Sasaki Y
Gan To Kagaku Ryoho. 1994 Oct;21 Suppl 3:310-4.
The role of clinical pharmacology in the development of new anticancer agents is discussed. In phase I studies, analysis of pharmacokinetic (PK) and pharmacodynamic (PD) relationship, in other words, the relationship among dose administered, pharmacological parameters and pharmacodynamic effects, is essential in the dose escalating process. In addition, we must pay careful attention to whether linearity between the dose administered and the pharmacological parameters is observed or not so as to assure a safe dose escalation strategy. Comparative analysis of the pharmacokinetics and pharmacodynamics between animal models and patients are also an important factor in safe dose escalation. A simple dose escalation strategy will be possible in such agents as the results of phase I are available in other countries. The concept of pharmacokinetic and/or pharmacodynamic drug interactions is essential in a combination phase I study, although this is not covered in the Good Clinical Practice (GCP) guideline. Pharmacological analysis should continue phase II studies to obtain a more accurate PK/PD relationship not only as to the side effects but also the clinical response, in order to analyze intra- or inter-patient variability in pharmacokinetics as well as pharmacodynamics. This would also be useful to establish population pharmacokinetic model or limited sampling strategy for phase III evaluation.
本文讨论了临床药理学在新型抗癌药物研发中的作用。在I期研究中,分析药代动力学(PK)和药效动力学(PD)关系,即给药剂量、药理学参数和药效学效应之间的关系,在剂量递增过程中至关重要。此外,我们必须密切关注给药剂量与药理学参数之间是否呈线性关系,以确保安全的剂量递增策略。动物模型与患者之间药代动力学和药效动力学的比较分析也是安全剂量递增的重要因素。对于在其他国家已获得I期研究结果的药物,采用简单的剂量递增策略是可行的。尽管《药物临床试验质量管理规范》(GCP)指南未涵盖,但药代动力学和/或药效动力学药物相互作用的概念在I期联合研究中至关重要。药理学分析应贯穿II期研究,以获得更准确的PK/PD关系,不仅涉及副作用,还包括临床反应,从而分析患者体内或患者间药代动力学和药效动力学的变异性。这对于建立群体药代动力学模型或用于III期评估的有限采样策略也将是有用的。