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Meertens M, de Vries N, Rosing H, Steeghs N, Beijnen JH, Huitema ADR. Analytical Validation of a Volumetric Absorptive Microsampling Method for Therapeutic Drug Monitoring of the Oral Targeted Anticancer Agents, Abiraterone, Alectinib, Cabozantinib, Imatinib, Olaparib, and Sunitinib, and Metabolites. Ther Drug Monit 2024; 46:494-502. [PMID: 38321598 DOI: 10.1097/ftd.0000000000001175] [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: 10/09/2023] [Accepted: 11/22/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND Volumetric Absorptive Microsampling (VAMS) is a useful tool for therapeutic drug monitoring (TDM) of oral targeted anticancer agents. VAMS aims to improve safety and efficacy by enabling at-home blood sample collection by patients. This study aimed to develop and validate an ultra-high performance liquid chromatography-tandem mass spectrometry method for the quantitative determination of abiraterone, alectinib, cabozantinib, imatinib, olaparib, sunitinib, and the metabolites, Δ(4)-abiraterone (D4A), alectinib-M4, imatinib-M1, and N -desethyl sunitinib, in dried whole blood samples using VAMS to support TDM. METHODS After the collection of 10 μL of whole blood sample using the VAMS device, the analytes were extracted from the tip using methanol with shaking, evaporated, and reconstituted in acetonitrile:0.1 mol/L ammonium hydroxide in water (1:1, vol/vol). The extracts were then analyzed using ultra-high performance liquid chromatography-tandem mass spectrometry. Validation experiments based on the ICH M10 guideline were carried out, and stability was evaluated under shipping and storage conditions. VAMS specimens were collected in the outpatient clinic to demonstrate the applicability of the assay. RESULTS The validated range of the method was considered accurate and precise for all analytes. Accordingly, the validation experiments met the relevant requirements, except for cross-analyte interference. Based on the stability data, shipment can be performed at room temperature within 14 days after sample collection and the VAMS specimen can be stored up to 9 months at -20 and -70°C. Samples from 59 patients were collected at the hospital. CONCLUSIONS The developed method could be used to successfully quantify the concentrations of abiraterone, D4A, alectinib, alectinib-M4, cabozantinib, imatinib, imatinib-M1, olaparib, sunitinib, and N -desethyl sunitinib within the validated range using VAMS. Therefore, the method can be used to estimate the dried whole blood-to-plasma ratios for TDM in the clinic.
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Affiliation(s)
- Marinda Meertens
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Niels de Vries
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Hilde Rosing
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Neeltje Steeghs
- Department of Medical Oncology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Jos H Beijnen
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
| | - Alwin D R Huitema
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
- Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, the Netherlands; and
- Department of Pharmacology, Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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Chamorey E, Pujalte-Martin M, Ferrero JM, Mahammedi H, Gravis G, Roubaud G, Beuzeboc P, Largillier R, Borchiellini D, Linassier C, Bouges H, Etienne-Grimaldi MC, Schiappa R, Gal J, Milano G. Long-Term Pharmacokinetic Follow-Up of Abiraterone Acetate in Patients with Metastatic Castration-Resistant Prostate Cancer. Int J Mol Sci 2024; 25:6058. [PMID: 38892246 PMCID: PMC11172583 DOI: 10.3390/ijms25116058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/23/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
This ABIGENE pharmacokinetic (PK) study sought mainly to characterize the unchanged drug PK during long-term abiraterone acetate (AA) administration in advanced prostate cancer patients (81 patients). It was observed that individual AA concentrations remained constant over treatment time, with no noticeable changes during repeated long-term drug administration for up to 120 days. There was no correlation between AA concentrations and survival outcomes. However, a significant association between higher AA concentrations and better clinical benefit was observed (p = 0.041). The safety data did not correlate with the AA PK data. A significant positive correlation (r = 0.40, p < 0.001) was observed between mean AA concentration and patient age: the older the patient, the higher the AA concentration. Patient age was found to impact steady-state AA concentration: the older the patient, the higher the mean AA concentration. Altogether, these data may help to guide future research and clinical trials in order to maximize the benefits of AA metastatic castration-resistant prostate cancer patients.
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Affiliation(s)
- Emmanuel Chamorey
- Epidemiology and Biostatistics Department, Centre Antoine Lacassagne, University Côte d’Azur, 06000 Nice, France (J.G.)
| | - Marc Pujalte-Martin
- Medical Oncology Department, Centre Antoine Lacassagne, University Côte d’Azur, 06000 Nice, France
| | - Jean-Marc Ferrero
- Medical Oncology Department, Centre Antoine Lacassagne, University Côte d’Azur, 06000 Nice, France
| | - Hakim Mahammedi
- Medical Oncology Department, Centre Jean Perrin, 63000 Clermond Ferrand, France
| | - Gwenaelle Gravis
- Medical Oncology Department, Institut Paoli Calmette, 13009 Marseille, France
| | - Guilhem Roubaud
- Department of Medical Oncology, Institut Bergonié, 33076 Bordeaux, France
| | | | - Remy Largillier
- Medical Oncology Department, Centre Azuréen de Cancérologie, 06250 Mougins, France
| | - Delphine Borchiellini
- Medical Oncology Department, Centre Antoine Lacassagne, University Côte d’Azur, 06000 Nice, France
- Clinical Research Department, Centre Antoine Lacassagne, University Côte d’Azur, 06000 Nice, France
| | - Claude Linassier
- Medical Oncology Department, Centre Hospitalier Régional Universitaire, 37000 Tours, France
| | - Hélène Bouges
- Oncopharmacology Unit, Centre Antoine Lacassagne, University Côte d’Azur, 06189 Nice, France
| | | | - Renaud Schiappa
- Epidemiology and Biostatistics Department, Centre Antoine Lacassagne, University Côte d’Azur, 06000 Nice, France (J.G.)
