1
|
Yaeger R, McKean MA, Haq R, Beck JT, Taylor MH, Cohen JE, Bowles DW, Gadgeel SM, Mihalcioiu C, Papadopoulos KP, Diamond EL, Sturtz KB, Feng G, Drescher SK, Reddy MB, Sengupta B, Maity AK, Brown SA, Singh A, Brown EN, Baer BR, Wong J, Mou TC, Wu WI, Kahn DR, Gadal S, Rosen N, Gaudino JJ, Lee PA, Hartley DP, Rothenberg SM. A next-generation BRAF inhibitor overcomes resistance to BRAF inhibition in patients with BRAF-mutant cancers using pharmacokinetics-informed dose escalation. Cancer Discov 2024:745099. [PMID: 38691346 DOI: 10.1158/2159-8290.cd-24-0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/21/2024] [Accepted: 04/26/2024] [Indexed: 05/03/2024]
Abstract
RAF inhibitors have transformed treatment for BRAF V600-mutant cancer patients, but clinical benefit is limited by adaptive induction of ERK signaling, genetic alterations that induce BRAF V600 dimerization, and poor brain penetration. Next-generation pan-RAF dimer inhibitors are limited by narrow therapeutic index. PF-07799933 (ARRY-440) is a brain-penetrant, selective, pan-mutant BRAF inhibitor. PF-07799933 inhibited signaling in vitro, disrupted endogenous mutant-BRAF:wild-type-CRAF dimers, and spared wild-type ERK signaling. PF-07799933 ± binimetinib inhibited growth of mouse xenograft tumors driven by mutant BRAF that functions as dimers and by BRAF V600E with acquired resistance to current RAF inhibitors. We treated patients with treatment-refractory BRAF-mutant solid tumors in a first-in-human clinical trial (NCT05355701) that utilized a novel, flexible, pharmacokinetics-informed dose escalation design that allowed rapid achievement of PF-07799933 efficacious concentrations. PF-07799933 ± binimetinib was well-tolerated and resulted in multiple confirmed responses, systemically and in the brain, in BRAF-mutant cancer patients refractory to approved RAF inhibitors.
Collapse
Affiliation(s)
- Rona Yaeger
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | | | - Rizwan Haq
- Dana-Farber Cancer Institute, Boston, MA, United States
| | | | - Matthew H Taylor
- Earle A. Chiles Research Institute, Providence Cancer Institute, Portland, Oregon, United States
| | | | - Daniel W Bowles
- University of Colorado School of Medicine, Aurora, United States
| | - Shirish M Gadgeel
- Henry Ford Cancer Institute/Henry Ford Health System, Detroit, MI, United States
| | | | | | - Eli L Diamond
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | | | - Gang Feng
- Pfizer (United States), Cambridge, MA, United States
| | | | | | | | | | | | | | | | | | - Jim Wong
- Pfizer, Boulder, CO, United States
| | | | - Wen-I Wu
- Pfizer (United States), Boulder, Colorado, United States
| | - Dean R Kahn
- Pfizer (United States), Boulder, CO, United States
| | - Sunyana Gadal
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Neal Rosen
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - John J Gaudino
- Pfizer (United States), Boulder, Colorado, United States
| | | | | | | |
Collapse
|
2
|
Drescher SK, Jiao Y, Chen MJ, Kurumaddali A, Shao J, Amini E, Hochhaus G, Bulitta JB. Central and peripheral lung deposition of fluticasone propionate dry powder inhaler formulations in humans characterized by population pharmacokinetics. Pharm Res 2023; 40:1177-1191. [PMID: 37081302 PMCID: PMC10686290 DOI: 10.1007/s11095-023-03472-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 01/12/2023] [Indexed: 04/22/2023]
Abstract
This study aimed to gain an in-depth understanding of the pulmonary fate of three experimental fluticasone propionate (FP) dry powder inhaler formulations which differed in mass median aerodynamic diameters (MMAD; A-4.5 µm, B-3.8 µm and C-3.7 µm; total single dose: 500 µg). Systemic disposition parameter estimates were obtained from published pharmacokinetic data after intravenous dosing to improve robustness. A biphasic pulmonary absorption model, with mucociliary clearance from the slower absorption compartment, and three systemic disposition compartments was most suitable. Rapid absorption, presumably from peripheral lung, had half-lives of 6.9 to 14.6 min. The peripherally deposited dose (12.6 µg) was significantly smaller for formulation A-4.5 µm than for the other formulations (38.7 and 39.3 µg for B-3.8 µm and C-3.7 µm). The slow absorption half-lives ranged from 6.86 to 9.13 h and were presumably associated with more central lung regions, where mucociliary clearance removed approximately half of the centrally deposited dose. Simulation-estimation studies showed that a biphasic absorption model could be reliably identified and that parameter estimates were unbiased and reasonably precise. Bioequivalence assessment of population pharmacokinetics derived central and peripheral lung doses suggested that formulation A-4.5 µm lacked bioequivalence compared to the other formulations both for central and peripheral doses. In contrast, the other fomulations were bioequivalent. Overall, population pharmacokinetics holds promise to provide important insights into the pulmonary fate of inhalation drugs, which are not available from non-compartmental analysis. This supports the assessment of the pulmonary bioequivalence of fluticasone propionate inhaled formulations through pharmacokinetic approaches, and may be helpful for discussions on evaluating alternatives to clinical endpoint studies.
