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Young GC, Spracklin DK, James AD, Hvenegaard MG, Pedersen ML, Wagner DS, Georgi K, Schieferstein H, Bjornsdottir I, Romeo AA, Cassidy KC, Da-Violante G, Blech S, Schulz SI, Cuyckens F, Nguyen MA, Scarfe G. Non-Labeled, Stable Labeled, or Radiolabelled Approaches for Provision of Intravenous Pharmacokinetics in Humans: A Discussion Piece. Clin Pharmacol Ther 2024; 115:931-938. [PMID: 38018358 DOI: 10.1002/cpt.3121] [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: 08/21/2023] [Accepted: 11/21/2023] [Indexed: 11/30/2023]
Abstract
A review of the use of microdoses and isotopic microtracers for clinical intravenous pharmacokinetic (i.v. PK) data provision is presented. The extent of application of the varied approaches available and the relative merits of each are highlighted with the aim of assisting practitioners in making informed decisions on the most scientifically appropriate design to adopt for any given new drug in development. It is envisaged that significant efficiencies will be realized as i.v. PK data in humans becomes more routinely available for suitable assets in early development, than has been the case prior to the last decade.
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Affiliation(s)
| | | | | | | | - Mette L Pedersen
- Drug Metabolism and Pharmacokinetics, Early Research and Development, Cardiovascular, Renal and Metabolism, Biopharmaceuticals R&D, AstraZeneca, Gothenburg, Sweden
| | | | - Katrin Georgi
- The Healthcare Business of Merck KGaA, Darmstadt, Germany
| | | | | | - Andrea A Romeo
- Roche Pharma Research and Early Development, Basel, Switzerland
| | | | | | - Stefan Blech
- Boehringer-Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
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2
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Ha EJ, Seo JI, Rehman SU, Park HS, Yoo SK, Yoo HH. Preclinical Bioavailability Assessment of a Poorly Water-Soluble Drug, HGR4113, Using a Stable Isotope Tracer. Pharmaceutics 2023; 15:1684. [PMID: 37376132 DOI: 10.3390/pharmaceutics15061684] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/23/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Drug solubility limits intravenous dosing for poorly water-soluble medicines, which misrepresents their bioavailability estimation. The current study explored a method using a stable isotope tracer to assess the bioavailability of drugs that are poorly water-soluble. HGR4113 and its deuterated analog, HGR4113-d7, were tested as model drugs. To determine the level of HGR4113 and HGR4113-d7 in rat plasma, a bioanalytical method using LC-MS/MS was developed. The HGR4113-d7 was intravenously administered to rats that were orally pre-administered HGR4113 at different doses; subsequently, the plasma samples were collected. HGR4113 and HGR4113-d7 were simultaneously determined in the plasma samples, and bioavailability was calculated using plasma drug concentration values. The bioavailability of HGR4113 was 53.3% ± 19.5%, 56.9% ± 14.0%, and 67.8% ± 16.7% after oral dosages of 40, 80, and 160 mg/kg, respectively. By eliminating the differences in clearance between intravenous and oral dosages at different levels, acquired data showed that the current method reduced measurement errors in bioavailability when compared to the conventional approach. The present study suggests a prominent method for evaluating the bioavailability of drugs with poor aqueous solubility in preclinical studies.
