Global population pharmacokinetics of the investigational Aurora A kinase inhibitor alisertib in cancer patients: rationale for lower dosage in Asia
Autor: | Emily Sheldon-Waniga, Diane R. Mould, Takatoshi Takubo, Xiaofei Zhou, Karthik Venkatakrishnan, Ashley Milton, Dirk Huebner |
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Rok vydání: | 2017 |
Předmět: |
Oncology
medicine.medical_specialty Population Pharmacology Neutropenia 030226 pharmacology & pharmacy law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Pharmacokinetics law Internal medicine medicine Mucositis Pharmacology (medical) Dosing education education.field_of_study Clinical pharmacology business.industry medicine.disease Bioavailability chemistry 030220 oncology & carcinogenesis Alisertib business |
Zdroj: | British Journal of Clinical Pharmacology. 84:35-51 |
ISSN: | 0306-5251 |
Popis: | Aims This population pharmacokinetic analysis was conducted to describe quantitatively the regional differences and sources of interpatient variability on the apparent oral clearance of alisertib. Methods A population pharmacokinetic analysis was performed on data from 671 cancer patients in Western countries and in Japan/East Asia to whom alisertib 5–150 mg once or twice daily (b.i.d.) was administered in multiple dosing schedules. The final model was used to simulate alisertib pharmacokinetics in patients in the West and East Asian regions in the single-agent schedule of 7 days of dosing in a 21-day cycle. Exposure–safety relationships for mechanism-related antiproliferative toxicities (neutropenia, mucositis and diarrhoea) were estimated by logistic regression. Results Alisertib pharmacokinetics were described by a two-compartment model with four-transit compartment absorption and linear elimination. The final model included a covariate effect of region on relative bioavailability, with patients in the East Asian region estimated to have a 52% higher bioavailability compared with Western patients. Population simulated exposure at 30 mg b.i.d. in patients in Asia was similar to that at 50 mg b.i.d. in Western patients [geometric mean (coefficient of variation) steady state area under the concentration-time curve over the dosing interval (AUC(0–τ)): 21.4 μM.h (52.3%) and 24.1 μM.h (53.6%), respectively]. Exposure–AE relationships could be described for neutropenia, stomatitis and diarrhoea, supporting the lower dosage of alisertib in Asia for global clinical development. Conclusions Model-based simulations support the achievement of similar alisertib exposures in patients in Asia who are administered a 40% lower dose compared with the Western population, thereby providing a quantitative clinical pharmacology bridging and regional dosing rationale for global drug development. |
Databáze: | OpenAIRE |
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