Synribo (omacetaxine mepesuccinate; Teva/Hospira) is a subcutaneously formulated, semisynthetic form of homoharringtonine, a naturally occurring alkaloid. In vitro studies show that Synribo binds to the ribosomal A-site cleft, inhibiting synthesis of a number of key oncoproteins. These oncoproteins include mcl-1 (an apoptosis inhibitor), cyclin-D1 (a promoter of cell proliferation), and c-Myc (a cell differentiation inhibitor).
Synribo has suffered due to its late entrance into the chronic myeloid leukemia (CML) market and an unfavorable subcutaneous administration route compared to other marketed drugs. The drug has displayed activity against T315I mutation-positive disease, but Iclusig (ponatinib; Takeda/Incyte/Otsuka) displays similar activity and is available in an orally administered formulation. Therefore, Synribo will continue to see only minimal uptake in CML.
Synribo: Chronic myeloid leukemia (CML)
List of Figures
Figure 1: Synribo for CML - SWOT analysis
Figure 2: Drug assessment summary of Synribo for CML
Figure 3: Drug assessment summary of Synribo for CML
List of Tables
Table 1: Synribo drug profile
Table 2: Synribo pivotal trial data in CML