| | - Jocelyn Gal
- Epidemiology and Biostatistics Department, Centre Antoine Lacassagne, University Côte d’Azur, 06000 Nice, France (J.G.)
| | - Gérard Milano
- Oncopharmacology Unit, Centre Antoine Lacassagne, University Côte d’Azur, 06189 Nice, France
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3
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Giraud EL, Te Brake LMH, van den Hombergh ECA, Desar IME, Kweekel DM, van Erp NP. Results of the first international quality control programme for oral targeted oncolytics. Br J Clin Pharmacol 2024; 90:336-343. [PMID: 37776845 DOI: 10.1111/bcp.15918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/20/2023] [Accepted: 09/22/2023] [Indexed: 10/02/2023] Open
Abstract
AIMS With the rising number of oral targeted oncolytics and growing awareness of the benefits of therapeutic drug monitoring (TDM) within the field of oncology, it is expected that the requests for quantifying concentrations of these drugs will increase. It is important to (cross-)validate available assays and ensure its quality, as results may lead to altered dosing recommendations. Therefore, we aimed to evaluate the performance of laboratories measuring concentrations of targeted oral oncolytics in a one-time international quality control (QC) programme. METHODS Participating laboratories received a set of plasma samples containing low, medium and high concentrations of imatinib, sunitinib, desethylsunitinib, pazopanib, cabozantinib, olaparib, enzalutamide, desmethylenzalutamide and abiraterone, with the request to report their results back within five weeks after shipment. Accuracy was defined acceptable if measurements where within 85%-115% from the weighed-in reference concentrations. Besides descriptive statistics, an exploratory ANOVA was performed. RESULTS Seventeen laboratories from six countries reported 243 results. Overall, 80.7% of all measurements were within the predefined range of acceptable accuracy. Laboratories performed best in quantifying imatinib and poorest in quantifying desethylsunitinib (median absolute inaccuracy respectively 4.0% (interquartile range (IQR) 1.8%-6.5%) and 15.5% (IQR 8.8%-34.9%)). The poorest performance of desethylsunitinib might be caused by using the stable-isotope-labelled sunitinib instead of desethylsunitinib as an internal standard, or due to the light-induced cis(Z)/trans(E) isomerization of (desethyl)sunitinib. Overall, drug substance and performing laboratory seemed to influence the absolute inaccuracy (F = 16.4; p < 0.001 and F = 35.5; p < 0.001, respectively). CONCLUSION Considering this is the first evaluation of an international QC programme for oral targeted oncolytics, an impressive high percentage of measurements were within the predefined range of accuracy. Cross-validation of assays that are used for dose optimization of oncolytics will secure the performance and will protect patients from incorrect advices.
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Affiliation(s)
- Eline L Giraud
- Department of Pharmacy, Research Institute for Medical Innovation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Lindsey M H Te Brake
- Department of Pharmacy, Research Institute for Medical Innovation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Erik C A van den Hombergh
- Department of Pharmacy, Research Institute for Medical Innovation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Ingrid M E Desar
- Department of Medical Oncology, Research Institute for Medical Innovation, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Dina M Kweekel
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Centre, Leiden, The Netherlands
- Drug Analysis and Toxicology division (KKGT) of the Dutch Foundation for Quality Assessment in Medical Laboratories (SKML), Utrecht, The Netherlands
| | - Nielka P van Erp
- Department of Pharmacy, Research Institute for Medical Innovation, Radboud University Medical Centre, Nijmegen, The Netherlands
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4
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Simultaneous determination of abiraterone and its five metabolites in human plasma by LC-MS/MS: Application to pharmacokinetic study in healthy Chinese subjects. J Pharm Biomed Anal 2022; 217:114826. [DOI: 10.1016/j.jpba.2022.114826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/28/2022] [Accepted: 05/05/2022] [Indexed: 11/18/2022]
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5
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Keranmu A, Yang FY, Wahafu W, Han SJ, Yang GS, Xing NZ. Biotransformation of Abiraterone Into Five Characteristic Metabolites by the Rat Gut Microbiota and Liver Microsomes. Front Oncol 2022; 12:890323. [PMID: 35936674 PMCID: PMC9354843 DOI: 10.3389/fonc.2022.890323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 06/07/2022] [Indexed: 12/24/2022] Open
Abstract
It is well known that the role of gut microbiota in drug metabolism, especially in oral difficult absorbable drugs. Understanding the gut microbiota could enable us to understand drugs in new ways. The purpose of the study was to investigate explore the metabolites of the anti-prostate cancer drug Abiraterone by examining gut microbiota metabolism and hepatic metabolism in vitro. In this study, five metabolites (M1, M2, M3, M4 and M5) of Abiraterone were discovered using LC/MSn-IT-TOF. Four isomeric metabolites M1-M4 were found in liver microsome. M5 was found in the intestinal contents of Sprague-Dawley rats with a molecular weight of 388.31. Among them, M4 was found to be Abiraterone N-Oxide by comparison with the standard sample. After further comparing the metabolic behavior of Abiraterone in rat gut microbiota and liver microsomes, we delineated the possible metabolic pathways of Abiraterone. In conclusion, Abiraterone is metabolized specifically in liver microsomes and gut microbiota. This study can provide a theoretical basis for elucidating the metabolic mechanism of Abiraterone and guide its rational application in clinic.
