Lin Swan, Shaik Naveed, Martinelli Giovanni, Wagner Andrew J, Cortes Jorge, Ruiz-Garcia Ana
Clinical Pharmacology, Global Product Development, Pfizer Inc, San Diego, California, USA.
Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST IRCCS), Meldola, Italy.
J Clin Pharmacol. 2020 May;60(5):605-616. doi: 10.1002/jcph.1556. Epub 2019 Nov 25.
Glasdegib is an inhibitor of the Hedgehog pathway recently approved in the United States for the treatment of acute myeloid leukemia. A population pharmacokinetic analysis was conducted to characterize the kinetic behavior of glasdegib and its sources of variability (covariates) by utilizing data from 269 patients with cancer treated with oral glasdegib doses ranging from 5 to 640 mg/d. Nonlinear mixed-effects modeling was conducted using NONMEM (v.7.3) and Perl-speaks NONMEM (v.4.2.0). The estimated apparent total clearance, apparent central volume of distribution, and apparent peripheral volume of distribution were 6.27 L/h, 3.32 L, and 279.2 L, respectively. Age, sex, race, and hepatic function were not significant covariates on glasdegib pharmacokinetic parameters. Baseline body weight, percentage bone marrow blasts, creatinine clearance, and use of moderate or strong cytochrome P450 3A inhibitors were statistically significant covariates on apparent total clearance; however, the magnitude of the effects was not considered clinically meaningful.
格拉斯吉布是一种刺猬信号通路抑制剂,最近在美国被批准用于治疗急性髓系白血病。通过利用269例接受口服格拉斯吉布剂量为5至640 mg/d治疗的癌症患者的数据,进行了群体药代动力学分析,以表征格拉斯吉布的动力学行为及其变异性来源(协变量)。使用NONMEM(v.7.3)和Perl-speaks NONMEM(v.4.2.0)进行非线性混合效应建模。估计的表观总清除率、表观中央分布容积和表观外周分布容积分别为6.27 L/h、3.32 L和279.2 L。年龄、性别、种族和肝功能不是格拉斯吉布药代动力学参数的显著协变量。基线体重、骨髓原始细胞百分比、肌酐清除率以及使用中度或强效细胞色素P450 3A抑制剂是表观总清除率的统计学显著协变量;然而,这些影响的程度在临床上不被认为有意义。