Collapse
Affiliation(s)
- Stefanie K Drescher
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Box 100494, Gainesville, FL, 32610, USA
| | - Yuanyuan Jiao
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, 6550 Sanger Road, Orlando, FL, 32827, USA
| | - Mong-Jen Chen
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Box 100494, Gainesville, FL, 32610, USA
| | - Abhinav Kurumaddali
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Box 100494, Gainesville, FL, 32610, USA
| | - Jie Shao
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Box 100494, Gainesville, FL, 32610, USA
| | - Elham Amini
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Box 100494, Gainesville, FL, 32610, USA
| | - Günther Hochhaus
- Department of Pharmaceutics, College of Pharmacy, University of Florida, Box 100494, Gainesville, FL, 32610, USA.
| | - Jürgen B Bulitta
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, 6550 Sanger Road, Orlando, FL, 32827, USA.
| |
Collapse
|
3
|
Hochhaus G, Chen MJ, Kurumaddali A, Schilling U, Jiao Y, Drescher SK, Amini E, Berger SM, Kandala B, Tabulov C, Shao J, Seay B, Abu-Hasan MN, Baumstein SM, Winner L, Shur J, Price R, Hindle M, Wei X, Carrasco C, Sandell D, Oguntimein O, Kinjo M, Delvadia R, Saluja B, Lee SL, Conti DS, Bulitta JB. Correction to: Can Pharmacokinetic Studies Assess the Pulmonary Fate of Dry Powder Inhaler Formulations of Fluticasone Propionate? AAPS J 2021; 24:1. [PMID: 34811595 DOI: 10.1208/s12248-021-00655-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
- Günther Hochhaus
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, FL, 32610, USA.
| | - Mong-Jen Chen
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, FL, 32610, USA.,AbbVie Inc., North Chicago, IL, USA
| | - Abhinav Kurumaddali
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, FL, 32610, USA
| | - Uta Schilling
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, FL, 32610, USA
| | - Yuanyuan Jiao
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, 6550 Sanger Road, Orlando, FL, 32827-7445, USA
| | - Stefanie K Drescher
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, FL, 32610, USA
| | - Elham Amini
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, FL, 32610, USA
| | - Simon M Berger
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, FL, 32610, USA
| | - Bhargava Kandala
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, FL, 32610, USA
| | - Christine Tabulov
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, FL, 32610, USA
| | - Jie Shao
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, FL, 32610, USA
| | - Brandon Seay
- Division of Pediatric Pulmonary and Sleep Medicine, Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Mutasim N Abu-Hasan
- Division of Pediatric Pulmonary and Sleep Medicine, Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Sandra M Baumstein
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, 6550 Sanger Road, Orlando, FL, 32827-7445, USA
| | - Lawrence Winner
- Department of Statistics, College of Liberal Arts & Sciences, University of Florida, Gainesville, FL, USA
| | - Jagdeep Shur
- Department of Pharmacy & Pharmacology, Centre for Therapeutic Innovation, University of Bath, Bath, UK
| | - Robert Price
- Department of Pharmacy & Pharmacology, Centre for Therapeutic Innovation, University of Bath, Bath, UK
| | - Michael Hindle
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA, USA
| | - Xiangyin Wei
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA, USA
| | | | | | - Oluwamurewa Oguntimein
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Minori Kinjo
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Renishkumar Delvadia
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA.,Office of New Drug Products, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Bhawana Saluja
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA.,Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Sau L Lee
- Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Denise S Conti
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, MD, USA
| | - Jürgen B Bulitta
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, 6550 Sanger Road, Orlando, FL, 32827-7445, USA.