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Affiliation(s)
- Eun Ji Ha
- Institute of Pharmaceutical Science and Technology, College of Pharmacy, Hanyang University, Ansan 15588, Gyeonggi-do, Republic of Korea
| | - Jeong In Seo
- Institute of Pharmaceutical Science and Technology, College of Pharmacy, Hanyang University, Ansan 15588, Gyeonggi-do, Republic of Korea
| | | | - Hyung Soon Park
- Glaceum Inc., Yeongtong-gu, Suwon 16675, Gyeonggi-do, Republic of Korea
| | - Sang-Ku Yoo
- Glaceum Inc., Yeongtong-gu, Suwon 16675, Gyeonggi-do, Republic of Korea
| | - Hye Hyun Yoo
- Institute of Pharmaceutical Science and Technology, College of Pharmacy, Hanyang University, Ansan 15588, Gyeonggi-do, Republic of Korea
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3
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Schueller O, Skucas E, Regev G, Shaw I, Singh N, Sanghvi M, Croft M, Lohmer L, Alabanza A, Patel J. Absolute Bioavailability, Mass Balance, and Metabolic Profiling Assessment of [ 14 C]-Belumosudil in Healthy Men: A Phase 1, Open-Label, 2-Part Study. Clin Pharmacol Drug Dev 2022; 11:786-794. [PMID: 35231159 DOI: 10.1002/cpdd.1085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/24/2022] [Indexed: 12/24/2022]
Abstract
Belumosudil is a selective Rho-associated coiled-coil containing protein kinase 2 (ROCK2) inhibitor. ROCK2 has been shown to drive proinflammatory response and fibrosis that occurs with chronic graft-versus-host disease; therefore, inhibition of ROCK2 has emerged as a therapeutic target for chronic graft-versus-host disease. In this phase 1 two-part study, the pharmacokinetics, mass balance, and metabolic profile of belumosudil were evaluated after single doses of unlabeled belumosudil oral tablets (200 mg), radiolabeled belumosudil intravenous (IV) microtracer infusions (100 μg), and radiolabeled oral capsules (200 mg). Absolute bioavailability based on area under the plasma concentration-time curve from time 0 to infinity for the oral dose/area under the plasma concentration-time curve from time 0 to infinity for the IV dose was calculated as 63.7%. Radiolabeled IV microtracer dosing demonstrated a low extraction ratio and distribution of belumosudil into tissues. The majority of total radioactivity was recovered in feces, with minimal amounts recovered in urine, suggesting minimal renal elimination of belumosudil. In addition to parent and main metabolite KD025m2, metabolites identified in plasma included the phase 2 metabolites O-dealkylated belumosudil sulfate and belumosudil glucuronide. These metabolites (with the exception of the glucuronide) in addition to monohydroxy-belumosudil, and belumosudil diol were identified in feces. No metabolites in urine accounted for >10% of the radioactive dose.
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Affiliation(s)
| | - Ed Skucas
- Kadmon Corporation LLC, Cambridge, Massachusetts, USA
| | - Galit Regev
- Kadmon Corporation LLC, Cambridge, Massachusetts, USA
| | | | | | | | | | | | | | - Jeegar Patel
- Kadmon Corporation LLC, Cambridge, Massachusetts, USA
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4
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Best practices in current models mimicking drug permeability in the gastrointestinal tract - an UNGAP review. Eur J Pharm Sci 2021; 170:106098. [PMID: 34954051 DOI: 10.1016/j.ejps.2021.106098] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/19/2021] [Accepted: 12/15/2021] [Indexed: 12/21/2022]
Abstract
The absorption of orally administered drug products is a complex, dynamic process, dependent on a range of biopharmaceutical properties; notably the aqueous solubility of a molecule, stability within the gastrointestinal tract (GIT) and permeability. From a regulatory perspective, the concept of high intestinal permeability is intrinsically linked to the fraction of the oral dose absorbed. The relationship between permeability and the extent of absorption means that experimental models of permeability have regularly been used as a surrogate measure to estimate the fraction absorbed. Accurate assessment of a molecule's intestinal permeability is of critical importance during the pharmaceutical development process of oral drug products, and the current review provides a critique of in vivo, in vitro and ex vivo approaches. The usefulness of in silico models to predict drug permeability is also discussed and an overview of solvent systems used in permeability assessments is provided. Studies of drug absorption in humans are an indirect indicator of intestinal permeability, but in vitro and ex vivo tools provide initial screening approaches are important tools for direct assessment of permeability in drug development. Continued refinement of the accuracy of in silico approaches and their validation with human in vivo data will facilitate more efficient characterisation of permeability earlier in the drug development process and will provide useful inputs for integrated, end-to-end absorption modelling.
