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Kikuchi R, Chothe PP, Chu X, Huth F, Ishida K, Ishiguro N, Jiang R, Shen H, Stahl SH, Varma MVS, Willemin ME, Morse BL. Utilization of OATP1B Biomarker Coproporphyrin-I to Guide Drug-Drug Interaction Risk Assessment: Evaluation by the Pharmaceutical Industry. Clin Pharmacol Ther 2023; 114:1170-1183. [PMID: 37750401 DOI: 10.1002/cpt.3062] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023]
Abstract
Drug-drug interactions (DDIs) involving hepatic organic anion transporting polypeptides 1B1/1B3 (OATP1B) can be substantial, however, challenges remain for predicting interaction risk. Emerging evidence suggests that endogenous biomarkers, particularly coproporphyrin-I (CP-I), can be used to assess in vivo OATP1B activity. The present work under the International Consortium for Innovation and Quality in Pharmaceutical Development was aimed primarily at assessing CP-I as a biomarker for informing OATP1B DDI risk. Literature and unpublished CP-I data along with pertinent in vitro and clinical DDI information were collected to identify DDIs primarily involving OATP1B inhibition and assess the relationship between OATP1B substrate drug and CP-I exposure changes. Static models to predict changes in exposure of CP-I, as a selective OATP1B substrate, were also evaluated. Significant correlations were observed between CP-I area under the curve ratio (AUCR) or maximum concentration ratio (Cmax R) and AUCR of substrate drugs. In general, the CP-I Cmax R was equal to or greater than the CP-I AUCR. CP-I Cmax R < 1.25 was associated with absence of OATP1B-mediated DDIs (AUCR < 1.25) with no false negative predictions. CP-I Cmax R < 2 was associated with weak OATP1B-mediated DDIs (AUCR < 2). A correlation was identified between CP-I exposure changes and OATP1B1 static DDI predictions. Recommendations for collecting and interpreting CP-I data are discussed, including a decision tree for guiding DDI risk assessment. In conclusion, measurement of CP-I is recommended to inform OATP1B inhibition potential. The current analysis identified changes in CP-I exposure that may be used to prioritize, delay, or replace clinical DDI studies.
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Affiliation(s)
- Ryota Kikuchi
- Quantitative, Translational and ADME Sciences, AbbVie Inc., North Chicago, Illinois, USA
| | - Paresh P Chothe
- Global Drug Metabolism and Pharmacokinetics, Takeda Development Center Americas, Inc. (TDCA), Lexington, Massachusetts, USA
| | - Xiaoyan Chu
- ADME and Discovery Toxicology, Merck & Co., Inc., Rahway, New Jersey, USA
| | - Felix Huth
- PK Sciences, Novartis Pharma AG, Basel, Switzerland
| | - Kazuya Ishida
- Drug Metabolism, Gilead Sciences Inc., Foster City, California, USA
| | - Naoki Ishiguro
- Pharmacokinetics and Non-Clinical Safety Department, Nippon Boehringer Ingelheim Co., Ltd., Kobe, Japan
| | - Rongrong Jiang
- Drug Metabolism and Pharmacokinetics, Eisai Inc., Cambridge, Massachusetts, USA
| | - Hong Shen
- Departments of Drug Metabolism and Pharmacokinetics, Bristol Myers Squibb Research and Development, Princeton, New Jersey, USA
| | - Simone H Stahl
- CVRM Safety, Clinical Pharmacology and Safety Sciences, R&D, AstraZeneca, Cambridge, UK
| | - Manthena V S Varma
- Pharmacokinetics, Dynamics and Metabolism, Medicine Design, Pfizer Inc., Groton, Connecticut, USA
| | - Marie-Emilie Willemin
- Drug Metabolism and Pharmacokinetics, Janssen Research and Development, a Division of Janssen Pharmaceutica NV, Beerse, Belgium
| | - Bridget L Morse
- Department of Drug Disposition, Eli Lilly, Indianapolis, Indiana, USA
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2
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Takahashi RH, Malhi V, Liederer BM, Cho S, Deng Y, Dean B, Nugteren J, Yost E, Al-Sayah MA, Sane R, Kshirsagar S, Ma S, Musib L. The Absolute Bioavailability and Absorption, Metabolism, and Excretion of Ipatasertib, a Potent and Highly Selective Protein Kinase B (Akt) Inhibitor. Drug Metab Dispos 2023; 51:1332-1341. [PMID: 37524543 DOI: 10.1124/dmd.122.001175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 07/06/2023] [Accepted: 07/21/2023] [Indexed: 08/02/2023] Open
Abstract
