Nelfinavir

Summary

Nelfinavir (CHEMBL584) is an approved small-molecule HIV protease inhibitor (ATC J05AE04); indicated across 20 conditions including carcinoma and hiv infectious disease.

At a glance

• Status: Approved (max clinical phase 4)
• Modality: Small molecule
• ATC class: J05AE04
• Indications: 20 conditions
• Clinical trials: 41
• Chemistry: 567.8 Da · C32H45N3O4S

Identifiers

Drug identity and classification

Field	Value
ChEMBL ID	CHEMBL584
Name	Nelfinavir
Type	Small molecule
Max phase	4
FDA approved	yes
PubChem CID	64143
ChEBI	CHEBI:7496
ATC	J05AE04
Molecular formula	C32H45N3O4S
Molecular weight	567.8
InChIKey	QAGYKUNXZHXKMR-HKWSIXNMSA-N

SMILES: CC1=C(C=CC=C1O)C(=O)N[C@@H](CSC2=CC=CC=C2)[C@@H](CN3C[C@H]4CCCC[C@H]4C[C@H]3C(=O)NC(C)(C)C)O

IUPAC name: (3S,4aS,8aS)-N-tert-butyl-2-[(2R,3R)-2-hydroxy-3-[(3-hydroxy-2-methylbenzoyl)amino]-4-phenylsulfanylbutyl]-3,4,4a,5,6,7,8,8a-octahydro-1H-isoquinoline-3-carboxamide

ChEBI definition: An aryl sulfide that is used (as its mesylate salt) for treatment of HIV and also exhibits some anticancer properties.

Pharmacological roles (ChEBI): HIV protease inhibitor, antineoplastic agent.

Also known as: Nelfinavir, NSC-747167, nelfinavir, SID56320472, NELFINAVIR

Parent form; salt/anhydrous children: CHEMBL1205

Patent coverage: 9,879 distinct patent families (36,859 SureChEMBL compound mentions), from 2 matched compound structure(s). One matched structure accounts for 36,127 (98%) of the total. Mentions count patents naming the compound (not distinct inventions), so promiscuous / reference molecules inflate the mention figure — families are the dedup metric.

Targets

Targets

Broader ChEMBL bioactivity targets: 31 (assay-derived). Sample: ATP-binding cassette sub-family C member 4, Thromboxane-A synthase, Tyrosine-protein kinase Fyn, Sodium channel protein type 5 subunit alpha, Epidermal growth factor receptor, Muscarinic acetylcholine receptor M5, D(1A) dopamine receptor, Thromboxane A2 receptor, Solute carrier family 22 member 1, Muscarinic acetylcholine receptor M1.

Bioactivity

ChEMBL activities: 23 potent at pChembl ≥ 5 of 61 total. Top 30 by potency (10 = 0.1 nM, 6 = 1 µM):

Target	pChembl	Type	Value	Unit	Activity ID
ABCB1	6.46	IC50	350	nM	CHEMBL_ACT_1154167
CYP3A4	6.32	Ki	480	nM	CHEMBL_ACT_6075219
CYP3A4	6.26	IC50	550	nM	CHEMBL_ACT_1154164
CYP3A5	6.24	Ki	570	nM	CHEMBL_ACT_6075246
CYP3A4	6	Ki	1000	nM	CHEMBL_ACT_12163654
ABCB1	5.85	IC50	1400	nM	CHEMBL_ACT_11000916
ABCB1	5.77	IC50	1700	nM	CHEMBL_ACT_19257517
ABCB1	5.7	IC50	2000	nM	CHEMBL_ACT_19257521
CYP3A4	5.7	IC50	2000	nM	CHEMBL_ACT_7741742
P21447	5.64	IC50	2300	nM	CHEMBL_ACT_11001310
P21447	5.64	IC50	2300	nM	CHEMBL_ACT_1154168
ADORA3	5.55	AC50	2842	nM	CHEMBL_ACT_25198866
ABCB1	5.47	IC50	3400	nM	CHEMBL_ACT_11001409
ABCB1	5.47	IC50	3400	nM	CHEMBL_ACT_1154170
ABCB1	5.24	IC50	5800	nM	CHEMBL_ACT_19257529
OPRM1	5.23	Ki	5859	nM	CHEMBL_ACT_7741831
DRD1	5.19	Ki	6467	nM	CHEMBL_ACT_7741745
FYN	5.1	IC50	7971	nM	CHEMBL_ACT_7741874
ADORA3	5.08	Ki	8363	nM	CHEMBL_ACT_7739629
SLC6A2	5.06	Ki	8779	nM	CHEMBL_ACT_7739651
SLC6A2	5.05	IC50	8852	nM	CHEMBL_ACT_7739650
ABCB1	5.04	IC50	9100	nM	CHEMBL_ACT_19257525
TACR2	5.01	Ki	9793	nM	CHEMBL_ACT_7743957

Target pathways

No target-pathway data for this drug (no mapped target genes).