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Affiliation(s)
- Adili Keranmu
- State Key Laboratory of Molecular Oncology, Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Urology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Fei-Ya Yang
- State Key Laboratory of Molecular Oncology, Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wasilijiang Wahafu
- State Key Laboratory of Molecular Oncology, Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Su-Jun Han
- State Key Laboratory of Molecular Oncology, Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guo-Sheng Yang
- Department of Urology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Nian-Zeng Xing
- State Key Laboratory of Molecular Oncology, Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Urology, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi, China
- *Correspondence: Nian-Zeng Xing,
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6
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Kanji H, Horiyama S, Kimachi T, Haginaka J. Determination of Abiraterone and Its Metabolites in Human Serum by LC-ESI-TOF/MS Using Solid-phase Extraction. ANAL SCI 2021; 37:1281-1287. [PMID: 33678729 DOI: 10.2116/analsci.21p035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We developed and validated a liquid chromatography-electrospray ionization-time of flight/mass spectrometry method for the determination of abiraterone (Abi) and its metabolites (Δ4-Abi, 3-keto-5α-Abi, 3α-OH-5α-Abi and 3β-OH-5α-Abi) in human serum using Abi-d4 as the internal standard. As a pretreatment procedure of serum samples, solid-phase extraction based on a silica-gel cartridge was used. The relative recovery of Abi and its metabolites was over the ranges of 84.5 - 109.2% at a concentration of 6.0 ng mL-1 for Abi and 0.6 ng mL-1 for its metabolites. The method was free from matrix effects. The calibration curve of Abi was linear over the range of 2.0 - 400 ng mL-1 and those of its metabolites over the ranges 0.2 - 40 ng mL-1. The results of the intra- and inter-day accuracy and precision data were within the FDA acceptance criteria. The optimized method was applied for the determination of Abi and its metabolites in human serum after oral administration of Abi acetate.
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Affiliation(s)
- Hiromi Kanji
- School of Pharmacy and Pharmaceutical Sciences, Mukogawa Women's University
| | - Shizuyo Horiyama
- School of Pharmacy and Pharmaceutical Sciences, Mukogawa Women's University
| | - Tetsutaro Kimachi
- School of Pharmacy and Pharmaceutical Sciences, Mukogawa Women's University
| | - Jun Haginaka
- Institute for Biosciences, Mukogawa Women's University
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7
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Boerrigter E, Benoist GE, Overbeek JK, Donders R, Mehra N, van Oort IM, Ter Heine R, van Erp NP. The effect of chemotherapy on the exposure-response relation of abiraterone in metastatic castration-resistant prostate cancer. Br J Clin Pharmacol 2021; 88:1170-1178. [PMID: 34436788 PMCID: PMC9293353 DOI: 10.1111/bcp.15057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/28/2021] [Accepted: 08/11/2021] [Indexed: 12/12/2022] Open
Abstract
Aims To assess whether the exposure–response relation for abiraterone is different in pre‐chemotherapy patients compared to post‐chemotherapy patients with metastatic castration‐resistant prostate cancer (mCRPC). Methods Data were collected from three clinical studies in mCRPC patients treated with abiraterone acetate. Cox regression analysis was used to determine the relation between abiraterone exposure and survival (progression‐free survival [PFS] and overall survival [OS]). An interaction term was used to test whether chemotherapy pretreatment was an effect modifier. To investigate the effect of the previously defined exposure threshold of 8.4 ng/mL on survival, Kaplan–Meier analysis was used. Results In total, 98 mCRPC patients were included, of which 78 were pre‐chemotherapy and 20 were post‐chemotherapy patients. Chemotherapy pretreatment in mCRPC setting appears to be an effect modifier. In pre‐chemotherapy patients, no significant association between abiraterone exposure and survival was observed (HR 0.68 [95% CI 0.42–1.10], P = .12 and HR 0.85 [95% CI 0.46–1.60], P = .61, PFS and OS, respectively) and no longer survival was seen for patients with an abiraterone exposure above the predefined threshold. In contrast, a significant association was seen in post‐chemotherapy patients (HR 0.30 [95% CI 0.12–0.74], P = .01 and HR 0.38 [95% CI 0.18–0.82] P = .01, PFS and OS, respectively), with an increased survival when exposed above this threshold. Conclusion Chemotherapy pretreatment in mCRPC setting modifies the abiraterone exposure–response relation. No relation between abiraterone exposure and survival was seen for pre‐chemotherapy patients. Therefore, potentially lower doses can be used in this setting to prevent overtreatment and reduce financial toxicity.
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Affiliation(s)
- Emmy Boerrigter
- Department of Pharmacy, Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Guillemette E Benoist
- Department of Pharmacy, Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Joanneke K Overbeek
- Department of Pharmacy, Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Rogier Donders
- Department for Heath Evidence, Radboud university medical center, Nijmegen, The Netherlands
| | - Niven Mehra
- Department of Medical Oncology, Radboud university medical center, Nijmegen, The Netherlands
| | - Inge M van Oort
- Department of Urology, Radboud university medical center, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands
| | - Rob Ter Heine
- Department of Pharmacy, Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Nielka P van Erp
- Department of Pharmacy, Radboud university medical center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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8
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Dai L, Lv P, He Y, Wang X, Chen L, Dai J. A Novel LC-MS Method for the Determination of Abiraterone in Rat Plasma and its Application to Pharmacokinetic Studies. CURR PHARM ANAL 2021. [DOI: 10.2174/2213337208666210816112837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
High-Performance Liquid Chromatography (HPLC)-Ultraviolet (UV) and
Liquid Chromatography (LC)-Mass Spectrometry (MS)/MS methods have been used to analyse abiraterone
(ART); however, a single-quadrupole mass spectrometer with LC-MS systems has never
been used to analyse ART.
Objective:
The study aimed to establish a novel, simple assay of quantitating ART in rat plasma
through LC-MS.
Method:
The analytical procedure involved the extraction of ART and D4-ART (internal standard,
IS) from rat plasma through simple protein precipitation. Chromatographic separation was
achieved using an isocratic mobile phase (acetonitrile: 5 mM ammonium formate with 0.1% formic
acid, 50:50 v/v) at a flow rate of 0.30 mL/min on a Waters XBridge® C18 column with a total run
time of 5 min. LC-MS ion transitions monitored were 350.1 and 354.1 for ART and IS, respectively.
The method was validated, and the results met acceptance criteria.
Results:
The lower limit of quantitation achieved was 1 ng/mL, and linearity was 1-8000 ng/mL.