Ipatasertib (GDC-0068) is a potent, highly selective, small-molecule inhibitor of protein kinase B (Akt) being developed by Genentech/Roche as a single agent and in combination with other therapies for the treatment of cancers. To fully understand the absorption, metabolism, and excretion of ipatasertib in humans, an open-label study using 14C-radiolabeled ipatasertib was completed to characterize the absolute bioavailability (period 1) and mass balance and metabolite profiling (period 2). In period 1, subjects were administered a 200 mg oral dose of ipatasertib followed by an 80 μg (800 nCi) intravenous dose of [14C]-ipatasertib. In period 2, subjects received a single oral dose containing approximately 200 mg (100 μCi) [14C]-ipatasertib. In an integrated analytical strategy, accelerator mass spectrometry was applied to measure the 14C microtracer intravenous pharmacokinetics in period 1 and fully profile plasma radioactivity in period 2. The systemic plasma clearance and steady-state volume of distribution were 98.8 L/h and 2530 L, respectively. The terminal half-lives after oral and intravenous administrations were similar (26.7 and 27.4 hours, respectively) and absolute bioavailability of ipatasertib was 34.0%. After a single oral dose of [14C]-ipatasertib, 88.3% of the administered radioactivity was recovered with approximately 69.0% and 19.3% in feces and urine, respectively. Radioactivity in feces and urine was predominantly metabolites with 24.4% and 8.26% of dose as unchanged parent, respectively; indicating that ipatasertib had been extensively absorbed and hepatic metabolism was the major route of clearance. The major metabolic pathway was N-dealkylation mediated by CYP3A, and minor pathways were oxidative by cytochromes P450 and aldehyde oxidase. SIGNIFICANCE STATEMENT: The study provided definitive information regarding the absolute bioavailability and the absorption, metabolism, and excretion pathways of ipatasertib, a potent, novel, and highly selective small-molecule inhibitor of protein kinase B (Akt). An ultrasensitive radioactive counting method, accelerator mass spectrometry was successfully applied for 14C-microtracer absolute bioavailability determination and plasma metabolite profiling.
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Affiliation(s)
- Ryan H Takahashi
- Drug Metabolism and Pharmacokinetics (R.H.T., B.M.L., S.C., Y.D., B.D., S.M.), Clinical Pharmacology (V.M., R.S., S.K., L.M.), BioAnalytical Sciences (J.N.), Small Molecule Pharmaceutics (E.Y.), and Small Molecule Analytical Chemistry (M.A.A.-S.), Genentech Inc., South San Francisco, California
| | - Vikram Malhi
- Drug Metabolism and Pharmacokinetics (R.H.T., B.M.L., S.C., Y.D., B.D., S.M.), Clinical Pharmacology (V.M., R.S., S.K., L.M.), BioAnalytical Sciences (J.N.), Small Molecule Pharmaceutics (E.Y.), and Small Molecule Analytical Chemistry (M.A.A.-S.), Genentech Inc., South San Francisco, California
| | - Bianca M Liederer
- Drug Metabolism and Pharmacokinetics (R.H.T., B.M.L., S.C., Y.D., B.D., S.M.), Clinical Pharmacology (V.M., R.S., S.K., L.M.), BioAnalytical Sciences (J.N.), Small Molecule Pharmaceutics (E.Y.), and Small Molecule Analytical Chemistry (M.A.A.-S.), Genentech Inc., South San Francisco, California
| | - Sungjoon Cho
- Drug Metabolism and Pharmacokinetics (R.H.T., B.M.L., S.C., Y.D., B.D., S.M.), Clinical Pharmacology (V.M., R.S., S.K., L.M.), BioAnalytical Sciences (J.N.), Small Molecule Pharmaceutics (E.Y.), and Small Molecule Analytical Chemistry (M.A.A.-S.), Genentech Inc., South San Francisco, California
| | - Yuzhong Deng
- Drug Metabolism and Pharmacokinetics (R.H.T., B.M.L., S.C., Y.D., B.D., S.M.), Clinical Pharmacology (V.M., R.S., S.K., L.M.), BioAnalytical Sciences (J.N.), Small Molecule Pharmaceutics (E.Y.), and Small Molecule Analytical Chemistry (M.A.A.-S.), Genentech Inc., South San Francisco, California
| | - Brian Dean
- Drug Metabolism and Pharmacokinetics (R.H.T., B.M.L., S.C., Y.D., B.D., S.M.), Clinical Pharmacology (V.M., R.S., S.K., L.M.), BioAnalytical Sciences (J.N.), Small Molecule Pharmaceutics (E.Y.), and Small Molecule Analytical Chemistry (M.A.A.-S.), Genentech Inc., South San Francisco, California
| | - James Nugteren
- Drug Metabolism and Pharmacokinetics (R.H.T., B.M.L., S.C., Y.D., B.D., S.M.), Clinical Pharmacology (V.M., R.S., S.K., L.M.), BioAnalytical Sciences (J.N.), Small Molecule Pharmaceutics (E.Y.), and Small Molecule Analytical Chemistry (M.A.A.-S.), Genentech Inc., South San Francisco, California
| | - Edward Yost
- Drug Metabolism and Pharmacokinetics (R.H.T., B.M.L., S.C., Y.D., B.D., S.M.), Clinical Pharmacology (V.M., R.S., S.K., L.M.), BioAnalytical Sciences (J.N.), Small Molecule Pharmaceutics (E.Y.), and Small Molecule Analytical Chemistry (M.A.A.-S.), Genentech Inc., South San Francisco, California
| | - Mohammad A Al-Sayah