Indications & clinical

Indications

20 indications (0 at ChEMBL trial phase 4). Phase below is the highest clinical-trial phase recorded for this drug against each disease — not the molecule’s overall approval status (that is in the Summary).

Indication	Trial phase	MONDO	EFO
carcinoma	3	MONDO:0004993	EFO:0000313
HIV infectious disease	3	MONDO:0005109	EFO:0000764
AIDS	3	MONDO:0012268	EFO:0000765
diarrheal disease	3	MONDO:0001673	HP:0002014
viral infectious disease	3	MONDO:0005108	EFO:0000763
plasma cell myeloma	2	MONDO:0009693	EFO:0001378
non-small cell lung carcinoma	2	MONDO:0005233	EFO:0003060
dysplasia of cervix	2	MONDO:0006736	EFO:1000910
systemic lupus erythematosus	2	MONDO:0007915	MONDO:0007915
colorectal adenocarcinoma	1	MONDO:0005008	EFO:0000365
glioblastoma	1	MONDO:0018177	EFO:0000519
neoplasm	1	MONDO:0005070	EFO:0000616
renal cell carcinoma	1	MONDO:0005086	EFO:0000681
pancreatic neoplasm	1	MONDO:0021040	EFO:0003860
lymphoma	1	MONDO:0005062	EFO:0000574
vulva cancer	1	MONDO:0001528	MONDO:0001528
lung neoplasm	1	MONDO:0021117	MONDO:0008903
paraganglioma	1	MONDO:0000448	EFO:1000453

2 further indication records had no mapped disease name (EFO/MeSH-only) or were duplicates, and are omitted.

Clinical trials

Total trials: 41.

Phase distribution

Phase	Trials
PHASE1	15
PHASE2	8
PHASE1/PHASE2	6
PHASE4	5
PHASE3	4
Not specified	2
EARLY_PHASE1	1

