Key Lab of Drug Metabolism & Pharmacokinetics, China Pharmaceutical University, Nanjing 210009, China, China.
China National Center for Biotechnology Development, Beijing 100039, China.
Biomed Pharmacother. 2018 Jan;97:1000-1010. doi: 10.1016/j.biopha.2017.10.158. Epub 2017 Nov 8.
To take full advantage of combination therapy of Docetaxel (DTX) and Magnesium isoglycyrrhizinate (MGIG), the pharmacokinetic- pharmacodynamic- toxicodynamics (PK-PD-TD) interaction of DTX and MGIG in non-small cell lung tumor-bearing mice was investigated in the present study. A model, an integrated semi-mechanistic PK-PD-TD, was established for elucidating the exposure-effect-toxicity relationship between DTX and MGIG. A tumor growth and a transit compartmental system were applied to imitate the growth and death of tumor cell. An indirect model with precursor-dependence was induced to clarify the temporal relationship between liver injury and drug exposure. No PK interaction between DTX and MGIG in plasma, liver and tumor was observed. In PD and TD results, MGIG had no antitumoral activity on non-small cell lung carcinoma, while it showed a strong hepatoprotection on DTX-induced liver injury. The PK-PD parameters of anti-tumor effect were related with the tumor growth characteristics, the kinetics of the tumor death and drug potency. In the PK-TD model, it was estimated about the elevation rate of ALT after DTX challenge in hepatocytes as well as plasma. MGIG reduced the DTX-induced ALT release rate from hepatocyte efficiently. Based on parameters estimated via PK-PD-TD correlation, the model successfully predicted the tumor growth kinetics and hepatoprotection at different dose regimes. Therefore, this prospective model might provide an alternative approache to the optimization of new experiment design.
为了充分利用多西他赛(DTX)和甘草酸镁(MGIG)的联合治疗,本研究考察了载非小细胞肺癌荷瘤小鼠中 DTX 和 MGIG 的药代动力学-药效动力学-毒代动力学(PK-PD-TD)相互作用。建立了一个整合的半机理 PK-PD-TD 模型,以阐明 DTX 和 MGIG 之间的暴露-效应-毒性关系。应用肿瘤生长和转运隔室系统来模拟肿瘤细胞的生长和死亡。引入了一个具有前体依赖性的间接模型,以阐明肝损伤与药物暴露之间的时间关系。在血浆、肝脏和肿瘤中未观察到 DTX 和 MGIG 之间的 PK 相互作用。在 PD 和 TD 结果中,MGIG 对非小细胞肺癌没有抗肿瘤活性,而对 DTX 诱导的肝损伤有很强的保肝作用。抗肿瘤作用的 PK-PD 参数与肿瘤生长特征、肿瘤死亡动力学和药物效力有关。在 PK-TD 模型中,估计了 DTX 刺激后肝细胞和血浆中 ALT 升高的速率。MGIG 有效降低了 DTX 诱导的 ALT 从肝细胞中的释放速率。基于 PK-PD-TD 相关性估计的参数,该模型成功预测了不同剂量方案下的肿瘤生长动力学和肝保护作用。因此,这种前瞻性模型可能为优化新的实验设计提供一种替代方法。