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切除术后 II 期和 III 期结肠癌患者末次给药后贝伐珠单抗的长期药代动力学特征。

Characterization of the long-term pharmacokinetics of bevacizumab following last dose in patients with resected stage II and III carcinoma of the colon.

机构信息

Genentech, Inc., South San Francisco, CA, USA.

出版信息

Cancer Chemother Pharmacol. 2013 Mar;71(3):575-80. doi: 10.1007/s00280-012-2031-7. Epub 2012 Dec 11.

Abstract

PURPOSE

The study characterizes the long-term pharmacokinetics (PK) following last dose of bevacizumab as adjuvant therapy in patients with resected stage II and III colon carcinoma in a Phase III clinical study (AVF3077s).

METHODS

Patients in AVF3077s received bevacizumab (5 mg/kg every 2 weeks) as adjuvant therapy for 1 year. Following the last dose bevacizumab concentration, data at 3 and 6 months were used to characterize long-term bevacizumab PK based on the population-modeling approach.

RESULTS

The long-term bevacizumab PK were consistent with previously reported results based on short-term bevacizumab PK. The clearance (CL), central volume of distribution (V(1)), intercompartmental clearance (Q), and the peripheral volume of distribution (V(2)) were 214 mL/day, 2,830 mL, 636 mL/day, and 2,490 mL, which correspond to a disposition and elimination half-life of 1.33 and 19.1 days, respectively. The empirical Bayes estimates of median post-treatment bevacizumab drug levels at 3 and 6 months were 6.14 and 0.23 μg/mL, respectively. For test covariates, the change in CL and V(1) of bevacizumab was less than 20% of the typical value. Body weight is the important covariate explaining the inter-individual variability on CL and V(1).

CONCLUSIONS

Long-term bevacizumab PK in this study was predictable based on short-term PK data from metastatic settings in other tumor types. An exploratory analysis demonstrated no apparent association of the tested covariates with bevacizumab PK. Further, the extended serum persistence of bevacizumab following last dose should be considered in clinical study designs and post-treatment evaluations that may be affected by bevacizumab.

摘要

目的

本研究对接受贝伐珠单抗辅助治疗的 II 期和 III 期结肠癌患者进行了 III 期临床试验(AVF3077s)的最后一剂后长期药代动力学(PK)特征分析。

方法

AVF3077s 中的患者接受贝伐珠单抗(每 2 周 5mg/kg)作为辅助治疗,持续 1 年。在最后一剂贝伐珠单抗后,根据群体建模方法,利用 3 个月和 6 个月时的数据来描述长期贝伐珠单抗 PK。

结果

长期贝伐珠单抗 PK 与基于短期贝伐珠单抗 PK 的先前报道结果一致。清除率(CL)、中央分布容积(V1)、隔室间清除率(Q)和外周分布容积(V2)分别为 214 mL/天、2830 mL、636 mL/天和 2490 mL,这分别对应处置和消除半衰期为 1.33 天和 19.1 天。治疗后 3 个月和 6 个月时贝伐珠单抗药物水平的经验贝叶斯估计中位数分别为 6.14μg/mL 和 0.23μg/mL。对于检验协变量,贝伐珠单抗 CL 和 V1 的变化小于典型值的 20%。体重是解释 CL 和 V1 个体间变异性的重要协变量。

结论

本研究中的长期贝伐珠单抗 PK 可基于其他肿瘤类型转移性疾病中的短期 PK 数据进行预测。探索性分析表明,测试的协变量与贝伐珠单抗 PK 无明显关联。此外,最后一剂后贝伐珠单抗的血清持续时间延长应在可能受贝伐珠单抗影响的临床研究设计和治疗后评估中加以考虑。

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