Authors' Affiliations: Eli Lilly and Company, Windlesham, United Kingdom; and
Eli Lilly and Company, Indianapolis, Indiana.
Clin Cancer Res. 2014 Jul 15;20(14):3763-74. doi: 10.1158/1078-0432.CCR-13-2846. Epub 2014 May 21.
Selective inhibition of cyclin-dependent kinases 4 and 6 (CDK4/6) represents a promising therapeutic strategy. However, despite documented evidence of clinical activity, limited information is available on the optimal dosing strategy of CDK4/6 inhibitors. Here, we present an integrated semi-mechanistic pharmacokinetic/pharmacodynamic model to characterize the quantitative pharmacology of LY2835219, a CDK4/6 inhibitor, in xenograft tumors.
LY2835219 plasma concentrations were connected to CDK4/6 inhibition and cell-cycle arrest in colo-205 human colorectal xenografts by incorporating the biomarkers, phospho-(ser780)-Rb, topoisomerase II α, and phosphohistone H3, into a precursor-dependent transit compartment model. This biomarker model was then connected to tumor growth inhibition (TGI) by: (i) relating the rate of tumor growth to mitotic cell density, and (ii) incorporating a concentration-dependent mixed cytostatic/cytotoxic effect driving quiescence and cell death at high doses. Model validation was evaluated by predicting LY2835219-mediated antitumor effect in A375 human melanoma xenografts.
The model successfully described LY2835219-mediated CDK4/6 inhibition, cell-cycle arrest, and TGI in colo-205, and was validated in A375. The model also demonstrated that a chronic dosing strategy achieving minimum steady-state trough plasma concentrations of 200 ng/mL is required to maintain durable cell-cycle arrest. Quiescence and cell death can be induced by further increasing LY2835219 plasma concentrations.
Our model provides mechanistic insight into the quantitative pharmacology of LY2835219 and supports the therapeutic dose and chronic dosing strategy currently adopted in clinical studies.
选择性抑制细胞周期蛋白依赖性激酶 4 和 6(CDK4/6)代表了一种很有前途的治疗策略。然而,尽管有临床活性的记录证据,但关于 CDK4/6 抑制剂的最佳剂量策略的信息有限。在这里,我们提出了一个综合的半机械性药代动力学/药效动力学模型,以描述 CDK4/6 抑制剂 LY2835219 在异种移植肿瘤中的定量药理学。
通过将生物标志物磷酸化(ser780)-Rb、拓扑异构酶 II α 和磷酸组蛋白 H3 纳入到一个前体依赖性转运隔室模型中,将 LY2835219 的血浆浓度与 colo-205 人结直肠异种移植肿瘤中的 CDK4/6 抑制和细胞周期阻滞联系起来。然后,通过以下方式将该生物标志物模型与肿瘤生长抑制(TGI)联系起来:(i)将肿瘤生长速度与有丝分裂细胞密度联系起来,(ii)通过浓度依赖性的混合细胞抑制/细胞毒性作用,在高剂量时驱动静止和细胞死亡。通过预测 LY2835219 在 A375 人黑色素瘤异种移植中的抗肿瘤作用,对模型进行了验证。
该模型成功地描述了 LY2835219 介导的 CDK4/6 抑制、细胞周期阻滞和 TGI 在 colo-205 中的作用,并在 A375 中得到了验证。该模型还表明,需要采用慢性给药策略,以维持最小稳态谷血浆浓度 200ng/mL,以维持持久的细胞周期阻滞。通过进一步增加 LY2835219 的血浆浓度,可以诱导静止和细胞死亡。
我们的模型提供了对 LY2835219 的定量药理学的机制见解,并支持目前在临床研究中采用的治疗剂量和慢性给药策略。