Omacetaxine mepesuccinate

Omacetaxine mepesuccinate

Clinical data
Trade names	Synribo
AHFS/Drugs.com	Monograph
License data	US FDA: Omacetaxine_mepesuccinate
Routes of administration	Subcutaneous, intravenous infusion
ATC code	L01XX40 (WHO)
Legal status
Legal status	US: ℞-only
Pharmacokinetic data
Protein binding	50%
Metabolism	Mostly via plasma esterases
Elimination half-life	6 hours
Excretion	Urine (≤15% unchanged)
Identifiers
IUPAC name 1-((1S,3aR,14bS)-2-Methoxy-1,5,6,8,9,14b-hexahydro-4H-cyclopenta(a)(1,3)dioxolo(4,5-h)pyrrolo(2,1-b)(3)benzazepin-1-yl) 4-methyl (2R)-2-hydroxy-2-(4-hydroxy-4-methylpentyl)butanedioate
CAS Number	26833-87-4
PubChem CID	285033
IUPHAR/BPS	7454
ChemSpider	251215
UNII	6FG8041S5B
KEGG	D08956
ChEBI	CHEBI:71019 Y
CompTox Dashboard (EPA)	DTXSID0045678
ECHA InfoCard	100.164.439
Chemical and physical data
Formula	C29H39NO9
Molar mass	545.629 g·mol−1
3D model (JSmol)	Interactive image
SMILES CC(C)(CCC[C@@](CC(=O)OC)(C(=O)O[C@H]1[C@H]2c3cc4c(cc3CCN5[C@@]2(CCC5)C=C1OC)OCO4)O)O
InChI InChI=1S/C29H39NO9/c1-27(2,33)8-5-10-29(34,16-23(31)36-4)26(32)39-25-22(35-3)15-28-9-6-11-30(28)12-7-18-13-20-21(38-17-37-20)14-19(18)24(25)28/h13-15,24-25,33-34H,5-12,16-17H2,1-4H3/t24-,25-,28+,29-/m1/s1 Key:HYFHYPWGAURHIV-JFIAXGOJSA-N

Omacetaxine mepesuccinate (INN; trade name Synribo; formerly named as homoharringtonine or HHT) is a pharmaceutical drug substance that is indicated for treatment of chronic myeloid leukemia (CML).

HHT is a natural plant alkaloid derived from Cephalotaxus fortunei. HHT and related compound esters of cephalotaxine were described first in 1970, and were the subject of intensive research efforts by Chinese investigators to clarify their role as anticancer and antileukemic agents from the 1970s until the present.^[1] It was approved by the US FDA in October 2012 for the treatment of adult patients with CML with resistance and/or intolerance to two or more tyrosine kinase inhibitors (TKIs).^[2]