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5
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Mahar KM, Caltabiano S, Andrews S, Ramanjineyulu B, Chen L, Young G, Pereira A, Lindsay AC, van den Berg F, Cobitz AR. Clinical Pharmacokinetics of Daprodustat: Results of an Absorption, Distribution, and Excretion Study With Intravenous Microtracer and Concomitant Oral Doses for Bioavailability Determination. Clin Pharmacol Drug Dev 2021; 10:1419-1431. [PMID: 34713596 PMCID: PMC9298194 DOI: 10.1002/cpdd.1029] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 09/13/2021] [Indexed: 12/19/2022]
Abstract
Daprodustat, an oral hypoxia‐inducible factor prolyl hydroxylase inhibitor, is being investigated for treatment of anemia in chronic kidney disease. This phase 1, nonrandomized, 2‐period, crossover study in 6 healthy men characterized the absorption, distribution, and excretion of daprodustat when administered as oral and intravenous (IV) doses of unlabeled and radiolabeled daprodustat ([14C]‐GSK1278863). Tolerability and pharmacokinetic properties of daprodustat, and its 6 metabolites in the systemic circulation, were also evaluated. The mean recovery of radiolabeled daprodustat was ≈95% by day 5, with the majority in feces and minor renal elimination, indicating that daprodustat and metabolites are primarily eliminated via hepatobiliary and fecal routes. Approximately 40% of total circulating radioactivity in plasma following both IV and oral administration was daprodustat; thus, 60% was attributed to metabolites. It was estimated that ≈80% of daprodustat was absorbed across the gastrointestinal tract, and ≈18% cleared by hepatic extraction. Pharmacokinetics were essentially dose proportional, with moderate (≈66%) oral tablet bioavailability. Following IV administration, daprodustat plasma clearance (19.3 L/h) and volume of distribution (14.6 L) were low, suggesting low tissue distribution outside systemic circulation with likely low penetration into tissues. Daprodustat was generally well tolerated, with no deaths or serious or significant adverse events reported.
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Affiliation(s)
- Kelly M Mahar
- Clinical Pharmacology Modeling & Simulation, GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Stephen Caltabiano
- Development-Clinical Sciences, GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Susan Andrews
- Clinical Science & Study Operations, GlaxoSmithKline, Research Triangle Park, North Carolina, USA
| | | | - Liangfu Chen
- Drug Metabolism and Pharmacokinetics, GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | - Graeme Young
- Disposition & Biotransformation, GlaxoSmithKline, Ware, UK
| | - Adrian Pereira
- Disposition & Biotransformation, GlaxoSmithKline, Ware, UK
| | - Alistair C Lindsay
- Development-Clinical Sciences, GlaxoSmithKline, Collegeville, Pennsylvania, USA
| | | | - Alexander R Cobitz
- Development-Clinical Sciences, GlaxoSmithKline, Collegeville, Pennsylvania, USA
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6
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Huynh C, Henrich A, Strasser DS, Boof ML, Al-Ibrahim M, Meyer Zu Schwabedissen HE, Dingemanse J, Ufer M. A Multipurpose First-in-Human Study With the Novel CXCR7 Antagonist ACT-1004-1239 Using CXCL12 Plasma Concentrations as Target Engagement Biomarker. Clin Pharmacol Ther 2021; 109:1648-1659. [PMID: 33406277 DOI: 10.1002/cpt.2154] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/04/2020] [Indexed: 11/09/2022]
Abstract
The C-X-C chemokine receptor 7 (CXCR7) has evolved as a promising, druggable target mainly in the immunology and oncology fields modulating plasma concentrations of its ligands CXCL11 and CXCL12 through receptor-mediated internalization. This "scavenging" activity creates concentration gradients of these ligands between blood vessels and tissues that drive directional cell migration. This randomized, double-blind, placebo-controlled first-in-human study assessed the safety, tolerability, pharmacokinetics, and pharmacodynamics of ACT-1004-1239, a first-in-class drug candidate small-molecule CXCR7 antagonist. Food effect and absolute bioavailability assessments were also integrated in this multipurpose study. Healthy male subjects received single ascending oral doses of ACT-1004-1239 (n = 36) or placebo (n = 12). At each of six dose levels (1-200 mg), repeated blood sampling was done over 144 hours for pharmacokinetic/pharmacodynamic assessments using CXCL11 and CXCL12 as biomarkers of target engagement. ACT-1004-1239 was safe and well tolerated up to the highest tested dose of 200 mg. CXCL12 plasma concentrations dose-dependently increased and more than doubled compared with baseline, indicating