Department of Clinical Pharmacology, Genentech, Inc, South San Francisco, California, USA.
Genentech Research and Early Development, 1 DNA Way, MS46-3a, South San Francisco, California, 94080, USA.
Pharm Res. 2020 Dec 1;37(12):252. doi: 10.1007/s11095-020-02933-6.
The established two-analyte integrated population pharmacokinetic model was applied to assess the impact of intrinsic/extrinsic factors on the pharmacokinetics (PK) of polatuzumab vedotin (pola) in patients with non-Hodgkin lymphoma (NHL) following bodyweight-based dosing.
Model simulations based on individual empirical Bayes estimates were used to evaluate the impact of intrinsic/extrinsic factors as patient subgroups on Cycle 6 exposures. Intrinsic factors included bodyweight, age, sex, hepatic and renal functions. Extrinsic factors included rituximab/obinutuzumab or bendamustine combination with pola and manufacturing process. The predicted impact on exposures along with the established exposure-response relationships were used to assess clinical relevance.
No clinically meaningful differences in Cycle 6 pola exposures were found for the following subgroups: bodyweight 100-146 kg versus 38-<100 kg, age ≥ 65 years versus <65 years, female versus male, mild hepatic impairment versus normal, mild-to-moderate renal impairment versus normal. Co-administration of rituximab/obinutuzumab or bendamustine, and change in the pola manufacturing process, also had no meaningful impact on PK.
In patients with NHL, bodyweight-based dosing is adequate, and no further dose adjustment is recommended for the heavier subgroup (100-146 kg). In addition, no dose adjustments are recommended for other subgroups based on intrinsic/extrinsic factors evaluated.
应用已建立的两分析物集成群体药代动力学模型评估内在/外在因素对基于体重给药的非霍奇金淋巴瘤(NHL)患者中泊洛妥珠单抗结合物(pola)药代动力学(PK)的影响。
基于个体经验贝叶斯估计的模型模拟用于评估内在/外在因素(如患者亚组)对第 6 周期暴露的影响。内在因素包括体重、年龄、性别、肝肾功能。外在因素包括与 pola 联合使用的利妥昔单抗/奥滨尤妥珠单抗或苯达莫司汀,以及生产工艺。使用预测的暴露影响以及已建立的暴露-反应关系来评估临床相关性。
对于以下亚组,第 6 周期 pola 暴露未发现有临床意义的差异:体重 100-146kg 与 38-<100kg、年龄≥65 岁与<65 岁、女性与男性、轻度肝损伤与正常、轻度至中度肾功能损害与正常。利妥昔单抗/奥滨尤妥珠单抗或苯达莫司汀联合使用,以及 pola 生产工艺的变化,对 PK 也没有明显影响。
在 NHL 患者中,基于体重的给药是足够的,不建议对较重的亚组(100-146kg)进行进一步的剂量调整。此外,不建议根据内在/外在因素评估对其他亚组进行剂量调整。