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高脂餐对单剂量维莫非尼药代动力学的影响。

The effects of a high-fat meal on single-dose vemurafenib pharmacokinetics.

作者信息

Ribas Antoni, Zhang Weijiang, Chang Ilsung, Shirai Keisuke, Ernstoff Marc S, Daud Adil, Cowey C Lance, Daniels Gregory, Seja Elizabeth, O'Laco Elizabeth, Glaspy John A, Chmielowski Bartosz, Hill Todd, Joe Andrew K, Grippo Joseph F

机构信息

Jonsson Comprehensive Cancer Center, University of California, Los Angeles, CA, USA.

出版信息

J Clin Pharmacol. 2014 Apr;54(4):368-74. doi: 10.1002/jcph.255. Epub 2014 Jan 22.

Abstract

Vemurafenib is an orally bioavailable BRAF inhibitor approved for the treatment of BRAF(V600) -mutant metastatic melanoma. It is important to understand the effects of a high-fat meal on the pharmacokinetics (PK) of vemurafenib in humans because it is a Biopharmaceutics Classification System Class IV drug and its PK can be altered by food. An open-label, multicenter, randomized, 2-period crossover study was performed to evaluate the effect of food (high-fat meal) on the PK of a single oral dose of vemurafenib. Secondary objectives were safety and tolerability, efficacy with best overall response rate, and overall survival during the treatment period. The concomitant intake of food (high-fat meal) increased mean Cmax 3.5 to 7.5 µg/mL and mean AUC0-∞ 119 to 360 µg·h/mL after a single 960 mg dose of vemurafenib (N = 13-15 patients). An effect of food on single-dose exposure is suggested by point estimates and 90% CI of geometric mean ratios for vemurafenib plasma AUC0-∞ (4.7) and Cmax (2.5). Toxicity and response rate of vemurafenib in this study were consistent with prior experience in patients with BRAF(V600) -mutant metastatic melanoma. A high-fat meal increased the exposure to vemurafenib without altering the mean terminal half-life.

摘要

维莫非尼是一种口服生物利用度良好的BRAF抑制剂,被批准用于治疗BRAF(V600)突变的转移性黑色素瘤。了解高脂餐对维莫非尼在人体药代动力学(PK)的影响很重要,因为它是生物药剂学分类系统IV类药物,其PK会受到食物的影响。进行了一项开放标签、多中心、随机、两阶段交叉研究,以评估食物(高脂餐)对单次口服维莫非尼剂量PK的影响。次要目标是安全性和耐受性、最佳总体缓解率的疗效以及治疗期间的总生存期。单次服用960 mg维莫非尼(N = 13 - 15例患者)后,同时摄入食物(高脂餐)使平均Cmax增加3.5至7.5 μg/mL,平均AUC0-∞增加119至360 μg·h/mL。维莫非尼血浆AUC0-∞(4.7)和Cmax(2.5)的几何平均比值的点估计值和90%CI表明食物对单剂量暴露有影响。本研究中维莫非尼的毒性和缓解率与BRAF(V600)突变转移性黑色素瘤患者的既往经验一致。高脂餐增加了维莫非尼的暴露量,但未改变平均末端半衰期。

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