Medication Pearl of the Day: Asciminib (Scemblix)
Indication: Asciminib (Scemblix) is a kinase inhibitor indicated for the treatment of adult patients with Philadelphia chromosome-positive chronic myeloid leukemia (Ph+ CML) in chronic phase (CP), previously treated with two or more tyrosine kinase inhibitors (TKIs), as well as adult patients with Ph+ CML-CP with the T315I mutation.
- Dosing: 80 mg orally once daily or 40 mg twice daily.
- Dosage forms: 20 mg and 40 mg.
- Adverse events: Most common adverse reactions (≥ 20%) are upper respiratory tract infections, musculoskeletal pain, fatigue, nausea, rash, and diarrhea. Most common laboratory abnormalities (≥ 20%) are platelet count decreased, triglycerides increased, neutrophil count decreased, hemoglobin decreased, creatine kinase increased, alanine aminotransferase increased, lipase increased, and amylase increased.
- Mechanism of action: Asciminib is an ABL/BCR-ABL1 tyrosine kinase inhibitor. Asciminib inhibits the ABL1 kinase activity of the BCRABL1 fusion protein, by binding to the ABL myristoyl pocket. In studies conducted in vitro or in animal models of CML, asciminib showed activity against wild-type BCR-ABL1 and several mutant forms of the kinase, including the T315I mutation.