- Drug Metabolism and Pharmacokinetics (R.H.T., B.M.L., S.C., Y.D., B.D., S.M.), Clinical Pharmacology (V.M., R.S., S.K., L.M.), BioAnalytical Sciences (J.N.), Small Molecule Pharmaceutics (E.Y.), and Small Molecule Analytical Chemistry (M.A.A.-S.), Genentech Inc., South San Francisco, California
| | - Rucha Sane
- Drug Metabolism and Pharmacokinetics (R.H.T., B.M.L., S.C., Y.D., B.D., S.M.), Clinical Pharmacology (V.M., R.S., S.K., L.M.), BioAnalytical Sciences (J.N.), Small Molecule Pharmaceutics (E.Y.), and Small Molecule Analytical Chemistry (M.A.A.-S.), Genentech Inc., South San Francisco, California
| | - Smita Kshirsagar
- Drug Metabolism and Pharmacokinetics (R.H.T., B.M.L., S.C., Y.D., B.D., S.M.), Clinical Pharmacology (V.M., R.S., S.K., L.M.), BioAnalytical Sciences (J.N.), Small Molecule Pharmaceutics (E.Y.), and Small Molecule Analytical Chemistry (M.A.A.-S.), Genentech Inc., South San Francisco, California
| | - Shuguang Ma
- Drug Metabolism and Pharmacokinetics (R.H.T., B.M.L., S.C., Y.D., B.D., S.M.), Clinical Pharmacology (V.M., R.S., S.K., L.M.), BioAnalytical Sciences (J.N.), Small Molecule Pharmaceutics (E.Y.), and Small Molecule Analytical Chemistry (M.A.A.-S.), Genentech Inc., South San Francisco, California
| | - Luna Musib
- Drug Metabolism and Pharmacokinetics (R.H.T., B.M.L., S.C., Y.D., B.D., S.M.), Clinical Pharmacology (V.M., R.S., S.K., L.M.), BioAnalytical Sciences (J.N.), Small Molecule Pharmaceutics (E.Y.), and Small Molecule Analytical Chemistry (M.A.A.-S.), Genentech Inc., South San Francisco, California
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Chan GH, Houle R, Zhang J, Katwaru R, Li Y, Chu X. Evaluation of the Selectivity of Several Organic Anion Transporting Polypeptide 1B Biomarkers Using Relative Activity Factor Method. Drug Metab Dispos 2023; 51:1089-1104. [PMID: 37137718 DOI: 10.1124/dmd.122.000972] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 04/13/2023] [Accepted: 05/01/2023] [Indexed: 05/05/2023] Open
Abstract
In recent years, some endogenous substrates of organic anion transporting polypeptide 1B (OATP1B) have been identified and characterized as potential biomarkers to assess OATP1B-mediated clinical drug-drug interactions (DDIs). However, quantitative determination of their selectivity to OATP1B is still limited. In this study, we developed a relative activity factor (RAF) method to determine the relative contribution of hepatic uptake transporters OATP1B1, OATP1B3, OATP2B1, and sodium-taurocholate co-transporting polypeptide (NTCP) on hepatic uptake of several OATP1B biomarkers, including coproporphyrin I (CPI), coproporphyrin I CPIII, and sulfate conjugates of bile acids: glycochenodeoxycholic acid sulfate (GCDCA-S), glycodeoxycholic acid sulfate (GDCA-S), and taurochenodeoxycholic acid sulfate (TCDCA-S). RAF values for OATP1B1, OATP1B3, OATP2B1, and NTCP were determined in cryopreserved human hepatocytes and transporter transfected cells using pitavastatin, cholecystokinin, resveratrol-3-O-β-D-glucuronide, and taurocholic acid (TCA) as reference compounds, respectively. OATP1B1-specific pitavastatin uptake in hepatocytes was measured in the absence and presence of 1 µM estropipate, whereas NTCP-specific TCA uptake was measured in the presence of 10 µM rifampin. Our studies suggested that CPI was a more selective biomarker for OATP1B1 than CPIII, whereas GCDCA-S and TCDCA-S were more selective to OATP1B3. OATP1B1 and OATP1B3 equally contributed to hepatic uptake of GDCA-S. The mechanistic static model, incorporating the fraction transported of CPI/III estimated by RAF and in vivo elimination data, predicted several perpetrator interactions with CPI/III. Overall, RAF method combined with pharmacogenomic and DDI studies is a useful tool to determine the selectivity of transporter biomarkers and facilitate the selection of appropriate biomarkers for DDI evaluation. SIGNIFICANCE STATEMENT: The authors developed a new relative activity factor (RAF) method to quantify the contribution of hepatic uptake transporters organic anion transporting polypeptide (OATP)1B1, OATP1B3, OATP2B1, and sodium taurocholate co-transporting polypeptide (NTCP) on several OATP1B biomarkers and evaluated their predictive value on drug-drug interactions (DDI). These studies suggest that the RAF method is a useful tool to determine the selectivity of transporter biomarkers. This method combined with pharmacogenomic and DDI studies will mechanistically facilitate the selection of appropriate biomarkers for DDI prediction.
