Jamaladdin Nora, Sigaud Romain, Kocher Daniela, Kolodziejczak Anna S, Nonnenbroich Leo F, Ecker Jonas, Usta Diren, Benzel Julia, Peterziel Heike, Pajtler Kristian W, van Tilburg Cornelis M, Oehme Ina, Witt Olaf, Milde Till
Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany.
Clinical Cooperation Unit Pediatric Oncology, German Cancer Research Center (DKFZ) and German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany.
Clin Pharmacol Ther. 2023 Oct;114(4):904-913. doi: 10.1002/cpt.3002. Epub 2023 Jul 25.
Novel drug treatments for pediatric patients with cancer are urgently needed. Success of drug development in pediatric oncology has been promising, but many drugs still fail in translation from preclinical to clinical phases. To increase the translational potential, several improvements have been implemented, including the use of clinically achievable concentrations in the drug testing phase. Although pharmacokinetic (PK) parameters of numerous investigated drugs are published, a comprehensive PK overview of the most common drugs in pediatric oncology could guide preclinical trial design and improve the translatability into clinical trials. A review of the literature was conducted for PK parameters of 74 anticancer drugs, from the drug sensitivity profiling library of the INdividualized Therapy FOr Relapsed Malignancies in Childhood (INFORM) registry. PK data in the pediatric population were reported and complemented by adult parameters when no pediatric data were available. In addition, blood-brain barrier (BBB)-penetration assessment of drugs was provided by using the BBB score. Maximum plasma concentration was available for 73 (97%), area under the plasma concentration-time curve for 69 (92%), plasma protein binding for 66 (88%), plasma half-life for 57 (76%), time to maximum concentration for 54 (72%), clearance for 52 (69%), volume of distribution for 37 (49%), lowest plasma concentration reached by the drug before the next dose administration for 21 (28%), and steady-state concentration for 4 (5%) of drugs. Pediatric PK data were available for 48 (65%) drugs. We provide a comprehensive review of PK data for 74 drugs studied in pediatric oncology. This data set can serve as a reference to design experiments more closely mimicking drug PK conditions in patients, and may thereby increase the probability of successful clinical translation.
迫切需要针对患癌儿科患者的新型药物治疗方法。儿科肿瘤学药物研发已展现出良好前景,但许多药物在从临床前阶段向临床阶段转化的过程中仍遭遇失败。为提高转化潜力,已实施了多项改进措施,包括在药物测试阶段使用临床可达到的浓度。尽管已公布了众多研究药物的药代动力学(PK)参数,但对儿科肿瘤学中最常用药物进行全面的PK概述,可为临床前试验设计提供指导,并提高向临床试验转化的可行性。我们对来自儿童复发性恶性肿瘤个体化治疗(INFORM)登记处药物敏感性分析库的74种抗癌药物的PK参数进行了文献综述。报告了儿科人群的PK数据,并在无儿科数据时补充了成人参数。此外,通过血脑屏障(BBB)评分提供了药物的血脑屏障穿透评估。73种(占97%)药物有最大血浆浓度数据,69种(占92%)有血浆浓度-时间曲线下面积数据,66种(占88%)有血浆蛋白结合数据,57种(占76%)有血浆半衰期数据,54种(占72%)有达峰时间数据,52种(占69%)有清除率数据,37种(占49%)有分布容积数据,21种(占28%)有给药前药物达到的最低血浆浓度数据,4种(占5%)有稳态浓度数据。48种(占65%)药物有儿科PK数据。我们对儿科肿瘤学中研究的74种药物的PK数据进行了全面综述。该数据集可作为参考,用于设计更接近患者药物PK情况的实验,从而可能提高临床转化成功的概率。