18. Turalio

(Daiihi Sankyo)

Active ingredient: pexidartinib
Disease: tenosynovial giant cell tumor
Peak sales estimate: n/a
Approved: Aug. 2, 2019
Company: Daiichi Sankyo

The scoop: Turalio marks a number of firsts: Not only is it the first FDA-approved drug to treat a rare type of joint tumor, it’s one of Daiichi Sankyo’s opening salvos as the Japanese drugmaker pivots toward oncology. While the company previously worked on the BRAF inhibitor Zelboraf with Genentech, Turalio represents its first solo cancer drug—and one of seven that Daiichi Sankyo hopes to obtain approvals for by 2025. Tenosynovial giant cell tumors affect the thin tissue sheaths that cover joint spaces and tendons. While rarely malignant, their benign growth can cause pain and stiffness, while damaging the surrounding joint. Now, the company is working to educate patients and prescribers about the orphan disease, which is not commonly known outside of sarcoma specialists—as well as on Turalio’s REMS and its boxed warning for potential liver injury. The oral kinase inhibitor debuts at a list price of $165 per 200-mg capsule, with an adult dose of 400 mg twice daily until the disease progresses. — Conor Hale

18. Turalio

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