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Affiliation(s)
- Grace Hoyee Chan
- ADME and Discovery Toxicity, Merck & Co., Inc., Rahway, New Jersey
| | - Robert Houle
- ADME and Discovery Toxicity, Merck & Co., Inc., Rahway, New Jersey
| | - Jinghui Zhang
- ADME and Discovery Toxicity, Merck & Co., Inc., Rahway, New Jersey
| | - Ravi Katwaru
- ADME and Discovery Toxicity, Merck & Co., Inc., Rahway, New Jersey
| | - Yang Li
- ADME and Discovery Toxicity, Merck & Co., Inc., Rahway, New Jersey
| | - Xiaoyan Chu
- ADME and Discovery Toxicity, Merck & Co., Inc., Rahway, New Jersey
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Hu C, Zhang Y, Pei T, Liu P, Zhang L. Itraconazole interferes in the pharmacokinetics of fuzuloparib in healthy volunteers. Cancer Chemother Pharmacol 2023; 91:523-529. [PMID: 37166499 DOI: 10.1007/s00280-023-04536-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 04/21/2023] [Indexed: 05/12/2023]
Abstract
OBJECTIVE Fuzuloparib is an orally administered poly [ADP-ribose] polymerase 1 (PARP1) inhibitor and has potential anti-tumor effect on ovarian cancer (such as fallopian tube cancer and primary peritoneal cancer) in China. As fuzuloparib is metabolized mainly by CYP3A4, we explored the effect of itraconazole, a strong CYP3A4 inhibitor, on a single oral dose of fuzuloparib in healthy male subjects. METHODS An open-label, single-arm, fixed sequence study was conducted. Twenty healthy adult males received one single dose of fuzuloparib (20 mg) with one dose administered alone and the other dose coadministered with itraconazole. Subjects received 200 mg QD itraconazole for 6 days during the study. Serials of blood samples were collected pre-dose of each fuzuloparib capsule administration and 48 h post-dose, and were used to analyze the PK parameters of fuzuloparib. RESULTS Coadministration of repeated 200 mg QD oral doses of itraconazole for 6 days increased fuzuloparib exposure by 1.51-fold and 4.81-fold for peak plasma concentration and area under the plasma concentration-time curve (AUC), respectively. Oral administration of 20 mg fuzuloparib alone or together with itraconazole was safe and tolerable in healthy male subjects. CONCLUSION The CYP3A4 inhibitor itraconazole has a significant influence on the PK behavior of fuzuloparib, suggesting to avoid using strong CYP3A4 inhibitors simultaneously with fuzuloparib. If it is necessary to use a strong CYP3A4 inhibitor, fuzuloparib would be discontinued and be restored to the original dose and frequency of administration after 5-7 half lives of CYP3A4 inhibitor stopped. TRIAL REGISTRATION http://www.chinadrugtrials.org.cn/index.html , CTR20191271.
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Affiliation(s)
- Chaoying Hu
- Phase I Clinical Trial Unit, Department of Pharmacy, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
| | - Yanping Zhang
- Phase I Clinical Trial Unit, Department of Pharmacy, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
| | - Tong Pei
- Phase I Clinical Trial Unit, Department of Pharmacy, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
| | - Ping Liu
- Phase I Clinical Trial Unit, Department of Pharmacy, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
| | - Lan Zhang
- Phase I Clinical Trial Unit, Department of Pharmacy, Xuanwu Hospital Capital Medical University, Beijing, 100053, China.
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5
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Sutaria DS, Agarwal P, Huang K, Miles DR, Rotmensch J, Hinton H, Gallo JD, Rasuo G, Sane RS. Mitigating ipatasertib-induced glucose increase through dose and meal timing modifications. Clin Transl Sci 2022; 15:2989-2999. [PMID: 36197694 PMCID: PMC9747122 DOI: 10.1111/cts.13420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 09/03/2022] [Indexed: 01/26/2023] Open
Abstract
Ipatasertib, an AKT inhibitor, in combination with prednisone and abiraterone, is under evaluation for the treatment of metastatic castration-resistant prostate cancer (mCRPC). Hyperglycemia is an on-target effect of ipatasertib. An open-label, single-arm, single-sequence, signal-seeking study (n = 25 mCRPC patients) was conducted to evaluate the glucose changes across four different treatment periods: ipatasertib alone, ipatasertib-prednisone combination, ipatasertib-prednisone-abiraterone combination (morning dose), and ipatasertib-prednisone-abiraterone combination (evening dose). Continuous glucose monitoring (CGM) was used in this study to compare the dynamic glucose changes across the different treatment periods. Four key parameters: average glucose, peak glucose and % time in range (70-180 and >180 mg/dl) were evaluated for this comparison. Ipatasertib-prednisone-abiraterone combination when administered in the morning after an overnight fast significantly increased average glucose, peak glucose and % time in range >180 mg/dl compared to ipatasertib monotherapy. Ipatasertib, when co-administered with abiraterone, increased ipatasertib and M1 (G-037720) metabolite exposures by approximately 1.5- and 2.2-fold, respectively. Exposure-response analysis results show that increased exposures of ipatasertib in combination with abiraterone are associated with increased glucose levels. When ipatasertib-prednisone-abiraterone combination was administered as an evening dose compared to a morning dose, lowered peak glucose and improved % time in range was observed. The results from this study suggest that dosing ipatasertib after an evening meal followed by overnight fasting can be an effective strategy for managing increased glucose levels.