| |
Collapse
|
4
|
Hochhaus G, Chen MJ, Kurumaddali A, Schilling U, Jiao Y, Drescher SK, Amini E, Berger SM, Kandala B, Tabulov C, Shao J, Seay B, Abu-Hasan MN, Baumstein SM, Winner L, Shur J, Price R, Hindle M, Wei X, Carrasco C, Sandell D, Oguntimein O, Kinjo M, Delvadia R, Saluja B, Lee SL, Conti DS, Bulitta JB. Can Pharmacokinetic Studies Assess the Pulmonary Fate of Dry Powder Inhaler Formulations of Fluticasone Propionate? AAPS J 2021; 23:48. [PMID: 33768368 PMCID: PMC10662255 DOI: 10.1208/s12248-021-00569-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 02/06/2021] [Indexed: 11/30/2022] Open
Abstract
In the context of streamlining generic approval, this study assessed whether pharmacokinetics (PK) could elucidate the pulmonary fate of orally inhaled drug products (OIDPs). Three fluticasone propionate (FP) dry powder inhaler (DPI) formulations (A-4.5, B-3.8, and C-3.7), differing only in type and composition of lactose fines, exhibited median mass aerodynamic diameter (MMAD) of 4.5 μm (A-4.5), 3.8 μm (B-3.8), and 3.7 μm (C-3.7) and varied in dissolution rates (A-4.5 slower than B-3.8 and C-3.7). In vitro total lung dose (TLDin vitro) was determined as the average dose passing through three anatomical mouth-throat (MT) models and yielded dose normalization factors (DNF) for each DPI formulation X (DNFx = TLDin vitro,x/TLDin vitro,A-4.5). The DNF was 1.00 for A-4.5, 1.32 for B-3.8, and 1.21 for C-3.7. Systemic PK after inhalation of 500 μg FP was assessed in a randomized, double-blind, four-way crossover study in 24 healthy volunteers. Peak concentrations (Cmax) of A-4.5 relative to those of B-3.8 or C-3.7 lacked bioequivalence without or with dose normalization. The area under the curve (AUC0-Inf) was bio-IN-equivalent before dose normalization and bioequivalent after dose normalization. Thus, PK could detect differences in pulmonary available dose (AUC0-Inf) and residence time (dose-normalized Cmax). The differences in dose-normalized Cmax could not be explained by differences in in vitro dissolution. This might suggest that Cmax differences may indicate differences in regional lung deposition. Overall this study supports the use of PK studies to provide relevant information on the pulmonary performance characteristics (i.e., available dose, residence time, and regional lung deposition).
Collapse
Affiliation(s)
- Günther Hochhaus
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, Florida, 32610, USA.
| | - Mong-Jen Chen
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, Florida, 32610, USA
- AbbVie Inc., North Chicago, Illinois, USA
| | - Abhinav Kurumaddali
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, Florida, 32610, USA
| | - Uta Schilling
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, Florida, 32610, USA
| | - Yuanyuan Jiao
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, 6550 Sanger Road, Gainesville, Florida, 32827-7445, USA
| | - Stefanie K Drescher
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, Florida, 32610, USA
| | - Elham Amini
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, Florida, 32610, USA
| | - Simon M Berger
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, Florida, 32610, USA
| | - Bhargava Kandala
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, Florida, 32610, USA
| | - Christine Tabulov
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, Florida, 32610, USA
| | - Jie Shao
- Department of Pharmaceutics, College of Pharmacy, University of Florida, 1345 Center Drive, Gainesville, Florida, 32610, USA
| | - Brandon Seay
- Division of Pediatric Pulmonary and Sleep Medicine, Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Mutasim N Abu-Hasan
- Division of Pediatric Pulmonary and Sleep Medicine, Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida, USA
| | - Sandra M Baumstein
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, 6550 Sanger Road, Gainesville, Florida, 32827-7445, USA
| | - Lawrence Winner
- Department of Statistics, College of Liberal Arts & Sciences, University of Florida, Gainesville, Florida, USA
| | - Jagdeep Shur
- Department of Pharmacy & Pharmacology, Centre for Therapeutic Innovation, University of Bath, Bath, UK
| | - Robert Price
- Department of Pharmacy & Pharmacology, Centre for Therapeutic Innovation, University of Bath, Bath, UK
| | - Michael Hindle
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Xiangyin Wei
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, Virginia, USA
| | | | | | - Oluwamurewa Oguntimein
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Minori Kinjo
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Renishkumar Delvadia
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
- Office of New Drug Products, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Bhawana Saluja
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
- Office of Clinical Pharmacology, Office of Translational Sciences, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Sau L Lee
- Office of Testing and Research, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Denise S Conti
- Office of Research and Standards, Office of Generic Drugs, Center for Drug Evaluation and Research, US Food and Drug Administration, Silver Spring, Maryland, USA
| | - Jürgen B Bulitta
- Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, 6550 Sanger Road, Gainesville, Florida, 32827-7445, USA.
| |
Collapse
|
5
|
Jiao Y, Kim TH, Tao X, Kinzig M, Landersdorfer CB, Drescher SK, Sutaria DS, Moya B, Holzgrabe U, Sörgel F, Bulitta JB. First population pharmacokinetic analysis showing increased quinolone metabolite formation and clearance in patients with cystic fibrosis compared to healthy volunteers. Eur J Pharm Sci 2018; 123:416-428. [DOI: 10.1016/j.ejps.2018.07.054] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Revised: 07/09/2018] [Accepted: 07/27/2018] [Indexed: 01/29/2023]
|
6
|
Singh RSP, Mukker JK, Drescher SK, Deitchman AN, Derendorf H. A need to revisit clinical breakpoints of tigecycline: effect of atypical non-linear plasma protein binding. Int J Antimicrob Agents 2017; 49:449-455. [DOI: 10.1016/j.ijantimicag.2016.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 12/04/2016] [Accepted: 12/17/2016] [Indexed: 11/29/2022]
|