The intra- and inter-day precisions were 1.26%-14.20% and 5.49%-13.08%, respectively, in rat
plasma.
Conclusion:
LC-MS offers a novel, specific, sensitive, and accurate method for quantifying ART
and it was successfully applied to pharmacokinetic studies of ART in rats.
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Affiliation(s)
- Linzhi Dai
- School of Pharmacy, Chengdu Medical College, Chengdu, China
| | - Pei Lv
- Analytical Research Department, Chengdu Hyperway Pharmaceuticals Co., Ltd., Chengdu, China
| | - Yun He
- Dental Department, School of Preclinical Medicine, Chengdu University, Chengdu, China
| | - Xiaoli Wang
- Clinical School of Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lili Chen
- Analytical Research Department, Chengdu Hyperway Pharmaceuticals Co., Ltd., Chengdu, China
| | - Jing Dai
- School of Pharmacy, Chengdu Medical College, Chengdu, China
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Boerrigter E, Benoist GE, van Oort IM, Verhaegh GW, van Hooij O, Groen L, Smit F, Oving IM, de Mol P, Smilde TJ, Somford DM, Mehra N, Schalken JA, van Erp NP. Liquid biopsy reveals KLK3 mRNA as a prognostic marker for progression free survival in patients with metastatic castration-resistant prostate cancer undergoing first-line abiraterone acetate and prednisone treatment. Mol Oncol 2021; 15:2453-2465. [PMID: 33650292 PMCID: PMC8410566 DOI: 10.1002/1878-0261.12933] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/12/2021] [Accepted: 02/26/2021] [Indexed: 12/22/2022] Open
Abstract
Circulating RNAs extracted from liquid biopsies represent a promising source of cancer‐ and therapy‐related biomarkers. We screened whole blood from patients with metastatic castration‐resistant prostate cancer (mCRPC) following their first‐line treatment with abiraterone acetate and prednisone (AA‐P) to identify circulating RNAs that may correlate with progression‐free survival (PFS). In a prospective multicenter observational study, 53 patients with mCRPC were included after they started first‐line AA‐P treatment. Blood was drawn at baseline, 1, 3, and 6 months after treatment initiation. The levels of predefined circulating RNAs earlier identified as being upregulated in patients with mCRPC (e.g., microRNAs, long noncoding RNAs, and mRNAs), were analyzed. Uni‐ and multivariable Cox regression and Kaplan–Meier analyses were used to analyze the prognostic value of the various circulating RNAs for PFS along treatment. Detectable levels of kallikrein‐related peptidase 3 (KLK3) mRNA at baseline were demonstrated to be an independent prognostic marker for PFS (201 vs 501 days, P = 0.00054). Three months after AA‐P treatment initiation, KLK3 could not be detected in the blood of responding patients, but was still detectable in 56% of the patients with early progression. Our study confirmed that KLK3 mRNA detection in whole blood is an independent prognostic marker in mCRPC patients receiving AA‐P treatment. Furthermore, the levels of circulating KLK3 mRNA in patients receiving AA‐P treatment might reflect treatment response or early signs of progression.
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Affiliation(s)
- Emmy Boerrigter
- Department of PharmacyRadboud University Medical CenterRadboud Institute for Health SciencesNijmegenthe Netherlands
| | - Guillemette E. Benoist
- Department of PharmacyRadboud University Medical CenterRadboud Institute for Health SciencesNijmegenthe Netherlands
| | - Inge M. van Oort
- Department of UrologyRadboud University Medical CenterRadboud Institute for Molecular Life SciencesNijmegenthe Netherlands
| | - Gerald W. Verhaegh
- Department of UrologyRadboud University Medical CenterRadboud Institute for Molecular Life SciencesNijmegenthe Netherlands
| | - Onno van Hooij
- Department of UrologyRadboud University Medical CenterRadboud Institute for Molecular Life SciencesNijmegenthe Netherlands
| | - Levi Groen
- Department of UrologyRadboud University Medical CenterRadboud Institute for Molecular Life SciencesNijmegenthe Netherlands
| | | | - Irma M. Oving
- Department of Medical OncologyZiekenhuisgroep TwenteAlmelothe Netherlands
| | - Pieter de Mol
- Department of Medical OncologyGelderse Vallei HospitalEdethe Netherlands
| | - Tineke J. Smilde
- Department of Medical OncologyJeroen Bosch Hospital‘s Hertogenboschthe Netherlands
| | | | - Niven Mehra
- Deparment of Medical OncologyRadboud University Medical CenterNijmegenthe Netherlands
| | - Jack A. Schalken
- Department of UrologyRadboud University Medical CenterRadboud Institute for Molecular Life SciencesNijmegenthe Netherlands
| | - Nielka P. van Erp
- Department of PharmacyRadboud University Medical CenterRadboud Institute for Health SciencesNijmegenthe Netherlands
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10
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Beg S, Malik AK, Afzal O, Altamimi ASA, Kazmi I, Al-Abbasi FA, Almalki WH, Barkat MA, Kawish SM, Pradhan DP, Rahman M. Systematic Development and Validation of a RP-HPLC Method for Estimation of Abiraterone Acetate and its Degradation Products. J Chromatogr Sci 2021; 59:79-87. [PMID: 33169159 DOI: 10.1093/chromsci/bmaa080] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/15/2020] [Accepted: 09/19/2020] [Indexed: 11/13/2022]
Abstract
The present study described the development of a reversed-phase liquid chromatographic method for the estimation of abiraterone acetate by Quality by Design (QbD) approach. Using an isocratic solvent system for the mobile phase, the chromatographic estimation of analyte was performed on a Hypersil BDS C18 column using mobile phase mixture containing acetonitrile and water with pH adjusted with 0.1% v/v orthophosphoric acid (15:85%v/v ratio), flow rate 1.0 mL.min-1 and detection at 250 nm using photodiode array detector. Systematic development of the chromatographic method was carried out by factor screening using a half-factorial design which suggested organic modifier (%), flow rate (mL.min-1) and autosampler temperature (°C) as influential variables. Further, the method was optimized by Box-Behnken design and trials performed were evaluated for the area under peak, retention time, theoretical plate count and tailing factor as the responses. Validation of the developed method showed good linearity, accuracy, precision and sensitivity. Evaluation of the stability-indicating profile of the method using forced degradation studies revealed the formation of a possible degradation product under acidic and alkaline conditions, while no such degradation product peaks were observed under the oxidative environment. Overall, the study construed the successful development of HPLC assay method for pharmaceutical applications.