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6
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Garrison DA, Jin Y, Talebi Z, Hu S, Sparreboom A, Baker SD, Eisenmann ED. Itraconazole-Induced Increases in Gilteritinib Exposure Are Mediated by CYP3A and OATP1B. Molecules 2022; 27:molecules27206815. [PMID: 36296409 PMCID: PMC9610999 DOI: 10.3390/molecules27206815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 10/07/2022] [Accepted: 10/08/2022] [Indexed: 11/25/2022] Open
Abstract
Gilteritinib, an FDA-approved tyrosine kinase inhibitor approved for the treatment of relapsed/refractory FLT3-mutated acute myeloid leukemia, is primarily eliminated via CYP3A4-mediated metabolism, a pathway that is sensitive to the co-administration of known CYP3A4 inhibitors, such as itraconazole. However, the precise mechanism by which itraconazole and other CYP3A-modulating drugs affect the absorption and disposition of gilteritinib remains unclear. In the present investigation, we demonstrate that pretreatment with itraconazole is associated with a significant increase in the systemic exposure to gilteritinib in mice, recapitulating the observed clinical drug–drug interaction. However, the plasma levels of gilteritinib were only modestly increased in CYP3A-deficient mice and not further influenced by itraconazole. Ensuing in vitro and in vivo studies revealed that gilteritinib is a transported substrate of OATP1B-type transporters, that gilteritinib exposure is increased in mice with OATP1B2 deficiency, and that the ability of itraconazole to inhibit OATP1B-type transport in vivo is contingent on its metabolism by CYP3A isoforms. These findings provide new insight into the pharmacokinetic properties of gilteritinib and into the molecular mechanisms underlying drug–drug interactions with itraconazole.
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Affiliation(s)
- Dominique A. Garrison
- Division of Pharmaceutics and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
| | - Yan Jin
- Division of Pharmaceutics and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
| | - Zahra Talebi
- Division of Pharmaceutics and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
| | - Shuiying Hu
- Division of Pharmaceutics and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
- Division of Outcomes and Translational Sciences, The Ohio State University, Columbus, OH 43210, USA
| | - Alex Sparreboom
- Division of Pharmaceutics and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
| | - Sharyn D. Baker
- Division of Pharmaceutics and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
| | - Eric D. Eisenmann
- Division of Pharmaceutics and Pharmacology, The Ohio State University, Columbus, OH 43210, USA
- Correspondence:
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Sutaria DS, Rasuo G, Harris A, Johnson R, Miles D, Gallo JD, Sane R. Drug-Drug Interaction Study to Evaluate the Pharmacokinetics, Safety, and Tolerability of Ipatasertib in Combination with Darolutamide in Patients with Advanced Prostate Cancer. Pharmaceutics 2022; 14:pharmaceutics14102101. [PMID: 36297536 PMCID: PMC9607266 DOI: 10.3390/pharmaceutics14102101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/17/2022] [Accepted: 09/22/2022] [Indexed: 11/06/2022] Open
Abstract
Ipatasertib is a selective, small molecule Akt inhibitor that is currently being developed for the treatment of metastatic castration-resistant prostate cancer. Darolutamide is an androgen receptor (AR) inhibitor that is approved for the treatment of non-metastatic castration-resistant prostate cancer. Ipatasertib is metabolized by CYP3A4 to form a less active metabolite M1 (G-037720). Ipatasertib is also a weak time-dependent CYP3A4 inhibitor. Darolutamide is a mild CYP3A4 inducer and is metabolized into an active keto-darolutamide metabolite via CYP3A4. In this Phase 1b open-label, single sequence crossover study, ipatasertib pharmacokinetics safety and tolerability were evaluated in combination with darolutamide in metastatic castration-resistant prostate cancer (n = 15 patients). Specifically, the effect of 600 mg BID of darolutamide on 400 mg QD ipatasertib was evaluated in this study. Based on pharmacokinetic analysis, a mild reduction in ipatasertib AUC0–24 h,ss and Cmax,ss exposures was observed (~8% and ~21%, respectively) when administered in combination with darolutamide, which is considered not clinically meaningful. M1 exposures were similar with and without darolutamide administration. Darolutamide and keto-darolutamide exposures in combination with ipatasertib were similar to previously reported exposures for single agent darolutamide. Overall, the combination appears to be well-tolerated in the metastatic castration-resistant prostate cancer indication with very few AEs.
