The selective arylation with 4-bromo-2-fluoro-1-iodobenzene [105931-73-5] (6) in the presence of a highly specialized Pd2(dba)3 Xantphos catalyst exclusively yielded the hindered primary aniline, PC141452303 (7). The methylation of the benzimidazole secondary nitrogen with methyl iodide in the presence of potassium carbonate occurred chemoselectively. Treatment with an excess of aqueous phosphoric acid cleaved the terminal t-butyl ether completing the synthesis of binimetinib (8).
↑"Binimetinib". PubChem. Archived from the original on 6 January 2021. Retrieved 26 January 2017.
↑Ascierto PA, Schadendorf D, Berking C, Agarwala SS, van Herpen CM, Queirolo P, etal. (March 2013). "MEK162 for patients with advanced melanoma harbouring NRAS or Val600 BRAF mutations: a non-randomised, open-label phase 2 study". The Lancet. Oncology. 14 (3): 249–256. doi:10.1016/S1470-2045(13)70024-X. PMID23414587.
↑Mehdizadeh A, Somi MH, Darabi M, Jabbarpour-Bonyadi M (February 2016). "Extracellular signal-regulated kinase 1 and 2 in cancer therapy: a focus on hepatocellular carcinoma". Molecular Biology Reports. 43 (2): 107–116. doi:10.1007/s11033-016-3943-9. PMID26767647. S2CID15113957.
↑Clinical trial number NCT01849874 for "A Study of MEK162 vs. Physician's Choice Chemotherapy in Patients With Low-grade Serous Ovarian, Fallopian Tube or Peritoneal Cancer" at ClinicalTrials.gov
↑Clinical trial number NCT01909453 for "Study Comparing Combination of LGX818 Plus MEK162 Versus Vemurafenib and LGX818 Monotherapy in BRAF Mutant Melanoma (COLUMBUS)" at ClinicalTrials.gov
↑Clinical trial number NCT01763164 for "Study Comparing the Efficacy of MEK162 Versus Dacarbazine in Unresectable or Metastatic NRAS Mutation-positive Melanoma" at ClinicalTrials.gov
↑Riely GJ, Smit EF, Ahn MJ, Felip E, Ramalingam SS, Tsao A, etal. (July 2023). "Phase II, Open-Label Study of Encorafenib Plus Binimetinib in Patients With BRAFV600-Mutant Metastatic Non-Small-Cell Lung Cancer". Journal of Clinical Oncology. 41 (21): 3700–3711. doi:10.1200/JCO.23.00774. hdl:1887/3750471. PMID37270692.
↑Flick AC, Leverett CA, Ding HX, McInturff E, Fink SJ, Helal CJ, etal. (October 2020). "Synthetic Approaches to New Drugs Approved during 2018". Journal of Medicinal Chemistry. 63 (19): 10652–10704. doi:10.1021/acs.jmedchem.0c00345. PMID32338902.
External links
Look up binimetinib in Wiktionary, the free dictionary.