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食物对原肌球蛋白受体激酶抑制剂VC004药代动力学的影响:一项在中国健康受试者中进行的随机交叉试验

Food Effect on the Pharmacokinetics of VC004, a Tropomyosin Receptor Kinase Inhibitor: A Randomized Crossover Trial in Healthy Chinese Subjects.

作者信息

Hu Linlin, Sun Qiuyue, Tang Lu, Cai Mingmin, Qian Wei, Dou Ting, Wang Huiping, Wu Yong, Liu Yongqiang

机构信息

Department of Pharmacy, Nanjing Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China.

Department of Phase I Clinical Trial Unit, Nanjing Zhongda Hospital, School of Medicine, Southeast University, Nanjing, 210009, China.

出版信息

Clin Drug Investig. 2024 Jan;44(1):79-85. doi: 10.1007/s40261-023-01334-y. Epub 2023 Dec 19.

Abstract

BACKGROUND AND OBJECTIVE

VC004 is a novel next-generation tropomyosin receptor kinase (TRK) inhibitor that is approved for the treatment of advanced or metastatic NTRK fusion-positive solid tumors and abrogated the drug resistance of the first-generation TRK inhibitors. The objective of the present study was to evaluate the effect of food on the pharmacokinetics and safety of VC004.

METHODS

The study was a randomized, open-label, two-period crossover, single-dose, phase I clinical trial. A total of 16 healthy subjects participated the trial. Subjects fasted for 10 h before drug administration in both fasting and fed states. Subjects received VC004 50 mg orally in the fasting state and after a high caloric food in the fed state. Blood samples at the designated time points were collected to determine the plasma concentration of VC004. Safety evaluation in both the fasted and fed periods were assessed via vital sign monitoring and clinical laboratory tests.

RESULTS

The maximum plasma concentration (C) of VC004 in fed group decreased by 32.8%, corresponding with the slower absorption rate (time to C (T) delayed by almost 3 h) compared with the fasting group. Ratios of geometric means (GMRs) and 90% confidence intervals (90% CIs) of C, the area under the curve of plasma concentration-time from zero to the last measurable concentration (AUC), and AUC from zero to infinity (AUC) for VC004 between the two states were 67.18 (58.16-77.60), 103.59 (95.04-112.92) and 103.55 (95.63-112.11), respectively. No serious adverse events (AEs) occurred; only three grade 1 or grade 2 adverse events occurred in the fasted group, who recovered by the end of the study.

CONCLUSIONS

The intake of high calorie food decreased the absorption rate and increased the T of VC004, while the AUC values were similar in both groups. No serious adverse event was reported. In conclusion, food does not alter the pharmacokinetics and safety profile of VC004 in a clinically meaningful manner.

TRIAL REGISTRATION

ClinicalTrials.gov ID: NCT055528120.

摘要

背景与目的

VC004是一种新型的下一代原肌球蛋白受体激酶(TRK)抑制剂,已被批准用于治疗晚期或转移性NTRK融合阳性实体瘤,并消除了第一代TRK抑制剂的耐药性。本研究的目的是评估食物对VC004药代动力学和安全性的影响。

方法

该研究是一项随机、开放标签、两期交叉、单剂量的I期临床试验。共有16名健康受试者参与了试验。在禁食和进食状态下,受试者在给药前均禁食10小时。受试者在禁食状态下口服50mg VC004,并在进食状态下食用高热量食物后口服。在指定时间点采集血样以测定VC004的血浆浓度。通过生命体征监测和临床实验室检查评估禁食期和进食期的安全性。

结果

与禁食组相比,进食组VC004的最大血浆浓度(Cmax)降低了32.8%,吸收速率减慢(达峰时间(Tmax)延迟近3小时)。两种状态下VC004的Cmax、从零至最后可测浓度的血浆浓度-时间曲线下面积(AUC)以及从零至无穷大的AUC的几何均数比(GMR)和90%置信区间(90%CI)分别为67.18(58.16 - 77.60)、103.59(95.04 - 112.92)和103.55(95.63 - 112.11)。未发生严重不良事件;禁食组仅发生3例1级或2级不良事件,在研究结束时恢复。

结论

高热量食物的摄入降低了VC004的吸收速率并延长了Tmax,而两组的AUC值相似。未报告严重不良事件。总之,食物不会以临床有意义的方式改变VC004的药代动力学和安全性。

试验注册

ClinicalTrials.gov标识符:NCT055528120。

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