在非小细胞肺癌荷兰成人队列中对奥希替尼群体药代动力学模型进行系统评估

IF 1.9 4区 医学 Q3 PHARMACOLOGY & PHARMACY
Niels Westra, Paul D Kruithof, Sander Croes, Robin M J M van Geel, Lizza E L Hendriks, Daan J Touw, Thijs H Oude Munnink, Paola Mian
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引用次数: 0

摘要

背景和目的:已有多项群体药代动力学(popPK)研究报道,这些研究可指导预测个体患者的奥希替尼血浆浓度。目前尚不清楚哪种 popPK 模型具有最佳的预测性能,也不清楚哪种 popPK 模型最适合用于非依从性管理和以模型为依据的精准用药。因此,本研究的目的是对现有文献中的所有奥希替尼 popPK 模型进行外部验证:使用 NONMEM 7.4.4 版构建了已发表的奥希替尼 popPK 模型。通过拟合优度(GoF)图、条件加权残差(CWRES)图和预测校正视觉预测检查(pcVPC)对奥西替尼及其活性代谢物 AZ5104 的预测质量进行评估。荷兰OSIBOOST试验的一个子集被用作评估队列,该试验纳入了11名奥西替尼暴露较低的患者:结果:所有四种模型的群体GoF图都不太符合特征线。在单个 GoF 图中,所有模型的表现相当,且紧密分布在同一直线上。四个模型的 CWRES 均呈倾斜状。所有四个模型的 pcVPCs 都显示出相似的趋势,即所有观测浓度都落在模拟阴影区域,但都落在模拟区域的较低区域:结论:所有四种 popPK 模型都可用于单独预测奥希替尼暴露量较低的患者的奥希替尼浓度。在群体预测方面,所有四种 popPK 模型在奥希替尼暴露量较低的患者中均表现不佳。应针对奥希替尼暴露量低的患者开发一种预测性能良好的新型 popPK 模型。理想情况下,我们的评估队列中奥西替尼暴露量相对较低的原因应该是已知的:临床试验注册:NCT03858491。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Systematic Evaluation of Osimertinib Population Pharmacokinetic Models in a Cohort of Dutch Adults with Non-Small Cell Lung Cancer.

Systematic Evaluation of Osimertinib Population Pharmacokinetic Models in a Cohort of Dutch Adults with Non-Small Cell Lung Cancer.

Background and objective: Several population pharmacokinetic (popPK) studies have been reported that can guide the prediction of osimertinib plasma concentrations in individual patients. It is currently unclear which popPK model offers the best predictive performance and which popPK models are most suitable for nonadherence management and model-informed precision dosing. Therefore, the objective of this study was to externally validate all osimertinib popPK models available in the current literature.

Methods: Published popPK models for osimertinib were constructed using NONMEM version 7.4.4. The predictive quality of the identified models was assessed with goodness-of-fit (GoF) plots, conditional weighted residuals (CWRES) plots and a prediction-corrected visual predictive check (pcVPC) for osimertinib and its active metabolite AZ5104. A subset from the Dutch OSIBOOST trial, where 11 patients with low osimertinib exposure were included, was used as evaluation cohort.

Results: The population GoF plots for all four models poorly followed the line of identity. For the individual GoF plots, all models performed comparable and were closely distributed among the line of identity. CWRES of the four models were skewed. The pcVPCs of all four models showed a similar trend, where all observed concentrations fell in the simulated shaded areas, but in the lower region of the simulated areas.

Conclusion: All four popPK models can be used to individually predict osimertinib concentrations in patients with low osimertinib exposure. For population predictions, all four popPK models performed poorly in patients with low osimertinib exposure. A novel popPK model with good predictive performance should be developed for patients with low osimertinib exposure. Ideally, the cause for the relatively low osimertinib exposure in our evaluation cohort should be known.

Clinical trials registration: NCT03858491.

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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
64
审稿时长
>12 weeks
期刊介绍: Hepatology International is a peer-reviewed journal featuring articles written by clinicians, clinical researchers and basic scientists is dedicated to research and patient care issues in hepatology. This journal focuses mainly on new and emerging diagnostic and treatment options, protocols and molecular and cellular basis of disease pathogenesis, new technologies, in liver and biliary sciences. Hepatology International publishes original research articles related to clinical care and basic research; review articles; consensus guidelines for diagnosis and treatment; invited editorials, and controversies in contemporary issues. The journal does not publish case reports.
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