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Affiliation(s)
- Sarwar Beg
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India
| | - Ankit K Malik
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India
| | - Obaid Afzal
- Department of Pharmaceutical Chemistry, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | | | - Imran Kazmi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Fahad A Al-Abbasi
- Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Waleed H Almalki
- Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia
| | - Md Abul Barkat
- Department of Pharmaceutics, College of Pharmacy, University of Hafr Al Batin, Al Jamiah, Hafr Al Batin 39524, Saudi Arabia
| | - S M Kawish
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India
| | - Debi Prasad Pradhan
- Analytical Research and Development, Sentiss Pharma Pvt. Ltd., 261, Phase IV, Udyog Vihar, Sector 18 Gurugram 122001, India
| | - Mahfoozur Rahman
- Department of Pharmaceutical Sciences, SIHAS, Faculty of Health Science, Sam Higginbottom University of Agriculture Technology and Sciences, Allahabad 211007, India
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11
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Krens SD, Lubberman FJE, van Egmond M, Jansman FGA, Burger DM, Hamberg P, Vervenne WL, Gelderblom H, van der Graaf WTA, Desar IME, van Herpen CML, van Erp NP. The impact of a 1-hour time interval between pazopanib and subsequent intake of gastric acid suppressants on pazopanib exposure. Int J Cancer 2021; 148:2799-2806. [PMID: 33428771 PMCID: PMC8048885 DOI: 10.1002/ijc.33469] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/16/2020] [Accepted: 12/17/2020] [Indexed: 01/01/2023]
Abstract
Co‐treatment with gastric acid suppressants (GAS) in patients taking anticancer drugs that exhibit pH‐dependant absorption may lead to decreased drug exposure and may hamper drug efficacy. In our study, we investigated whether a 1‐hour time interval between subsequent intake of pazopanib and GAS could mitigate this negative effect on drug exposure. We performed an observational study in which we collected the first steady‐state pazopanib trough concentration (Cmin) levels from patients treated with pazopanib 800 mg once daily (OD) taken fasted or pazopanib 600 mg OD taken with food. All patients were advised to take GAS 1 hour after pazopanib. Patients were grouped based on the use of GAS and the geometric (GM) Cmin levels were compared between groups for each dose regimen. Additionally, the percentage of patients with exposure below the target threshold of 20.5 mg/L and the effect of the type of PPI was explored. The GM Cmin levels were lower in GAS users vs non‐GAS users for both the 800 and 600 mg cohorts (23.7 mg/L [95% confidence interval [CI]: 21.1‐26.7] vs 28.2 mg/L [95% CI: 25.9‐30.5], P = .015 and 26.0 mg/L [95% CI: 22.4‐30.3] vs 33.5 mg/L [95% CI: 30.3‐37.1], P = .006). Subtherapeutic exposure was more prevalent in GAS users vs non‐GAS users (33.3% vs 19.5% and 29.6% vs 14%). Sub‐analysis showed lower GM pazopanib Cmin in patients who received omeprazole, while minimal difference was observed in those receiving pantoprazole compared to non‐users. Our research showed that a 1‐hour time interval between intake of pazopanib and GAS did not mitigate the negative effect of GAS on pazopanib exposure and may hamper pazopanib efficacy.
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Affiliation(s)
- Stefanie D. Krens
- Department of PharmacyRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenThe Netherlands
| | | | - Marthe van Egmond
- Department of Clinical PharmacyRadboud University Medical CenterNijmegenThe Netherlands
| | - Frank G. A. Jansman
- Department of PharmacyDeventer HospitalDeventerThe Netherlands
- PharmacoTherapy, ‐Epidemiology & ‐EconomicsUniversity of Groningen, Groningen Research Institute of PharmacyGroningenThe Netherlands
| | - David M. Burger
- Department of PharmacyRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenThe Netherlands
| | - Paul Hamberg
- Department of Medical OncologyFranciscus Gasthuis & VlietlandRotterdamThe Netherlands
| | | | - Hans Gelderblom
- Department of Medical OncologyLeiden University Medical CenterLeidenThe Netherlands
| | - Winette T. A. van der Graaf
- Department of Medical OncologyRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenThe Netherlands
| | - Ingrid M. E. Desar
- Department of Medical OncologyRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenThe Netherlands
| | - Carla M. L. van Herpen
- Department of Medical OncologyRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenThe Netherlands
| | - Nielka P. van Erp
- Department of Clinical PharmacyRadboud University Medical Center, Radboud Institute for Health SciencesNijmegenThe Netherlands
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12
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Dillenburg Weiss TL, Gössling G, Venzon Antunes M, Schwartsmann G, Linden R, Gasparin Verza S. Evaluation of dried blood spots as an alternative matrix for therapeutic drug monitoring of abiraterone and delta(4)-abiraterone in prostate cancer patients. J Pharm Biomed Anal 2020; 195:113861. [PMID: 33373824 DOI: 10.1016/j.jpba.2020.113861] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 02/07/2023]
Abstract
Therapeutic drug monitoring (TDM) approaches may benefit patients treated with abiraterone acetate (AA) as drug efficacy is imprecise and important pharmacokinetic variability is known. Current methods based on the analysis of plasma present the disadvantage of the fast degradation of the analytes in the liquid sample. Dried blood spots (DBS) consist of a minimally invasive and unexplored sampling strategy to monitor the levels of abiraterone (ABI) and delta(4)-abiraterone (D4A) in patients. This study presents the development and validation of a precise and accurate method to monitor ABI and D4A in DBS samples by UPLC-MS/MS. Bioanalytical method validation was carried out according to current guidelines, evaluating the impact of DBS-specific parameters such as hematocrit and spot volume on accuracy. Based on the analysis of quality control samples prepared at low, medium and high concentrations, the method was precise with CV ≤ 6.97 % and 10.26 % for ABI and D4A, respectively. The method was also highly accurate, between 93.6-106.8 % for ABI and 96.0-108.5 % for D4A. The DBS method is compatible with the analysis of samples of unknown volume and hematocrit range of the studied population. In addition, ABI and D4A were stable for 7 days in DBS at room temperature, which is feasible for sample transportation in postal service and analysis in the laboratory. Method application to 16 clinical samples revealed good correlation between measured plasma concentrations and estimated plasma concentrations for ABI (r = 0.884, P < 0.05) and D4A (r = 0.920, P < 0.05). Passing-Bablok regression analysis and Bland-Altmann plots indicated correlation between the results obtained from DBS and plasma, with a slight overestimation of the concentrations of ABI in DBS, which could be related to the small study cohort. Therefore, the results of this first work indicate that DBS consist of a promising alternative sampling strategy in TDM studies of AA.
