What medicine is Voranigo (Vorasidenib)?

Voranigo (Vorasidenib) is an isocitrate dehydrogenase-1 (IDH1) and isocitrate dehydrogenase-2 (IDH2) inhibitor indicated for the treatment of grade 2 IDH-mutated gliomas. Voranigo is indicated for the treatment of adult and pediatric patients 12 years of age and older with grade 2 astrocytoma or oligodendroglioma who are predisposed to IDH1 or IDH2 mutations after surgery, including biopsy, subtotal resection, or total resection.

Gliomas are brain tumors that originate from glial or precursor cells in the central nervous system. There are four groups of gliomas, and adult diffuse gliomas account for approximately 81% of primary malignant brain tumors. Of these, approximately 20% have IDH mutations. Adult-type diffuse gliomas are subdivided into astrocytomas, IDH-mutant (CNS WHO grade 2-4), oligodendrogliomas, IDH-mutant and 1p19q codeleted (CNS WHO grade 2-3), and IDH-wild-type glioblastoma (CNS WHO grade 4).

Voranigo contains vorasidenib, a brain-penetrating agent and dual inhibitor of mutant IDH1 and IDH2 enzymes. The IDH enzyme helps break down nutrients and produce energy for cells, and mutations in IDH1 and IDH2 have been linked to a variety of cancers. Voranigo reduces the production of 2-hydroxyglutarate (2-HG), which is associated with tumor survival and progression, by reducing the activity of mutant IDH1 and IDH2 enzymes.

Voranigo tablets are taken orally once daily; common (≥15%) adverse reactions include fatigue, headache, COVID-19, musculoskeletal pain, diarrhea, nausea, and seizures; Grade 3 or 4 (≥2%) laboratory abnormalities include increased ALT, increased AST, increased GGT, and neutropenia. Warnings and precautions related to Voranigo include hepatotoxicity and fetal harm.