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氟康唑对呋咱帕利在中国健康男性志愿者体内药代动力学的影响:一项开放标签、交叉研究。

Effect of fluconazole on the pharmacokinetics of fuzuloparib: an open-label, crossover study in Chinese healthy male volunteers.

机构信息

Early Clinical Trial Center, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, China.

Office of National Drug Clinical Trial Institution, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China.

出版信息

Cancer Chemother Pharmacol. 2022 Jan;89(1):141-148. doi: 10.1007/s00280-021-04376-1. Epub 2021 Dec 1.

Abstract

PURPOSE

Fuzuloparib (AiRuiYi, formerly fluzoparib, SHR3162) is a new orally active poly adenosine diphosphate ribose polymerase (PARP) inhibitor. It has multiple pharmacological activities in breast, ovarian, and prostatic cancer. Fuzuloparib is mainly metabolized through the enzyme CYP3A4 may slow fuzuloparib metabolism and increase its concentrations in blood. We evaluated the pharmacokinetics and tolerability of fuzuloparib by fluconazole, which is a broad antifungal agent and a moderate inhibitor of CYP3A4.

METHODS

In this study, the effects of CYP3A4 inhibition on the pharmacokinetics of fuzuloparib were assessed in a total of 20 healthy Chinese male subjects in an open-label, two-period, single-sequence, crossover study.

RESULTS

Pharmacokinetic parameters, including the maximal plasma concentration (C) the plasma concentration-time curve from time 0 to last measurable area under concentration (AUC), and from time 0 to infinity (AUC), were increased by 32.4%, 104.5%, and 109.6%, with corresponding 90% confidence intervals of (23-43%), (93-116%), and (98-122%), respectively, when fluconazole was combined with fuzuloparib compared to fuzuloparib alone. There was also a slight increase in the incidence of treatment emergent adverse events, including hyperlipidemia and elevated aspartate transaminase.

CONCLUSION

The fuzuloparib is 150 mg b.i.d in clinics use. Our results suggest that fuzuloparib could well be tolerated when administered as a single 20 mg oral dose alone or co-administered with 400 mg fluconazole in healthy male subjects. It is recommended to avoid using moderate CYP3A4 inhibitors together with fuzuloparib or instead of 50 mg when necessary.

摘要

目的

氟唑帕利(艾瑞颐,原氟唑帕利,SHR3162)是一种新型的口服聚腺苷二磷酸核糖聚合酶(PARP)抑制剂。它在乳腺癌、卵巢癌和前列腺癌中具有多种药理作用。氟唑帕利主要通过酶 CYP3A4 代谢,氟康唑可能会减缓氟唑帕利的代谢并增加其血液浓度。我们评估了氟康唑对氟唑帕利药代动力学和耐受性的影响,氟康唑是一种广谱抗真菌药物,也是 CYP3A4 的中度抑制剂。

方法

在这项研究中,在一项总共 20 名健康中国男性受试者的开放标签、两周期、单序列、交叉研究中,评估了 CYP3A4 抑制对氟唑帕利药代动力学的影响。

结果

与氟唑帕利单药相比,氟康唑联合氟唑帕利使药代动力学参数最大血浆浓度(C)从 0 到最后可测量浓度-时间曲线下面积(AUC)和从 0 到无穷大(AUC)分别增加 32.4%、104.5%和 109.6%,相应的 90%置信区间分别为(23-43%)、(93-116%)和(98-122%)。同时,治疗中出现的不良事件(AE)发生率也略有增加,包括高脂血症和天门冬氨酸转氨酶升高。

结论

氟唑帕利在临床中 150mg 每日两次使用。我们的结果表明,氟唑帕利单独使用时可耐受良好,当作为单次 20mg 口服剂量单独使用或与 400mg 氟康唑联合使用时,氟唑帕利可耐受良好。建议避免与氟唑帕利联合使用或在必要时改用 50mg 中度 CYP3A4 抑制剂。

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