target engagement, whereas CXCL11 concentrations remained unchanged. An indirect-response pharmacokinetic/pharmacodynamic model well described the relationship between ACT-1004-1239 and CXCL12 concentrations across the full dose range, supporting once-daily dosing for future clinical studies. At doses ≥ 10 mg, time to reach maximum plasma concentration ranged from 1.3 to 3.0 hours and terminal elimination half-life from 17.8 to 23.6 hours. The exposure increase across the dose range was essentially dose-proportional and no relevant food effect on pharmacokinetics was determined. The absolute bioavailability was 53.0% based on radioactivity data after oral vs. intravenous 14 C-radiolabeled microtracer administration of ACT-1004-1239. Overall, these comprehensive data support further clinical development of ACT-1004-1239.
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Affiliation(s)
- Christine Huynh
- Idorsia Pharmaceuticals Ltd, Allschwil, Switzerland.,University of Basel, Basel, Switzerland
| | | | | | | | | | | | | | - Mike Ufer
- Idorsia Pharmaceuticals Ltd, Allschwil, Switzerland
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7
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Combining Isotopic Tracer Techniques to Increase Efficiency of Clinical Pharmacokinetic Trials in Oncology. Drugs R D 2020; 20:147-154. [PMID: 32300967 PMCID: PMC7221104 DOI: 10.1007/s40268-020-00304-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
With increasing numbers of drugs tested in oncology for smaller patient populations, fewer patients are available to answer important clinical pharmacological questions in the timeframe of clinical drug development. The quality and efficiency of trials to assess the pharmacokinetics of new drugs can be improved by making better use of available resources. One approach to do this is by making more effective use of isotopic tracer techniques. With increasing sensitivity of liquid chromatography-tandem mass spectrometry analyzing equipment over the years, it has now become possible to generate much more rich, high-quality pharmacokinetic data than before. In particular we want to make a plea here for a hybrid trial approach, where both radiolabeled drug and stable isotopically labeled drug are administered to patients to assess both the absolute bioavailability and absorption, distribution, metabolism and excretion in a single clinical trial experiment.
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8
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Roosendaal J, Groenland SL, Rosing H, Lucas L, Venekamp N, Nuijen B, Huitema ADR, Beijnen JH, Steeghs N. Determination of the absolute bioavailability of oral imatinib using a stable isotopically labeled intravenous imatinib-d8 microdose. Eur J Clin Pharmacol 2020; 76:1075-1082. [PMID: 32430518 PMCID: PMC7351863 DOI: 10.1007/s00228-020-02888-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Accepted: 04/30/2020] [Indexed: 12/27/2022]
Abstract
PURPOSE The aim of this study was to ascertain whether the absolute bioavailability of oral imatinib (Glivec®) during steady state plasma pharmacokinetics in cancer patients could be determined through a concomitant intravenous administration of a single 100 μg microdose of deuterium labeled imatinib (imatinib-d8). Secondly, the usefulness of liquid chromatography-tandem mass spectrometry (LC-MS/MS) was investigated for simultaneous analysis of orally and intravenously administered imatinib. METHODS Included patients were on a stable daily dose of 400 mg oral imatinib prior to study participation. On day 1, patients received a 100 μg intravenous imatinib-d8 microdose 2.5 h after intake of the oral dose. Plasma samples were collected for 48 h. Imatinib and imatinib-d8 concentrations were simultaneously quantified using a validated LC-MS/MS assay. The absolute bioavailability was calculated by comparing the dose-normalized exposure with unlabeled and stable isotopically labeled imatinib in plasma. RESULTS A total of six patients were enrolled. All patients had a history of gastrointestinal stromal tumors (GIST). The median absolute bioavailability of oral imatinib at steady state was 76% (range 44-106%). Imatinib and imatinib-d8 plasma concentrations were quantified in all collected plasma samples, with no samples below the limit of quantification for imatinib-d8. CONCLUSION The absolute bioavailability of imatinib was successfully estimated at steady state plasma pharmacokinetics using the stable isotopically labeled microdose trial design. This study exhibits the use of a stable isotopically labeled intravenous microdose to determine the absolute bioavailability of an oral anticancer agent in patients with LC-MS/MS as the analytical tool.