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Affiliation(s)
- Thaís Luise Dillenburg Weiss
- Graduate Program in Toxicology and Analytical Toxicology, Institute of Health Sciences, University Feevale, Novo Hamburgo, Brazil
| | - Gustavo Gössling
- Department of Oncology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Marina Venzon Antunes
- Graduate Program in Toxicology and Analytical Toxicology, Institute of Health Sciences, University Feevale, Novo Hamburgo, Brazil
| | | | - Rafael Linden
- Graduate Program in Toxicology and Analytical Toxicology, Institute of Health Sciences, University Feevale, Novo Hamburgo, Brazil
| | - Simone Gasparin Verza
- Graduate Program in Toxicology and Analytical Toxicology, Institute of Health Sciences, University Feevale, Novo Hamburgo, Brazil.
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13
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Weiss TLD, Furtado CM, Antunes MV, Gössling G, Schwartsmann G, Linden R, Verza SG. A quick UPLC–MS/MS method for therapeutic drug monitoring of abiraterone and delta(4)‐abiraterone in human plasma. Biomed Chromatogr 2020; 34:e4947. [DOI: 10.1002/bmc.4947] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/19/2020] [Accepted: 07/09/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Thaís Luise Dillenburg Weiss
- Graduate Program on Toxicology and Analytical Toxicology, Institute of Health Sciences University Feevale Novo Hamburgo Brazil
| | - Carolina Mesquita Furtado
- Graduate Program on Toxicology and Analytical Toxicology, Institute of Health Sciences University Feevale Novo Hamburgo Brazil
| | - Marina Venzon Antunes
- Graduate Program on Toxicology and Analytical Toxicology, Institute of Health Sciences University Feevale Novo Hamburgo Brazil
| | - Gustavo Gössling
- Oncology Department, Hospital de Clínicas de Porto Alegre Porto Alegre RS Brazil
| | | | - Rafael Linden
- Graduate Program on Toxicology and Analytical Toxicology, Institute of Health Sciences University Feevale Novo Hamburgo Brazil
| | - Simone Gasparin Verza
- Graduate Program on Toxicology and Analytical Toxicology, Institute of Health Sciences University Feevale Novo Hamburgo Brazil
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14
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Lubberman FJE, Benoist GE, Gerritsen W, Burger DM, Mehra N, Hamberg P, van Oort I, van Erp NP. A prospective phase I multicentre randomized cross-over pharmacokinetic study to determine the effect of food on abiraterone pharmacokinetics. Cancer Chemother Pharmacol 2019; 84:1179-1185. [PMID: 31515667 PMCID: PMC6820614 DOI: 10.1007/s00280-019-03952-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 08/30/2019] [Indexed: 01/03/2023]
Abstract
Purpose Abiraterone acetate is used at a fixed oral dose of 1000 mg once daily (OD) taken fasted. By administering abiraterone acetate with food, a reduced dose can potentially be given while maintaining equivalent abiraterone exposure. Moreover, administering abiraterone acetate with a breakfast is considered more patient friendly. The aim of this study was to establish the bio-equivalent lower dose of abiraterone when taken with a continental breakfast (CB) compared to the standard intake of 1000 mg OD fasted. Methods In this phase I, randomized cross-over, multi-center study, abiraterone pharmacokinetics (PK) were evaluated in patients with metastatic castration-resistant prostate cancer who were treated for 14 days with 1000 mg abiraterone acetate taken fasted, followed by 14 days of treatment with 500 mg taken with a CB. Results 14 patients were enrolled into the study, of whom 12 were eligible for PK analysis. The geometric mean ratio (GMR) (fed/fasted) was 0.88 (90% CI 0.73–1.07) for area-under-the-curve (AUC0–24h), 1.03 (90% CI 0.79–1.34) for Cmax and 0.81 (90% CI 0.60–1.10) for Ctrough, respectively. High inter-patient variability (> 50%) was found for all PK parameters under both intake conditions. Patients seemed to be slightly more satisfied about the intake of 500 mg abiraterone acetate when taken with a CB compared to 1000 mg fasted. Conclusion In conclusion, a bioequivalent lower dose of abiraterone taken with food could not be established in our study. Although based on the absence of a exposure–toxicity relationship, the strict bioequivalence margins as defined by the FDA guidelines could be applied more flexible for abiraterone. Information on the effect of food on abiraterone pharmacokinetics as presented in our study can be used for patients with difficulties taken their medication fasted. Electronic supplementary material The online version of this article (10.1007/s00280-019-03952-w) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Floor J E Lubberman
- Department of Pharmacy (864), Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Guillemette E Benoist
- Department of Pharmacy (864), Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Winald Gerritsen
- Department of Medical Oncology, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - David M Burger
- Department of Pharmacy (864), Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Niven Mehra
- Department of Medical Oncology, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Paul Hamberg
- Department of Medical Oncology, Franciscus Gasthuis and Vlietland, Kleiweg 500, 3045 PM, Rotterdam, The Netherlands
| | - Inge van Oort
- Department of Urology, Radboud Institute for Health Sciences, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Nielka P van Erp
- Department of Pharmacy (864), Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
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15
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Bioanalytical evaluation of dried plasma spots for monitoring of abiraterone and ∆(4)-abiraterone from cancer patients. J Chromatogr B Analyt Technol Biomed Life Sci 2019; 1126-1127:121741. [DOI: 10.1016/j.jchromb.2019.121741] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/03/2019] [Accepted: 07/30/2019] [Indexed: 02/03/2023]
