chemistry

Neratinib

Neratinib is a chemistry topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Neratinib rather than just read about it. In short: Neratinib (INN), sold under the brand name Nerlynx, is a tyrosine kinase inhibitor anti-cancer medication used for the treatment of breast cancer. The most common side effect is diarrhea, which affects nearly all patients.

Key takeaways

Neratinib belongs to chemistry; place it in that map before memorising details.
Learn the definition first, then one example that makes the definition concrete.
Connect Neratinib to a quantity you can measure, compute or draw — that is where exam questions come from.
Reproduce the core statement of Neratinib from memory before moving on to harder problems.

Reference excerpt

Neratinib (INN), sold under the brand name Nerlynx, is a tyrosine kinase inhibitor anti-cancer medication used for the treatment of breast cancer. The most common side effect is diarrhea, which affects nearly all patients. Other common side effects include nausea (feeling sick), vomiting, tiredness, belly pain, rash, decreased appetite, stomatitis (sore, inflamed mouth), and muscle spasms.

Medical uses In the European Union and the United States, neratinib is indicated for the extended adjuvant treatment of adults with early stage (human epidermal growth factor receptor 2) HER2-overexpressed/amplified breast cancer and who are less than one year from the completion of prior adjuvant trastuzumab based therapy. In the United States, it is also indicated, in combination with capecitabine, for the treatment of adults with advanced or metastatic HER2-positive breast cancer who have received two or more prior anti-HER2 based regimens in the metastatic setting.

Contraindications Women who are pregnant should not take it, and women should not become pregnant while taking it, and women who are breast-feeding should not use it, as it can cause harm to the fetus and to the baby.

Adverse effects Neratinib can cause life-threatening diarrhea in some people and mild to moderate diarrhea in almost everyone; people who take it are also at risk for complications of diarrhea like dehydration and electrolyte imbalance. Similarly, there is a risk of severe liver damage and many patients have some level of it; symptoms of liver damage include fatigue, nausea, vomiting, right upper quadrant pain or tenderness, fever, rash, and high levels of eosinophils. In addition to the above, more than 10% of people taking it have nausea, abdominal pain, vomiting, sores on their lips, stomach upset, decreased appetite, rashes, and muscle spasms.

Interactions People taking neratinib should avoid concurrent use of gastric acid–reducing agents, including proton pump inhibitors and H2-receptor antagonists. Antacids may be taken at least three hours before or after administration of neratinib. Drugs that inhibit CYP3A4 increase the activity of neratinib and can make adverse effects worse, and drugs that induce CYP3A4 make neratinib less active and can reduce its efficacy. Neratinib also inhibits p-glycoprotein and effectively raises the dose of drugs like digoxin that depend on it for elimination.

Pharmacology Like lapatinib and afatinib, it is a dual inhibitor of the human epidermal growth factor receptor 2 (Her2) and epidermal growth factor receptor (EGFR) kinases. It inhibits them by covalently binding with a cysteine side chain in those proteins. Unlike related noncovalent inhibitors, neratinib is effective against the T790M resistant variant of EGFR. Neratinib has an IC50 of 59 nM against HER2 and shows weak inhibition against KDR and Scr with IC50 values of 0.8 μM and 1.4 μM, respectively. In BT474 cells, neratinib reduces HER2 autophosphorylation, and inhibited cyclin D1 expression while reduced proliferation has been observed A431 cells when treated with neratinib at concentrations of 3 or 5 nM. In xenograft models with 3T3/neu tumors oral administration of neratinib at 10, 20, 40 or 80 mg/kg was able to inhibit tumor growth while in SK-OV-3 models doses of 5 and 60 mg/kg significantly inhibited tumor growth.

Cell biology Neratinib is found to strongly reduce the amount of HER2 released by extracellular vesicles and to enhance the capacity of clathrin mediated endocytosis. However, despite HER2 mediated signaling downregulation, Neratinib exerts only a modest effect on HER2 trafficking at IC50 of 6nM in SKBR3 cells.

Chemistry Neratinib is a 4-anilino-3-cyano quinoline derivative.

History Neratinib was discovered and initially developed by Wyeth; Pfizer continued development up to Phase III in breast cancer, and licensed it to Puma Biotechnology in 2011. It was approved for medical use in the United States in July 2017, for the extended adjuvant treatment of adults with early stage HER2-overexpressed/amplified breast cancer, (after adjuvant trastuzumab-based therapy). Approval was based on the ExteNET trial (NCT00878709), a multicenter, randomized, double-blind, placebo-controlled trial of neratinib following adjuvant trastuzumab treatment. Neratinib was approved for medical use in the European Union in August 2018.

Brand names In Bangladesh it is sold under the trade name Hernix.

References

External links "Neratinib". Drug Information Portal. U.S. National Library of Medicine. Archived from the original on 28 October 2019. "Neratinib maleate". Drug Information Portal. U.S. National Library of Medicine. Archived from the original on 16 November 2020. "Neratinib maleate". National Cancer Institute. 27 July 2017. "Neratinib maleate". NCI Drug Dictionary. National Cancer Institute. Clinical trial number NCT00878709 for "Study Evaluating The Effects Of Neratinib After Adjuvant Trastuzumab In Women With Early Stage Breast Cancer (ExteNET)" at ClinicalTrials.gov

Illustrations

Worked examples

Example 1 — a first encounter with Neratinib

Start with the simplest possible case. Write down what Neratinib claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In chemistry, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Neratinib before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Neratinib ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Neratinib

In research: Neratinib appears in chemistry research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Neratinib in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Neratinib is common in secondary-school and first-year university syllabi. It links to neighbouring topics 2-Pyridyl compounds, Alkene derivatives, Aromatic amines, so understanding it makes those chapters shorter.
In everyday life: Look for Neratinib outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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How to study Neratinib in 20 minutes

Read the reference excerpt below once, without taking notes.
Close the page and write down what Neratinib means in your own words.
Compare your version with the excerpt and mark what you missed.
Work through the three examples above with pen and paper.
Explain Neratinib out loud to somebody else — or to Teacher Smith in the lgStudy chat.

Frequently asked questions

What is Neratinib in simple terms?

Why does Neratinib matter?

Because it connects several chemistry ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

How should I study Neratinib?

Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

What does this page cover?

It gives you a compact reference excerpt plus original lgStudy explanations, examples, applications and study material on Neratinib.