Zhou Haiyan, Yan Jiaqing, Chen Wei, Yang Jun, Liu Min, Zhang Yuan, Shen Xin, Ma Yinglin, Hu Xingsheng, Wang Yan, Du Kehe, Li Guohui
Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Oncol. 2021 Feb 5;10:1731. doi: 10.3389/fonc.2020.01731. eCollection 2020.
Paclitaxel liposome (Lipusu) is the first commercialized liposomal formulation of paclitaxel. There has been little data collected on the pharmacokinetics (PK) of paclitaxel liposome, especially in relation to patient use. This study aimed to build a population pharmacokinetic (PopPK) model and further explore the exposure-safety relationship for paclitaxel liposome in patients with non-small cell lung cancer (NSCLC).
Data from 45 patients with a total of 349 plasma concentrations were analyzed. The PopPK model was built using the non-linear mixed effect modeling technique.
The PK of paclitaxel liposome were well described by a three-compartment model with first-order elimination. For a dose of 175 mg m, the estimated clearance of total plasma paclitaxel was 21.55 L h. Age, sex, body weight, total bilirubin, albumin, serum creatinine, and creatinine clearance did not influence the paclitaxel PK. Exposure to paclitaxel had no significant change in the presence of the traditional Chinese medicine, aidi injection. The exploratory exposure-safety relationship was well described by a generalized linear regression model. Higher probabilities of grade >1 neutropenia were observed in patients with higher exposure to paclitaxel.
This PopPK model adequately described the PK of paclitaxel liposome in patients with NSCLC. Predicted exposure of paclitaxel did not change in the presence of the traditional Chinese medicine, aidi injection. The exposure-safety analysis suggested that a higher risk of neutropenia was correlated with higher exposure to paclitaxel.
紫杉醇脂质体(力扑素)是首个商业化的紫杉醇脂质体制剂。关于紫杉醇脂质体的药代动力学(PK),尤其是与患者使用相关的数据收集较少。本研究旨在建立群体药代动力学(PopPK)模型,并进一步探讨非小细胞肺癌(NSCLC)患者中紫杉醇脂质体的暴露 - 安全性关系。
分析了45例患者共349个血浆浓度的数据。使用非线性混合效应建模技术建立PopPK模型。
紫杉醇脂质体的PK可用具有一级消除的三室模型很好地描述。对于175mg/m²的剂量,总血浆紫杉醇的估计清除率为21.55L/h。年龄、性别、体重、总胆红素、白蛋白、血清肌酐和肌酐清除率均不影响紫杉醇的PK。在使用中药艾迪注射液的情况下,紫杉醇的暴露无显著变化。广义线性回归模型很好地描述了探索性暴露 - 安全性关系。在紫杉醇暴露较高的患者中观察到≥2级中性粒细胞减少的概率更高。
该PopPK模型充分描述了NSCLC患者中紫杉醇脂质体的PK。在使用中药艾迪注射液的情况下,预测的紫杉醇暴露无变化。暴露 - 安全性分析表明,中性粒细胞减少风险较高与紫杉醇暴露较高相关。