Ozawa Kazuhiro, Minami Hironobu, Sato Hitoshi
Department of Clinical and Molecular Pharmacokinetics/Pharmacodynamics, School of Pharmaceutical Sciences, Showa University, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan.
Cancer Sci. 2007 Dec;98(12):1985-92. doi: 10.1111/j.1349-7006.2007.00615.x. Epub 2007 Sep 19.
The present study describes a population pharmacokinetic and pharmacodynamic (PK/PD) analysis based on data obtained from cancer patients treated with docetaxel at the National Cancer Center Hospital East in Japan. Docetaxel was infused intravenously over 1 h every 3 weeks, and time courses of absolute neutrophil counts (ANC) for a total of 395 observations (62 patients) were analyzed using a semimechanistic-physiological PK/PD model in the NONMEM program. The prominent feature of our PK/PD model is that it has the capability to predict a temporary increase in ANC. Among 10 patient factors, alpha(1)-acid glycoprotein was selected as a significant covariate for drug effect as the increase in alpha(1)-acid glycoprotein was negatively correlated with the drug effect. Goodness-of-fit plots indicated that the model fitted well with the observed data, and the bootstrap method guaranteed robustness of the model. In conclusion, we developed a novel population PK/PD model that can adequately analyze ANC profiles after docetaxel administration in oncology practice, where temporary but consistent increases in ANC were observed.
本研究基于在日本国立癌症中心东医院接受多西他赛治疗的癌症患者的数据,描述了一项群体药代动力学和药效学(PK/PD)分析。多西他赛每3周静脉输注1小时,使用NONMEM程序中的半机制生理PK/PD模型分析了总共395次观察(62例患者)的绝对中性粒细胞计数(ANC)的时间进程。我们的PK/PD模型的突出特点是它能够预测ANC的暂时增加。在10个患者因素中,α1-酸性糖蛋白被选为药物效应的显著协变量,因为α1-酸性糖蛋白的增加与药物效应呈负相关。拟合优度图表明该模型与观察数据拟合良好,自举法保证了模型的稳健性。总之,我们开发了一种新型群体PK/PD模型,该模型能够在肿瘤学实践中充分分析多西他赛给药后的ANC谱,在该实践中观察到ANC有暂时但持续的增加。