A Novel Empirical Autoinduction Model to Characterize the Population Pharmacokinetics and Recommend Dose for Repotrectinib in Adult and Adolescents With Advanced Solid Tumors Harboring ALK, ROS1, or NTRK1-3 Rearrangements.

IF 3.1 3区 医学 Q2 PHARMACOLOGY & PHARMACY
Shengnan Du, Zheyi Hu, Jun Shen, Lora Hamuro, Justine Lam, Ming Lu, Li Zhu, Amit Roy, Anna Kondic
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Abstract

Repotrectinib is approved in the US for treating ROS1-positive non-small cell lung cancer (NSCLC) and solid tumors harboring an NTRK gene fusion. A Population Pharmacokinetic (PopPK) model for repotrectinib was developed using data from 620 adults (118 healthy volunteers and 502 patients) across seven studies and 24 pediatric patients from one study. The PopPK model, a two-compartment model with first-order absorption and an absorption lag time, incorporating a time-varying clearance due to drug-induced autoinduction, adequately described all PK data. Clearance was modeled as a time- and concentration-dependent (Ctrough) autoinduction process, accounting for increased clearance over time. While empirical in nature, this Ctrough-driven autoinduction model effectively described the changes in clearance and avoided the abrupt concentration changes that can occur with discrete dose-driven autoinduction models. Additionally, this approach avoided time-consuming differential equation computations for the semi-mechanistic enzyme turnover autoinduction models. The model estimated that the maximum drug-induced clearance (CLMAX) was 4.9 times the baseline clearance. Body weight (BW) effects on clearance and volume of distribution were estimated as allometric scaling exponents of 0.477 and 0.962, respectively. Age was found to affect CLMAX, with younger patients generally exhibiting higher CLMAX values. Simulations suggested that a flat dosing regimen (e.g., 160 mg QD for 14 days followed by 160 mg BID) provides comparable drug exposures in both adult and adolescent patients. The PopPK model supported the health authority approval of the dosing regimen for repotrectinib in both adult and adolescent patients with NTRK gene fusion-positive solid tumors.

一种新的经验自诱导模型表征成人和青少年晚期实体肿瘤患者ALK、ROS1或NTRK1-3重排的群体药代动力学和推荐剂量
Repotrectinib在美国被批准用于治疗ros1阳性的非小细胞肺癌(NSCLC)和含有NTRK基因融合的实体瘤。采用7项研究的620名成年人(118名健康志愿者和502名患者)和1项研究的24名儿科患者的数据,建立了repotrectinib的群体药代动力学(PopPK)模型。PopPK模型是一种具有一阶吸收和吸收滞后时间的两室模型,包含药物诱导的自诱导引起的时变清除率,充分描述了所有的PK数据。清除被建模为一个时间和浓度依赖(Ctrough)的自诱导过程,考虑到随着时间的推移而增加的清除。虽然本质上是经验性的,但这个槽驱动的自感应模型有效地描述了间隙的变化,并避免了离散剂量驱动的自感应模型可能出现的浓度突变。此外,该方法避免了耗时的半机械酶周转自诱导模型的微分方程计算。该模型估计最大药物诱导清除率(CLMAX)是基线清除率的4.9倍。体重(BW)对清除率和体积分布的影响分别为0.477和0.962。发现年龄影响CLMAX,年轻患者通常表现出较高的CLMAX值。模拟表明,在成人和青少年患者中,固定给药方案(例如,每日160毫克,持续14天,然后是每日160毫克BID)提供了相当的药物暴露。PopPK模型支持卫生当局批准repotrectinib用于NTRK基因融合阳性实体瘤的成人和青少年患者的给药方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.00
自引率
11.40%
发文量
146
审稿时长
8 weeks
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