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奥拉帕利在晚期实体瘤及轻度或中度肝功能损害患者中的药代动力学和安全性。

Pharmacokinetics and safety of olaparib in patients with advanced solid tumours and mild or moderate hepatic impairment.

作者信息

Rolfo Christian, Isambert Nicolas, Italiano Antoine, Molife L Rhoda, Schellens Jan H M, Blay Jean-Yves, Decaens Thomas, Kristeleit Rebecca, Rosmorduc Olivier, Demlova Regina, Lee Myung-Ah, Ravaud Alain, Kopeckova Katerina, Learoyd Maria, Bannister Wendy, Locker Gershon, de Vos-Geelen Judith

机构信息

Marlene and Stewart Greenebaum Comprehensive Cancer Center, Experimental Therapeutics Program, University of Maryland School of Medicine, Baltimore, Maryland, USA.

Centre Georges François Leclerc, Dijon, France.

出版信息

Br J Clin Pharmacol. 2020 Sep;86(9):1807-1818. doi: 10.1111/bcp.14283. Epub 2020 Apr 5.

Abstract

AIMS

Olaparib, a potent oral poly(ADP-ribose) polymerase inhibitor, is partially hepatically cleared. We investigated the pharmacokinetics (PK) and safety of olaparib in patients with mild or moderate hepatic impairment to provide dosing recommendations.

METHODS

This Phase I open-label study assessed the PK, safety and tolerability of single doses of olaparib 300-mg tablets in patients with advanced solid tumours. Patients had normal hepatic function (NHF), or mild (MiHI; Child-Pugh class A) or moderate (MoHI; Child-Pugh class B) hepatic impairment. Blood was collected for PK assessments for 96 hours. Patients could continue taking olaparib 300 mg twice daily for long-term safety assessment.

RESULTS

Thirty-one patients received ≥1 dose of olaparib and 30 were included in the PK assessment. Patients with MiHI had an area under the curve geometric least-squares mean (GLSmean) ratio of 1.15 (90% confidence interval 0.72, 1.83) and a GLSmean maximum plasma concentration ratio of 1.13 (0.82, 1.56) vs those with NHF. In patients with MoHI, GLSmean ratio for area under the curve was 1.08 (0.66, 1.74) and for maximum plasma concentration was 0.87 (0.63, 1.22) vs those with NHF. For patients with mild or moderate hepatic impairment, no new safety signals were detected.

CONCLUSION

Patients with MiHI or MoHI had no clinically significant changes in exposure to olaparib compared with patients with NHF. The safety profile of olaparib did not differ from a clinically relevant extent between cohorts. No olaparib tablet or capsule dose reductions are required for patients with MiHI or MoHI.

摘要

目的

奥拉帕利是一种强效口服聚(ADP - 核糖)聚合酶抑制剂,部分经肝脏清除。我们研究了奥拉帕利在轻度或中度肝功能损害患者中的药代动力学(PK)和安全性,以提供给药建议。

方法

这项I期开放标签研究评估了晚期实体瘤患者单次服用300毫克奥拉帕利片的PK、安全性和耐受性。患者肝功能正常(NHF),或有轻度(MiHI;Child - Pugh A级)或中度(MoHI;Child - Pugh B级)肝功能损害。采集血液进行96小时的PK评估。患者可继续每日两次服用300毫克奥拉帕利进行长期安全性评估。

结果

31例患者接受了≥1剂奥拉帕利,30例纳入PK评估。与NHF患者相比,MiHI患者曲线下面积几何最小二乘均值(GLSmean)比值为1.15(90%置信区间0.72,1.83),最大血浆浓度GLSmean比值为1.13(0.82,1.56)。在MoHI患者中,与NHF患者相比,曲线下面积的GLSmean比值为1.08(0.66,1.74),最大血浆浓度的GLSmean比值为0.87(0.63,1.22)。对于轻度或中度肝功能损害患者,未检测到新的安全信号。

结论

与NHF患者相比,MiHI或MoHI患者奥拉帕利的暴露量无临床显著变化。各队列之间奥拉帕利的安全性特征在临床相关程度上无差异。MiHI或MoHI患者无需减少奥拉帕利片剂或胶囊剂量。

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