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一项评估质子泵抑制剂雷贝拉唑和食物对健康受试者洛拉替尼药代动力学影响的 I 期研究。

Phase 1 Study Evaluating the Effects of the Proton Pump Inhibitor Rabeprazole and Food on the Pharmacokinetics of Lorlatinib in Healthy Participants.

机构信息

Pfizer Inc., San Diego, California, USA.

Pfizer Inc., Groton, Connecticut, USA.

出版信息

Clin Pharmacol Drug Dev. 2021 Nov;10(11):1395-1404. doi: 10.1002/cpdd.1000. Epub 2021 Jul 20.

Abstract

Lorlatinib is approved worldwide as treatment for anaplastic lymphoma kinase-positive and c-ros oncogene 1-positive non-small cell lung cancer. The objectives of this phase 1, open-label crossover study (NCT02569554) in healthy adult participants were to determine (1) the effects of the proton pump inhibitor (PPI) rabeprazole on lorlatinib pharmacokinetics (PK), (2) the effects of a high-fat meal on lorlatinib PK, and (3) the relative bioavailability of an oral solution to tablet formulation of lorlatinib under fasted conditions. Participants were followed on-study for ≥50 days after the first dose of lorlatinib. Participants received treatments over 4 periods, with a washout of ≥10 days between consecutive lorlatinib doses. Twenty-seven participants were enrolled and received lorlatinib, and all were assessed for PK and safety. Results showed no effect of multiple doses of rabeprazole on the total plasma exposure of a single oral dose of lorlatinib 100-mg tablets. The results also indicated that a high-fat meal had no effect on lorlatinib PK after a single 100-mg oral dose. In addition, the relative bioavailability of lorlatinib oral solution compared with lorlatinib tablets was complete (approximately 108%). The safety profile of lorlatinib was consistent with that reported in previous studies, and most treatment-related adverse events were mild to moderate. These data indicate that lorlatinib can be administered with drugs that modify gastric acid, including PPIs, without restriction. These results also confirm that lorlatinib can be administered regardless of food intake.

摘要

洛拉替尼在全球范围内被批准用于治疗间变性淋巴瘤激酶阳性和 c-ros 原癌基因 1 阳性的非小细胞肺癌。这项在健康成年参与者中进行的 1 期、开放性交叉研究(NCT02569554)的目的是确定:(1)质子泵抑制剂(PPI)雷贝拉唑对洛拉替尼药代动力学(PK)的影响;(2)高脂肪餐对洛拉替尼 PK 的影响;(3)空腹条件下洛拉替尼口服液相对于片剂制剂的相对生物利用度。参与者在首次服用洛拉替尼后至少 50 天进行了研究随访。参与者接受了 4 个周期的治疗,连续服用洛拉替尼的洗脱期≥10 天。27 名参与者入组并接受了洛拉替尼治疗,所有参与者均进行了 PK 和安全性评估。结果表明,多次服用雷贝拉唑对单次口服 100 毫克洛拉替尼片的总血浆暴露无影响。结果还表明,单次口服 100 毫克洛拉替尼后,高脂肪餐对洛拉替尼 PK 无影响。此外,洛拉替尼口服液相对于洛拉替尼片剂的相对生物利用度完全(约 108%)。洛拉替尼的安全性特征与之前研究报告的一致,大多数与治疗相关的不良事件为轻度至中度。这些数据表明,洛拉替尼可以与改变胃酸的药物(包括 PPI)一起使用,而无需限制。这些结果还证实,无论是否进食,均可给予洛拉替尼。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/802d/9292600/f8655e816713/CPDD-10-1395-g001.jpg

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