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16
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Bouhajib M, Tayab Z. Evaluation of the Pharmacokinetics of Abiraterone Acetate and Abiraterone Following Single-Dose Administration of Abiraterone Acetate to Healthy Subjects. Clin Drug Investig 2019; 39:309-317. [DOI: 10.1007/s40261-019-00752-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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17
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van Nuland M, Venekamp N, de Vries N, de Jong KAM, Rosing H, Beijnen JH. Development and validation of an UPLC-MS/MS method for the therapeutic drug monitoring of oral anti-hormonal drugs in oncology. J Chromatogr B Analyt Technol Biomed Life Sci 2019; 1106-1107:26-34. [PMID: 30639947 DOI: 10.1016/j.jchromb.2019.01.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/31/2018] [Accepted: 01/02/2019] [Indexed: 10/27/2022]
Abstract
A liquid chromatography-mass spectrometry assay was developed and validated for simultaneous quantification of anti-hormonal compounds abiraterone, anastrozole, bicalutamide, Δ(4)-abiraterone (D4A), N-desmethyl enzalutamide, enzalutamide, Z-endoxifen, exemestane and letrozole for the purpose of therapeutic drug monitoring (TDM). Plasma samples were prepared with protein precipitation. Analyses were performed with a triple quadrupole mass spectrometer operating in the positive and negative ion-mode. The validated assay ranges from 2 to 200 ng/mL for abiraterone, 0.2-20 ng/mL for D4A, 10-200 ng/mL for anastrozole and letrozole, 1-20 ng/mL for Z-endoxifen, 1.88-37.5 ng/mL for exemestane and 1500-30,000 ng/mL for enzalutamide, N-desmethyl enzalutamide and bicalutamide. Due to low sensitivity for exemestane, the final extract of exemestane patient samples should be concentrated prior to injection and a larger sample volume should be prepared for exemestane patient samples and QC samples to obtain adequate sensitivity. Furthermore, we observed a batch-dependent stability for abiraterone in plasma at room temperature and therefore samples should be shipped on ice. This newly validated method has been successfully applied for routine TDM of anti-hormonal drugs in cancer patients.
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Affiliation(s)
- M van Nuland
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute and MC Slotervaart, Amsterdam, the Netherlands; Division of Pharmacology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
| | - N Venekamp
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute and MC Slotervaart, Amsterdam, the Netherlands
| | - N de Vries
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute and MC Slotervaart, Amsterdam, the Netherlands
| | - K A M de Jong
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute and MC Slotervaart, Amsterdam, the Netherlands; Division of Pharmacology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - H Rosing
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute and MC Slotervaart, Amsterdam, the Netherlands
| | - J H Beijnen
- Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute and MC Slotervaart, Amsterdam, the Netherlands; Division of Pharmacology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, the Netherlands
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18
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Caron P, Turcotte V, Lévesque E, Guillemette C. An LC-MS/MS method for quantification of abiraterone, its active metabolites D(4)-abiraterone (D4A) and 5α-abiraterone, and their inactive glucuronide derivatives. J Chromatogr B Analyt Technol Biomed Life Sci 2019; 1104:249-255. [DOI: 10.1016/j.jchromb.2018.12.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/15/2018] [Accepted: 12/03/2018] [Indexed: 11/29/2022]
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19
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Woei-A-Jin FJSH, Van Nieuwenhuyse T, van Erp NP, Beuselinck B, Stroobants S, Moes DJAR, Osanto S, Spriet I. Dose Reduction May Jeopardize Efficacy of Abiraterone Acetate. J Clin Oncol 2018; 36:3062-3064. [PMID: 30188790 DOI: 10.1200/jco.2018.79.3182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- F J Sherida H Woei-A-Jin
- F.J. Sherida H. Woei-A-Jin, University Hospitals Leuven, Leuven, Belgium; and Leiden University Medical Center, Leiden, the Netherlands; Tine Van Nieuwenhuyse, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium; Nielka P. van Erp, Radboud University Medical Center, Nijmegen, the Netherlands; Benoit Beuselinck and Stephanie Stroobants, University Hospitals Leuven, Leuven, Belgium; Dirk Jan A.R. Moes and Susanne Osanto, Leiden University Medical Center, Leiden, the Netherlands; and Isabel Spriet, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium
| | - Tine Van Nieuwenhuyse
- F.J. Sherida H. Woei-A-Jin, University Hospitals Leuven, Leuven, Belgium; and Leiden University Medical Center, Leiden, the Netherlands; Tine Van Nieuwenhuyse, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium; Nielka P. van Erp, Radboud University Medical Center, Nijmegen, the Netherlands; Benoit Beuselinck and Stephanie Stroobants, University Hospitals Leuven, Leuven, Belgium; Dirk Jan A.R. Moes and Susanne Osanto, Leiden University Medical Center, Leiden, the Netherlands; and Isabel Spriet, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium
| | - Nielka P van Erp
- F.J. Sherida H. Woei-A-Jin, University Hospitals Leuven, Leuven, Belgium; and Leiden University Medical Center, Leiden, the Netherlands; Tine Van Nieuwenhuyse, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium; Nielka P. van Erp, Radboud University Medical Center, Nijmegen, the Netherlands; Benoit Beuselinck and Stephanie Stroobants, University Hospitals Leuven, Leuven, Belgium; Dirk Jan A.R. Moes and Susanne Osanto, Leiden University Medical Center, Leiden, the Netherlands; and Isabel Spriet, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium
| | - Benoit Beuselinck
- F.J. Sherida H. Woei-A-Jin, University Hospitals Leuven, Leuven, Belgium; and Leiden University Medical Center, Leiden, the Netherlands; Tine Van Nieuwenhuyse, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium; Nielka P. van Erp, Radboud University Medical Center, Nijmegen, the Netherlands; Benoit Beuselinck and Stephanie Stroobants, University Hospitals Leuven, Leuven, Belgium; Dirk Jan A.R. Moes and Susanne Osanto, Leiden University Medical Center, Leiden, the Netherlands; and Isabel Spriet, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium
| | - Stephanie Stroobants
- F.J. Sherida H. Woei-A-Jin, University Hospitals Leuven, Leuven, Belgium; and Leiden University Medical Center, Leiden, the Netherlands; Tine Van Nieuwenhuyse, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium; Nielka P. van Erp, Radboud University Medical Center, Nijmegen, the Netherlands; Benoit Beuselinck and Stephanie Stroobants, University Hospitals Leuven, Leuven, Belgium; Dirk Jan A.R. Moes and Susanne Osanto, Leiden University Medical Center, Leiden, the Netherlands; and Isabel Spriet, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium
| | - Dirk Jan A R Moes
- F.J. Sherida H. Woei-A-Jin, University Hospitals Leuven, Leuven, Belgium; and Leiden University Medical Center, Leiden, the Netherlands; Tine Van Nieuwenhuyse, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium; Nielka P. van Erp, Radboud University Medical Center, Nijmegen, the Netherlands; Benoit Beuselinck and Stephanie Stroobants, University Hospitals Leuven, Leuven, Belgium; Dirk Jan A.R. Moes and Susanne Osanto, Leiden University Medical Center, Leiden, the Netherlands; and Isabel Spriet, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium
| | - Susanne Osanto
- F.J. Sherida H. Woei-A-Jin, University Hospitals Leuven, Leuven, Belgium; and Leiden University Medical Center, Leiden, the Netherlands; Tine Van Nieuwenhuyse, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium; Nielka P. van Erp, Radboud University Medical Center, Nijmegen, the Netherlands; Benoit Beuselinck and Stephanie Stroobants, University Hospitals Leuven, Leuven, Belgium; Dirk Jan A.R. Moes and Susanne Osanto, Leiden University Medical Center, Leiden, the Netherlands; and Isabel Spriet, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium
| | - Isabel Spriet
- F.J. Sherida H. Woei-A-Jin, University Hospitals Leuven, Leuven, Belgium; and Leiden University Medical Center, Leiden, the Netherlands; Tine Van Nieuwenhuyse, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium; Nielka P. van Erp, Radboud University Medical Center, Nijmegen, the Netherlands; Benoit Beuselinck and Stephanie Stroobants, University Hospitals Leuven, Leuven, Belgium; Dirk Jan A.R. Moes and Susanne Osanto, Leiden University Medical Center, Leiden, the Netherlands; and Isabel Spriet, University Hospitals Leuven; and Katholieke Universiteit Leuven, Leuven, Belgium
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20
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Quantitation of the anticancer drug abiraterone and its metabolite Δ(4)-abiraterone in human plasma using high-resolution mass spectrometry. J Pharm Biomed Anal 2018. [DOI: 10.1016/j.jpba.2018.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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21
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Benoist GE, van der Doelen MJ, Ter Heine R, van Erp NP, Mehra N. A clinically relevant decrease in abiraterone exposure associated with carbamazepine use in a patient with castration-resistant metastatic prostate cancer. Br J Clin Pharmacol 2018; 84:1064-1067. [PMID: 29384591 DOI: 10.1111/bcp.13532] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/19/2018] [Accepted: 01/19/2018] [Indexed: 12/13/2022] Open
Abstract
ADVERSE EVENT Decreased abiraterone exposure after introducing carbamazepine. DRUGS IMPLICATED Abiraterone acetate and carbamazepine. THE PATIENT A 65-year-old man with metastatic castration resistant prostate cancer, was treated with abiraterone acetate and prednisolone, and received concomitant carbamazepine for treatment of facial neuropathy. EVIDENCE THAT LINKS THE DRUG TO THE EVENT The interaction was confirmed by a decrease in abiraterone exposure >2-fold (area-under-the-curve and trough levels). After discontinuation of carbamazepine therapy, the abiraterone exposure normalized. No alternative causes were found that explain the decrease in abiraterone exposure. MECHANISM Induction of CYP3A and potentially phase I metabolism (SULT2A1) by carbamazepine. IMPLICATIONS FOR THERAPY Clinicians and pharmacists should be aware of this clinically relevant interaction. The national drug-drug interaction checker does not warn for this interaction, whereas both the Lexicomp® and Micromedex® advice to avoid if possible or to increase the abiraterone dose frequency to twice daily. Carbamazepine should not be combined with abiraterone to avoid underexposure and suboptimal therapy. Therapeutic drug monitoring of abiraterone is useful to guide therapy when drug-drug interactions cannot be avoided.
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Affiliation(s)
- Guillemette E Benoist
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Maarten J van der Doelen
- Department of Urology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Medical Oncology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rob Ter Heine
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nielka P van Erp
- Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Niven Mehra
- Department of Medical Oncology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
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