Top trials by phase / activity

NCT	Phase	Status	Title
NCT00023400	PHASE4	COMPLETED	TBTC Study 23B:Intensive PK of the Nelfinavir Rifabutin Interaction in Patients With HIV-TB
NCT00192660	PHASE4	COMPLETED	HIV Infection And Metabolic Abnormalities Protocol 1 (HAMA001)
NCT00251030	PHASE4	COMPLETED	A Study To Estimate The Effect Of Omeprazole On The Pharmacokinetics Of Nelfinavir In Healthy Subjects
NCT00312182	PHASE4	COMPLETED	Thorough QT Study of Nelfinavir
NCT00457665	PHASE4	COMPLETED	Mechanisms of Lipodystrophy in HIV-Infected Pateints
NCT00099359	PHASE3	COMPLETED	Trial of Three Neonatal Antiretroviral Regimens for Prevention of Intrapartum HIV Transmission
NCT00234091	PHASE3	COMPLETED	When to Start Anti-HIV Drugs in Children Infected With HIV (The PREDICT Study)
NCT00650637	PHASE3	TERMINATED	A Study to Determine Effective Prophylaxis and Treatment of Nelfinavir-Associated Diarrhea
NCT03256916	PHASE3	COMPLETED	Radiosensitizing Effect of Nelfinavir in Locally Advanced Carcinoma of Cervix
NCT05036226	PHASE1/PHASE2	RECRUITING	COAST Therapy in Advanced Solid Tumors and Prostate Cancer
NCT06971744	PHASE2	RECRUITING	Autophagy Maintenance (AUTOMAIN)
NCT07281781	PHASE1/PHASE2	RECRUITING	Treating Anemia in Myelofibrosis With Repurposed Drugs (Nelfinavir) That Restore Iron Delivery to the Bone Marrow
NCT00704600	PHASE1/PHASE2	COMPLETED	Nelfinavir, a Phase I/Phase II Rectal Cancer Study
NCT00791336	PHASE2	TERMINATED	Study to Evaluate Using Nelfinavir With Chemoradiation for Non-small Cell Lung Cancer
NCT01065844	PHASE2	COMPLETED	Nelfinavir in Recurrent Adenoid Cystic Cancer of the Head and Neck
NCT01108666	PHASE2	TERMINATED	Proton Beam Radiation With Concurrent Chemotherapy and Nelfinavir for Inoperable Stage III Non Small Cell Lung Cancer (NSCLC)
NCT01447589	PHASE1/PHASE2	WITHDRAWN	Radical Lung Radiotherapy Plus Nelfinavir
NCT01555281	PHASE1/PHASE2	TERMINATED	Nelfinavir and Lenalidomide/Dexamethasone in Progressive Multiple Myeloma
NCT01728779	PHASE2	COMPLETED	Stereotactic Body Radiation With Nelfinavir for Oligometastases
NCT01925378	PHASE2	WITHDRAWN	A Phase II Single-arm Intervention Trial of Nelfinavir in Patients With Grade 2/3 or 3 Cervical Intraepithelial Neoplasia
NCT02024009	PHASE1/PHASE2	COMPLETED	Systemic Therapy and Chemoradiation in Advanced Localised Pancreatic Cancer - 2
NCT02066311	PHASE2	TERMINATED	Nelfinavir in Systemic Lupus Erythematosus
NCT02188537	PHASE2	COMPLETED	Nelfinavir as Bortezomib-sensitizing Drug in Patients With Proteasome Inhibitor-nonresponsive Myeloma
NCT04169763	PHASE1	RECRUITING	Nelfinavir, Cisplatin, and External Beam Radiation Therapy for the Treatment of Locally Advanced Vulvar Cancer That Cannot Be Removed by Surgery
NCT00001766	PHASE1	COMPLETED	Drug Interactions Among Anti-HIV Agents
NCT00307502	PHASE1	COMPLETED	Study to Determine the Pharmacokinetic Behavior of Antiretroviral Drugs in Patients Infected by HIV
NCT00346580	PHASE1	COMPLETED	The Effects of HIV Protease Inhibitors in Severe Sepsis
NCT00346619	PHASE1	COMPLETED	Determining the Amount of Time Needed for Nelfinavir to Boost the Immune System in Adults
NCT00385450	PHASE1	TERMINATED	Cardiopulmonary Bypass-Induced Lymphocytopenia and the Potential Effects of Protease Inhibitor
NCT00694837	PHASE1	COMPLETED	Study With Nelfinavir and Combined Radiochemotherapy for Glioblastoma
NCT01020292	PHASE1	COMPLETED	A Trial of the Protease Inhibitor Nelfinavir and Concurrent Radiation and Temozolomide in Patients With WHO Grade IV Glioma
NCT01079286	PHASE1	COMPLETED	Study of Nelfinavir and Temsirolimus in Patients With Advanced Cancers
NCT01086332	PHASE1	TERMINATED	Evaluation of Nelfinavir and Chemoradiation for Pancreatic Cancer
NCT01445106	PHASE1	COMPLETED	A Phase I Trial of Nelfinavir (Viracept ) in Adults With Solid Tumors
NCT01485731	PHASE1	COMPLETED	Safety Study of Nelfinavir + Cisplatin + Pelvic Radiation Therapy to Treat Cervical Cancer
NCT02257008	PHASE1	COMPLETED	Effect of Different Boosting Agents on Pharmacokinetics of BILR 355 BS Dissolved in Polyethylene Glycol 400 (PEG 400) in Healthy Male Volunteers
NCT02363829	PHASE1	COMPLETED	A Study of Nelfinavir Added to Cisplatin Chemotherapy Concurrent With Pelvic Radiation for Locally Advanced Cervical Cancer (II-IVA)
NCT03422874	PHASE1	WITHDRAWN	Dose Escalation Study of Nelfinavir Plus MLN9708 in Patients With Advanced Solid Tumors or Lymphoma
NCT02080416	EARLY_PHASE1	TERMINATED	Nelfinavir for the Treatment of Gammaherpesvirus-Related Tumors
NCT00122590	Not specified	TERMINATED	Evaluation of Therapeutic Drug Monitoring of Protease Inhibitors on Virologic Success and Tolerance of Highly Active Antiretroviral Therapy (HAART)

Clinical evidence (CIViC)

No CIViC predictive evidence (expected for non-precision-medicine drugs).

Pharmacology

Pharmacogenomics

No CPIC/DPWG dosing guideline, but PharmGKB curates 2 clinical and 9 variant annotation(s) for this drug (gene-keyed; see PharmGKB).

Related molecules

Related molecules

No competitor molecules sharing a primary target (ChEMBL phase ≥2 or PubChem drug-class).