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Affiliation(s)
- Jeroen Roosendaal
- Department of Pharmacy & Pharmacology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
| | - Stefanie L Groenland
- Department of Medical Oncology and Clinical Pharmacology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Hilde Rosing
- Department of Pharmacy & Pharmacology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Luc Lucas
- Department of Pharmacy & Pharmacology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Nikkie Venekamp
- Department of Pharmacy & Pharmacology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Bastiaan Nuijen
- Department of Pharmacy & Pharmacology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
| | - Alwin D R Huitema
- Department of Pharmacy & Pharmacology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Department of Clinical Pharmacy, University Medical Center, Utrecht University, Utrecht, The Netherlands
| | - Jos H Beijnen
- Department of Pharmacy & Pharmacology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands
- Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Neeltje Steeghs
- Department of Medical Oncology and Clinical Pharmacology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
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Roosendaal J, Rosing H, Beijnen JH. Stable Isotopically Labeled Intravenous Microdose Pharmacokinetic Trials as a Tool to Assess Absolute Bioavailability: Feasibility and Paradigm to Apply for Protein Kinase Inhibitors in Oncology. Clin Pharmacol Drug Dev 2020; 9:552-559. [PMID: 32573110 PMCID: PMC7383911 DOI: 10.1002/cpdd.840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 05/18/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Jeroen Roosendaal
- Department of Pharmacy & Pharmacology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.,Division of Pharmacoepidemiology and Clinical Pharmacology, Science Faculty, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Hilde Rosing
- Department of Pharmacy & Pharmacology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
| | - Jos H Beijnen
- Department of Pharmacy & Pharmacology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.,Division of Pharmacoepidemiology and Clinical Pharmacology, Science Faculty, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.,Division of Pharmacology, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands
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10
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Johne A, Scheible H, Becker A, van Lier JJ, Wolna P, Meyring M. Open-label, single-center, phase I trial to investigate the mass balance and absolute bioavailability of the highly selective oral MET inhibitor tepotinib in healthy volunteers. Invest New Drugs 2020; 38:1507-1519. [PMID: 32221754 PMCID: PMC7497692 DOI: 10.1007/s10637-020-00926-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 03/16/2020] [Indexed: 12/13/2022]
Abstract
Tepotinib (MSC2156119J) is an oral, potent, highly selective MET inhibitor. This open-label, phase I study in healthy volunteers (EudraCT 2013-003226-86) investigated its mass balance (part A) and absolute bioavailability (part B). In part A, six participants received tepotinib orally (498 mg spiked with 2.67 MBq [14C]-tepotinib). Blood, plasma, urine, and feces were collected up to day 25 or until excretion of radioactivity was <1% of the administered dose. In part B, six participants received 500 mg tepotinib orally as a film-coated tablet, followed by an intravenous [14C]-tepotinib tracer dose (53–54 kBq) 4 h later. Blood samples were collected until day 14. In part A, a median of 92.5% (range, 87.1–96.9%) of the [14C]-tepotinib dose was recovered in excreta. Radioactivity was mainly excreted via feces (median, 78.7%; range, 69.4–82.5%). Urinary excretion was a minor route of elimination (median, 14.4% [8.8–17.7%]). Parent compound was the main constituent in excreta (45% [feces] and 7% [urine] of the radioactive dose). M506 was the only major metabolite. In part B, absolute bioavailability was 72% (range, 62–81%) after oral administration of 500 mg tablets (the dose and formulation used in phase II trials). In conclusion, tepotinib and its metabolites are mainly excreted via feces; parent drug is the major eliminated constituent. Oral bioavailability of tepotinib is high, supporting the use of the current tablet formulation in clinical trials. Tepotinib was well tolerated in this study with healthy volunteers.