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Affiliation(s)
| | | | - Adam Harris
- Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Ryan Johnson
- Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | - Dale Miles
- Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
| | | | - Rucha Sane
- Genentech, Inc., 1 DNA Way, South San Francisco, CA 94080, USA
- Correspondence: ; Tel.: +1-650-467-8083
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8
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Yoshikado T, Aoki Y, Mochizuki T, Rodrigues AD, Chiba K, Kusuhara H, Sugiyama Y. Cluster Gauss-Newton method analyses of PBPK model parameter combinations of coproporphyrin-I based on OATP1B-mediated rifampicin interaction studies. CPT Pharmacometrics Syst Pharmacol 2022; 11:1341-1357. [PMID: 35945914 PMCID: PMC9574750 DOI: 10.1002/psp4.12849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 12/02/2022] Open
Abstract
Coproporphyrin I (CP-I) is an endogenous biomarker supporting the prediction of drug-drug interactions (DDIs) involving hepatic organic anion transporting polypeptide 1B (OATP1B). We previously constructed a physiologically-based pharmacokinetic (PBPK) model for CP-I using clinical DDI data with an OATP1B inhibitor, rifampicin (RIF). In this study, PBPK model parameters for CP-I were estimated using the cluster Gauss-Newton method (CGNM), an algorithm used to find multiple approximate solutions for nonlinear least-squares problems. Eight unknown parameters including the hepatic overall intrinsic clearance (CLint,all ), the rate of biosynthesis (vsyn ), and the OATP1B inhibition constant of RIF(Ki,u,OATP ) were estimated by fitting to the observed CP-I blood concentrations in two different clinical studies involving changing the RIF dose. Multiple parameter combinations were obtained by CGNM that could well capture the clinical data. Among those, CLint,all , Ki,u,OATP , and vsyn were sensitive parameters. The obtained Ki,u,OATP for CP-I was 5.0- and 2.8-fold lower than that obtained for statins, confirming our previous findings describing substrate-dependent Ki,u,OATP values. In conclusion, CGNM analyses of PBPK model parameter combinations enables estimation of the three essential parameters for CP-I to capture the DDI profiles, even if the other parameters remain unidentified. The CGNM also clarified the importance of appropriate combinations of other unidentified parameters to enable capture of the CP-I concentration time course under the influence of RIF. The described CGNM approach may also support the construction of robust PBPK models for additional transporter biomarkers beyond CP-I.
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Affiliation(s)
- Takashi Yoshikado
- Laboratory of Clinical PharmacologyYokohama University of PharmacyYokohamaKanagawaJapan
| | - Yasunori Aoki
- Laboratory of Quantitative System Pharmacokinetics/Pharmacodynamics, School of PharmacyJosai International UniversityTokyoJapan,Present address:
AstraZenecaMölndalSweden
| | - Tatsuki Mochizuki
- Laboratory of Molecular Pharmacokinetics, Graduate School of Pharmaceutical Sciencesthe University of TokyoTokyoJapan
| | - A. David Rodrigues
- Transporter Sciences Group, ADME Sciences, Medicine Design, PfizerGrotonConnecticutUSA
| | - Koji Chiba
- Laboratory of Clinical PharmacologyYokohama University of PharmacyYokohamaKanagawaJapan
| | - Hiroyuki Kusuhara
- Laboratory of Molecular Pharmacokinetics, Graduate School of Pharmaceutical Sciencesthe University of TokyoTokyoJapan
| | - Yuichi Sugiyama
- Laboratory of Quantitative System Pharmacokinetics/Pharmacodynamics, School of PharmacyJosai International UniversityTokyoJapan
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9
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Rodrigues AD. Reimagining the Framework Supporting the Static Analysis of Transporter Drug Interaction Risk; Integrated Use of Biomarkers to Generate
Pan‐Transporter
Inhibition Signatures. Clin Pharmacol Ther 2022; 113:986-1002. [PMID: 35869864 DOI: 10.1002/cpt.2713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/14/2022] [Indexed: 11/11/2022]
Abstract
Solute carrier (SLC) transporters present as the loci of important drug-drug interactions (DDIs). Therefore, sponsors generate in vitro half-maximal inhibitory concentration (IC50 ) data and apply regulatory agency-guided "static" methods to assess DDI risk and the need for a formal clinical DDI study. Because such methods are conservative and high false-positive rates are likely (e.g., DDI study triggered when liver SLC R value ≥ 1.04 and renal SLC maximal unbound plasma (Cmax,u )/IC50 ratio ≥ 0.02), investigators have attempted to deploy plasma- and urine-based SLC biomarkers in phase I studies to de-risk DDI and obviate the need for drug probe-based studies. In this regard, it was possible to generate in-house in vitro SLC IC50 data for various clinically (biomarker)-qualified perpetrator drugs, under standard assay conditions, and then estimate "% inhibition" for each SLC and relate it empirically to published clinical biomarker data (area under the plasma concentration vs. time curve (AUC) ratio (AUCR, AUCinhibitor /AUCreference ) and % decrease in renal clearance (ΔCLrenal )). After such a "calibration" exercise, it was determined that only compounds with high R values (> 1.5) and Cmax,u /IC50 ratios (> 0.5) are likely to significantly modulate liver (AUCR > 1.25) and renal (ΔCLrenal > 25%) biomarkers and evoke DDI risk. The % inhibition approach supports integration of liver and renal SLC data and allows one to generate pan-SLC inhibition signatures for different test perpetrators (e.g., SLC % inhibition ranking). In turn, such signatures can guide the selection of the most appropriate individual (or combinations of) biomarkers for testing in phase I studies.
