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鲁卡帕尼在晚期卵巢癌或其他实体瘤患者中的群体药代动力学。

Population pharmacokinetics of rucaparib in patients with advanced ovarian cancer or other solid tumors.

作者信息

Green Michelle L, Ma Shu Chin, Goble Sandra, Giordano Heidi, Maloney Lara, Simmons Andrew D, Beltman Jeri, Harding Thomas C, Xiao Jim J

机构信息

Certara Strategic Consulting, Menlo Park, CA, USA.

Clovis Oncology, Inc., 5500 Flatiron Pkwy, Boulder, CO, 80301, USA.

出版信息

Cancer Chemother Pharmacol. 2022 May;89(5):671-682. doi: 10.1007/s00280-022-04413-7. Epub 2022 Apr 10.

Abstract

PURPOSE

To develop a population pharmacokinetics (PPK) model for rucaparib, an oral poly(ADP-ribose) polymerase inhibitor.

METHODS

The PPK analysis used PK data from patients in Study 1014 (NCT01009190, n = 35), Study 10 (NCT01482715, n = 123), and ARIEL2 (NCT01891344, n = 300), including intensive intravenous data (12-40 mg), intensive and sparse oral data (12-360 mg single-dose, 40-500 mg once daily, and 240-840 mg twice daily [BID]), and intensive single-dose oral data under fasted conditions and after a high-fat meal (40, 300, and 600 mg).

RESULTS

Rucaparib PK was well described by a two-compartment model with sequential zero-order release and first-order absorption and first-order elimination. A high-fat meal slightly increased bioavailability at 600 mg but not at lower doses; this is not considered clinically significant, and rucaparib can be taken with or without food. Covariate effects of baseline creatinine clearance and albumin on rucaparib clearance were identified. Despite numerical increases in exposure with renal impairment, no dose adjustment is recommended for patients with mild or moderate renal impairment. No statistically significant relationships were detected for demographics, hepatic function (normal versus mild impairment), CYP1A2 and CYP2D6 phenotypes, or strong CYP1A2 or CYP2D6 inhibitors. Concomitant proton pump inhibitors showed no clinically significant effect on absorption. External validation of the model with data from ARIEL3 (NCT01968213) and TRITON2 (NCT02952534) studies showed no clinically meaningful PK differences across indications or sex.

CONCLUSION

The PPK model adequately described rucaparib PK, and none of the covariates evaluated had a clinically relevant effect.

CLINICALTRIALS

GOV: Study 1014 (NCT01009190), Study 10 (NCT01482715), ARIEL2 (NCT01891344), ARIEL3 (NCT01968213), and TRITON2 (NCT02952534).

摘要

目的

建立口服聚(ADP - 核糖)聚合酶抑制剂鲁卡帕尼的群体药代动力学(PPK)模型。

方法

PPK分析使用了来自研究1014(NCT01009190,n = 35)、研究10(NCT01482715,n = 123)和ARIEL2(NCT01891344,n = 300)患者的药代动力学数据,包括强化静脉给药数据(12 - 40毫克)、强化和稀疏口服给药数据(12 - 360毫克单剂量、40 - 500毫克每日一次以及240 - 840毫克每日两次[BID]),以及禁食条件下和高脂餐后的强化单剂量口服数据(40、300和600毫克)。

结果

鲁卡帕尼的药代动力学可用具有顺序零级释放、一级吸收和一级消除的二室模型很好地描述。高脂餐在600毫克剂量时略微增加了生物利用度,但在较低剂量时未增加;这在临床上不被认为具有显著意义,鲁卡帕尼可以与食物同服或空腹服用。确定了基线肌酐清除率和白蛋白对鲁卡帕尼清除率的协变量效应。尽管肾功能损害时暴露量有数值上的增加,但不建议对轻度或中度肾功能损害患者进行剂量调整。在人口统计学、肝功能(正常与轻度损害)、CYP1A2和CYP2D6表型或强效CYP1A2或CYP2D6抑制剂方面未检测到统计学上显著的关系。同时使用质子泵抑制剂对吸收未显示出临床上显著的影响。用来自ARIEL3(NCT01968213)和TRITON2(NCT02952534)研究的数据对模型进行外部验证,结果显示不同适应症或性别之间在临床上没有有意义的药代动力学差异。

结论

PPK模型充分描述了鲁卡帕尼的药代动力学,并且所评估的协变量均无临床相关影响。

临床试验

政府编号:研究1014(NCT01009190)、研究10(NCT01482715)、ARIEL2(NCT01891344)、ARIEL3(NCT01968213)和TRITON2(NCT0295253)。

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