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维利帕尼与拓扑替康加卡铂联合用药在血液系统恶性肿瘤患者中的群体药代动力学及作用部位暴露情况

Population pharmacokinetics and site of action exposures of veliparib with topotecan plus carboplatin in patients with haematological malignancies.

作者信息

Mehrotra Shailly, Gopalakrishnan Mathangi, Gobburu Jogarao, Greer Jacqueline M, Piekarz Richard, Karp Judith E, Pratz Keith, Rudek Michelle A

机构信息

Center for Translational Medicine, University of Maryland, Baltimore, Maryland.

The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland.

出版信息

Br J Clin Pharmacol. 2017 Aug;83(8):1688-1700. doi: 10.1111/bcp.13253. Epub 2017 Mar 19.

Abstract

AIMS

Veliparib is a potent inhibitor of poly(ADP-ribose) polymerase (PARP) enzyme. The objectives of the analysis were to evaluate the effect of baseline covariates and co-administration of topotecan plus carboplatin (T + C) on pharmacokinetics of veliparib in patients with refractory acute leukaemia, and compare veliparib concentration in various biological matrices.

METHODS

A population pharmacokinetic model was developed and effect of age, body size indices, sex, creatinine clearance (CrCL) and co-administration of T + C on the pharmacokinetics of veliparib were evaluated. The final model was qualified using bootstrap and quantitative predictive check. Linear regression was conducted to correlate concentrations of veliparib in various biological matrices.

RESULTS

A two compartment model with first-order absorption with T described veliparib pharmacokinetics. The apparent clearance (CL/F) and volume (V /F) were 16.5 l h and 122.7 l, respectively. The concomitant administration of T + C was not found to affect veliparib CL/F. CrCL and lean body mass (LBM) were significant covariates on CL/F and Vc/F, respectively. While a strong positive relationship was observed between veliparib concentrations in plasma and bone marrow supernatant, no correlation was observed between plasma and peripheral blood or bone marrow blasts.

CONCLUSIONS

Consistent with veliparib's physiochemical properties and its elimination mechanism, LBM and CrCL were found to affect pharmacokinetics of veliparib while concomitant administration of T + C did not affect veliparib's CL/F. Plasma concentrations were found to be a reasonable surrogate for veliparib concentrations in peripheral blood and bone marrow supernatant but not blasts. The current model will be utilized to conduct exposure-response analysis to support dosing recommendations.

摘要

目的

维利帕尼是一种有效的聚(ADP - 核糖)聚合酶(PARP)抑制剂。本分析的目的是评估基线协变量以及拓扑替康联合卡铂(T + C)对难治性急性白血病患者维利帕尼药代动力学的影响,并比较维利帕尼在各种生物基质中的浓度。

方法

建立了群体药代动力学模型,并评估了年龄、体型指数、性别、肌酐清除率(CrCL)以及T + C的联合使用对维利帕尼药代动力学的影响。使用自抽样法和定量预测检验对最终模型进行验证。进行线性回归以关联维利帕尼在各种生物基质中的浓度。

结果

用具有一级吸收的二室模型描述了维利帕尼的药代动力学。表观清除率(CL/F)和体积(V/F)分别为16.5 l/h和122.7 l。未发现T + C的联合使用会影响维利帕尼的CL/F。CrCL和去脂体重(LBM)分别是CL/F和Vc/F的显著协变量。虽然在血浆和骨髓上清液中的维利帕尼浓度之间观察到强正相关,但在血浆与外周血或骨髓原始细胞之间未观察到相关性。

结论

与维利帕尼的理化性质及其消除机制一致,发现LBM和CrCL会影响维利帕尼的药代动力学,而T + C的联合使用不会影响维利帕尼的CL/F。发现血浆浓度是外周血和骨髓上清液中维利帕尼浓度的合理替代指标,但不是原始细胞中的替代指标。当前模型将用于进行暴露 - 反应分析以支持给药建议。

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