Department of Breast Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, China.
The GCP Office, The Central Hospital of Jing'an District, Shanghai, China.
Curr Med Res Opin. 2021 Aug;37(8):1421-1433. doi: 10.1080/03007995.2021.1929895. Epub 2021 Jun 7.
Docetaxel is a widely prescribed chemotherapy drug in oncology and post expiry of its patent, the drug has been marketed as a generic by multiple manufacturers. It is also classified as a narrow therapeutic window drug. Through enhanced permeability and retention effect, polymeric micelles can passively target agents to tumor tissue, thereby decreasing toxicity of the drug in normal tissue. However, various studies have raised concerns that generic docetaxel leads to greater incidences of toxicities among patients with cancer. Thus, we herein review the pharmaceutical challenges associated with different docetaxel formulations and provide insights into the dissimilarities in the quality and safety of branded and generic docetaxel formulations. Literature review reported that 90% of the generic formulations of docetaxel contain inadequate quantity of active drug and high levels of impurities. Higher amounts of solvents such as polysorbate 80 and ethanol in docetaxel formulation lead to severe toxicities such as febrile neutropenia, hematological, and cutaneous toxicities. In most of the studies, even minor changes in excipients, solvents, unbound fraction of docetaxel were associated with adverse events, while in few, the source of docetaxel remained unidentified. One study reported incidence of febrile neutropenia due to a switch in the formulation from branded to generic. The quality, safety, and efficacy of medicines will directly affect the life of patients, and therefore, use of docetaxel formulations that guarantee safety of patients are the necessity of the hour. Being an injectable anti-cancer drug, it is important to determine the consistency of the various formulations of docetaxel globally, conduct bioequivalence studies as per the regulatory standards, taking into account the permissible limits of the excipients or the presence of such unapproved excipients.
多西他赛是一种广泛应用于肿瘤学的化疗药物,在其专利过期后,该药物已被多家制造商作为仿制药上市。它也被归类为一种治疗窗较窄的药物。通过增强通透性和保留效应,聚合物胶束可以被动地将药物靶向肿瘤组织,从而降低药物在正常组织中的毒性。然而,多项研究表明,仿制药多西他赛会导致癌症患者出现更多的毒性反应。因此,我们在此回顾了与不同多西他赛制剂相关的药物制剂挑战,并深入探讨了品牌药和仿制药多西他赛制剂在质量和安全性方面的差异。文献综述报道,90%的多西他赛仿制药制剂中活性药物含量不足,杂质水平较高。多西他赛制剂中含有较高量的聚山梨酯 80 和乙醇等溶剂,会导致发热性中性粒细胞减少症、血液学和皮肤毒性等严重毒性。在大多数研究中,即使是多西他赛赋形剂、溶剂、游离分数的微小变化也与不良事件相关,而在少数研究中,多西他赛的来源仍未确定。有一项研究报告称,由于从品牌药转换为仿制药制剂,导致出现发热性中性粒细胞减少症。药物的质量、安全性和疗效将直接影响患者的生命,因此,使用能够保证患者安全的多西他赛制剂是当务之急。作为一种注射用抗癌药物,确定全球各种多西他赛制剂的一致性,按照监管标准进行生物等效性研究非常重要,同时要考虑到赋形剂的允许限度或是否存在未经批准的赋形剂。