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Affiliation(s)
- A. David Rodrigues
- Pharmacokinetics & Drug Metabolism, Medicine Design, Worldwide Research & Development, Pfizer Inc Groton CT USA
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Deng K, Zou Y, Zou C, Wang H, Xiang Y, Yang X, Yang S, Cui C, Yang G, Huang J. Study on pharmacokinetic interactions between SHR2554 and itraconazole in healthy subjects: A single-center, open-label phase I trial. Cancer Med 2022; 12:1431-1440. [PMID: 35841331 PMCID: PMC9883540 DOI: 10.1002/cam4.5028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 06/22/2022] [Accepted: 06/29/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND SHR2554, a novel oral Enhancer of Zeste Homolog 2 inhibitor, shows broad-spectrum anti-tumor efficacy in preclinical studies. As SHR2554 is mainly metabolized by CYP3A4, it is helpful to conduct research on the effects of itraconazole, a strong inhibitor of CYP3A4-metabolizing enzymes, on the pharmacokinetic characteristics and safety of SHR2554. METHODS We conducted a single-center, open-label pharmacokinetic study of itraconazole on SHR2554 in 18 healthy Chinese subjects. Subjects were orally administrated SHR2554 50 mg on Day 1, itraconazole 200 mg Quaque Die (QD) from Days 4 to 7, SHR2554 50 mg co-administrated with itraconazole 200 mg on Day 8, and itraconazole 200 mg QD from Days 9 to 12. Then, 4 ml of venous blood was collected at predetermined time points. Plasma SHR2554 concentrations were analyzed using a validated high-performance liquid chromatography tandem mass spectrometry method. Pharmacokinetic parameters were calculated using Phoenix WinNonlin v8.1. RESULTS The Cmax of SHR2554 alone and in combination was 10.197 ± 7.0262 ng·ml-1 versus 70.538 ± 25.0219 ng·ml-1 , AUC0-∞ was 50.99 ± 19.358 h·ng·ml-1 versus 641.53 ± 319.538 h·ng·ml-1 , and AUC0-t was 28.70 ± 18.913 h·ng·ml-1 versus 612.13 ± 315.720 h·ng·ml-1 . Co-administration of SHR2554 and itraconazole caused 7.73-, 12.47-, and 23.75-fold adjusted geometric mean ratios increases in SHR2554 Cmax , AUC0-∞ and AUC0-t respectively. The co-administration regimen was well tolerated and had a good safety profile. CONCLUSIONS Compared with a single dose of SHR2554 50 mg, the exposure of SHR2554 in vivo was significantly affected by the combined administration of itraconazole.
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Affiliation(s)
- Kunhong Deng
- Center of Clinical PharmacologyThe Third Xiangya Hospital, Central South UniversityChangshaChina
| | - Yi Zou
- School of Mathematics and StatisticsCentral South UniversityChangshaChina
| | - Chan Zou
- Center of Clinical PharmacologyThe Third Xiangya Hospital, Central South UniversityChangshaChina
| | - Hong Wang
- School of Mathematics and StatisticsCentral South UniversityChangshaChina
| | - Yuxia Xiang
- Center of Clinical PharmacologyThe Third Xiangya Hospital, Central South UniversityChangshaChina,Research Center of Drug Clinical Evaluation of Central South UniversityChangshaChina
| | - Xiaoyan Yang
- Center of Clinical PharmacologyThe Third Xiangya Hospital, Central South UniversityChangshaChina
| | - Shuang Yang
- Center of Clinical PharmacologyThe Third Xiangya Hospital, Central South UniversityChangshaChina
| | - Chang Cui
- Center of Clinical PharmacologyThe Third Xiangya Hospital, Central South UniversityChangshaChina
| | - Guoping Yang
- Center of Clinical PharmacologyThe Third Xiangya Hospital, Central South UniversityChangshaChina,Research Center of Drug Clinical Evaluation of Central South UniversityChangshaChina,Department of PharmacyThe Third Xiangya Hospital, Central South UniversityChangshaChina,XiangYa School of Pharmaceutical SciencesCentral South UniversityChangshaChina,National‐Local Joint Engineering Laboratory of Drug Clinical Evaluation TechnologyChangshaChina
| | - Jie Huang
- Center of Clinical PharmacologyThe Third Xiangya Hospital, Central South UniversityChangshaChina,Research Center of Drug Clinical Evaluation of Central South UniversityChangshaChina
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Arya V, Reynolds KS, Yang X. Utilizing Endogenous Biomarkers to Derisk Assessment of Transporter Mediated Drug-Drug Interactions: A Scientific Perspective. J Clin Pharmacol 2022; 62:1501-1506. [PMID: 35778968 DOI: 10.1002/jcph.2119] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 06/24/2022] [Indexed: 11/08/2022]
Abstract
