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PharmGKB annotates drug labels containing pharmacogenetic information approved by the US Food and Drug Administration (FDA), European Medicines Agency (EMA), the Pharmaceuticals and Medical Devices Agency, Japan (PMDA), and Health Canada (Santé Canada) (HCSC). PharmGKB annotations provide a brief summary of the PGx in the label, an excerpt from the label and a downloadable highlighted label PDF file. A list of genes and phenotypes found within the label is mapped to label section headers and listed at the end of each annotation. PharmGKB also attempts to interpret the level of action implied in each label with the "PGx Level" tag.
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The FDA-approved drug label for denileukin diftitox (Ontak) notes that it is indicated for patients with persistent or recurrent cutaneous T-cell lymphoma whose malignant cells express the CD25 component of the IL-2 receptor. Confirmation of malignant cells expressing CD25 is necessary prior to administration of the drug.
Denileukin diftitox (Ontak) is indicated for patients with persistent or recurrent cutaneous T-cell lymphoma. The FDA-approved drug label for denileukin diftitox states that confirmation that a patient's malignant cells express CD25 is necessary prior to beginning treatment with the drug.
Excerpts from the denileukin diftitox (Ontak) label:
Ontak is a CD25-directed cytotoxin indicated for the treatment of patients with persistent or recurrent cutaneous T-cell lymphoma whose malignant cells express the CD25 component of the IL-2 receptor.
CD25 Tumor Expression and Evaluation...Confirm that the patient's malignant cells express CD25 prior to administration of Ontak. A testing service for the assay of CD25 expression in tumor biopsy samples is available.
For the complete drug label text with sections containing pharmacogenetic information highlighted, see the denileukin diftitox drug label.
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Genes and/or phenotypes found in this label
- Indications & usage section, Description section, Clinical pharmacology section, Warnings and precautions section, efficacy
- source: FDA Label
PharmGKB contains no Clinical Variants that meet the highest level of criteria.
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The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.
- Diphtheria toxin precursor
- NAD(+--diphthamide ADP- ribosyltransferase)
- denileukin diftitox
- Ontak (Seragen Inc)
A recombinant DNA-derived cytotoxic protein composed of the amino acid sequences for diphtheria toxin fragments A and B (Met 1-Thr 387)-His followed by the sequences for interleukin-2 (IL-2; Ala 1-Thr 133). It is produced in an E. coli expression system.
Source: Drug Bank
Information pulled from DrugBank has not been reviewed by PharmGKB.
Pharmacology, Interactions, and Contraindications
Mechanism of Action
Denileukin diftitox binds to the high-affinity IL-2 receptor complex. The IL-2 receptor (Tac) subunit is expressed on activated but not resting lymphocytes. The diphtheria toxin associated with Ontak then selectively kills the IL-2 bearing cells.
Source: Drug Bank
Denileukin diftitox (Ontak) directs the cytocidal action of diphtheria toxin to cells which express the IL-2 receptor. The human IL-2 receptor exists in three forms, low (CD25), intermediate (CD122/CD132) and high (CD25/CD122/CD132) affinity. Malignant cells expressing one or more of the subunits of the IL-2 receptor are found in certain leukemias and lymphomas including cutaneous T-cell lymphoma (CTCL). Ontak interacts with the high affinity IL-2 receptor on the cell surface and inhibits cellular protein synthesis, resulting in cell death within hours.
Source: Drug Bank
Absorption, Distribution, Metabolism, Elimination & Toxicity
- 0.6 - 2.0 mL/min/kg Lymphoma
Source: Drug Bank
These are trials that mention denileukin diftitox and are related to either pharmacogenetics or pharmacogenomics.