Comprehensive characterization of transporter mediated drug-drug interactions (DDIs) is important to formulate clinical management strategies and ensure the safe and effective use of concomitantly administered drugs. The potential of a drug to inhibit transporters is predicted by comparing the ratio of the relevant concentration (depending on the transporter) and the half maximum inhibitory concentration (IC50 ) to a pre-defined "cut off" value. If the ratio is greater than the cut off value, modeling approaches such as Physiologically Based Pharmacokinetic (PBPK) Modeling or a clinical DDI trial may be recommended. Because false positive (in vitro data suggests the potential for a DDI, whereas no significant DDI is observed in vivo) and false negative (in vitro data does not suggest the potential for a DDI, whereas significant DDI is observed in vivo) outcomes have been observed, there is interest in exploring additional approaches to facilitate prediction of transporter mediated DDIs. The idea of assessing changes in the concentration of endogenous biomarkers (which are substrates of clinically relevant transporters) to gain insight on the potential for a drug to inhibit transporter activity has received widespread attention. This brief report describes how endogenous biomarkers may help to expand the DDI assessment toolkit, highlights some current knowledge gaps, and outlines a conceptual framework that may complement the current paradigm of predicting the potential for transporter mediated DDIs. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Vikram Arya
- Division of Infectious Disease Pharmacology, Office of Clinical Pharmacology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Kellie S Reynolds
- Division of Infectious Disease Pharmacology, Office of Clinical Pharmacology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Xinning Yang
- Guidance and Policy Team, Office of Clinical Pharmacology, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
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Assessment of cytochrome P450 3A4-mediated drug–drug interactions for ipatasertib using a fit-for-purpose physiologically based pharmacokinetic model. Cancer Chemother Pharmacol 2022; 89:707-720. [PMID: 35428895 PMCID: PMC9054915 DOI: 10.1007/s00280-022-04434-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 04/02/2022] [Indexed: 12/04/2022]
Abstract
Purpose Ipatasertib, a potent and highly selective small-molecule inhibitor of AKT, is currently under investigation for treatment of cancer. Ipatasertib is a substrate and a time-dependent inhibitor of CYP3A4. It exhibits non-linear pharmacokinetics at subclinical doses in the clinical dose escalation study. To assess the DDI risk of ipatasertib at the intended clinical dose of 400 mg with CYP3A4 inhibitors, inducers, and substrates, a fit-for-purpose physiologically based pharmacokinetic (PBPK) model of ipatasertib was developed. Methods The PBPK model was constructed in Simcyp using in silico, in vitro, and clinical data and was optimized and verified using clinical data. Results The PBPK model described non-linear pharmacokinetics of ipatasertib and captured the magnitude of the observed clinical DDIs. Following repeated doses of 400 mg ipatasertib once daily (QD), the PBPK model predicted a 3.3-fold increase of ipatasertib exposure with itraconazole; a 2–2.5-fold increase with moderate CYP3A4 inhibitors, erythromycin and diltiazem; and no change with a weak CYP3A4 inhibitor, fluvoxamine. Additionally, in the presence of strong or moderate CYP3A4 inducers, rifampicin and efavirenz, ipatasertib exposures were predicted to decrease by 86% and 74%, respectively. As a perpetrator, the model predicted that ipatasertib (400 mg) caused a 1.7-fold increase in midazolam exposure. Conclusion This study demonstrates the value of using a fit-for-purpose PBPK model to assess the clinical DDIs for ipatasertib and to provide dosing strategies for the concurrent use of other CYP3A4 perpetrators or victims. Supplementary Information The online version contains supplementary material available at 10.1007/s00280-022-04434-2.
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Denny WA. Inhibitors and Activators of the p38 Mitogen- Activated MAP Kinase (MAPK) Family as Drugs to Treat Cancer and Inflammation. Curr Cancer Drug Targets 2022; 22:209-220. [PMID: 35168519 DOI: 10.2174/1568009622666220215142837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 11/27/2021] [Accepted: 12/05/2021] [Indexed: 11/22/2022]
Abstract
The p38 MAP kinases are a sub-family of the broad group of mitogen-activated serine-threonine protein kinases. The best-characterised, most widely expressed, and most targeted by drugs is p38α MAP kinase. This review briefly summarises the place of p38α MAP kinase in cellular signalling and discusses the structures and activity profiles of representative examples of the major classes of inhibitors and activators (both synthetic compounds and natural products) of this enzyme. Primary screening was primarily direct in vitro inhibition of isolated p38α enzyme.
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Affiliation(s)
- William A Denny
- Auckland Cancer Society Research Centre, School of Medical Sciences, Private Bag 92019, Auckland 1142, New Zealand
- Maurice Wilkins Centre, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
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