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Affiliation(s)
- Andreas Johne
- Global Clinical Development, Merck KGaA, Frankfurter Strasse 250, 64293, Darmstadt, Germany.
| | - Holger Scheible
- Institute of Drug Metabolism and Pharmacokinetics, Merck KGaA, Grafing, Germany
| | - Andreas Becker
- Global Clinical Development, Merck KGaA, Frankfurter Strasse 250, 64293, Darmstadt, Germany
| | - Jan Jaap van Lier
- Pharmaceutical Research Association (PRA), Groningen, The Netherlands
| | - Peter Wolna
- Global Clinical Development, Merck KGaA, Frankfurter Strasse 250, 64293, Darmstadt, Germany
| | - Michael Meyring
- Institute of Drug Metabolism and Pharmacokinetics, Merck KGaA, Grafing, Germany
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11
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Harrell AW, Wilson R, Man YL, Riddell K, Jarvis E, Young G, Chambers R, Crossman L, Georgiou A, Pereira A, Kenworthy D, Beaumont C, Marotti M, Wilkes D, Hessel EM, Fahy WA. An Innovative Approach to Characterize Clinical ADME and Pharmacokinetics of the Inhaled Drug Nemiralisib Using an Intravenous Microtracer Combined with an Inhaled Dose and an Oral Radiolabel Dose in Healthy Male Subjects. Drug Metab Dispos 2019; 47:1457-1468. [PMID: 31649125 DOI: 10.1124/dmd.119.088344] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 10/12/2019] [Indexed: 12/22/2022] Open
Abstract
An innovative open-label, crossover clinical study was used to investigate the excretion balance, pharmacokinetics, and metabolism of nemiralisib-an inhaled phosphoinositide 3-kinase delta inhibitor being developed for respiratory diseases. Six healthy men received a single intravenous microtracer of 10 µg [14C]nemiralisib with a concomitant inhaled nonradiolabeled 1000 µg dose followed by an oral 800 µg dose of [14C]nemiralisib 14 days later. Complementary methods including accelerator mass spectrometry allowed characterization of a range of parameters including oral absorption (Fabs), proportion of nemiralisib escaping gut wall metabolism (Fg), hepatic extraction (Eh), fraction of dose absorbed from inhaled dose (Flung), and renal clearance. Intravenous pharmacokinetics of nemiralisib were characterized by low blood clearance (10.0 l/h), long terminal half-life (55 hours), and high volume of distribution at steady state (728 l). Nemiralisib exhibited moderate inhaled and oral bioavailability (38% and 35%) while Flung was 29%. Absorption and first-pass parameters were corrected for blood renal clearance and compared with values without correction. Any swallowed nemiralisib was relatively well absorbed (Fabs, 0.48) with a high fraction escaping gut wall metabolism and low extraction by the liver (Fg and Eh being 0.83 and 0.10, respectively). There were no major human plasma metabolites requiring further qualification in animal studies. Both unchanged nemiralisib and its oxidative/conjugative metabolites were secreted in bile, with nemiralisib likely subject to further metabolism through enterohepatic recirculation. Direct renal clearance and metabolism followed by renal clearance were lesser routes of elimination. SIGNIFICANCE STATEMENT: A number of innovative features have been combined into one small clinical study enabling a comprehensive description of the human pharmacokinetics and metabolism of an inhaled molecule. Design elements included an intravenous 14C tracer administration concomitant with an inhalation dose that enabled derivation of parameters such as fraction absorbed (Fabs), the proportion of drug escaping first-pass extraction through the gut wall and liver (Fg and Fh) and hepatic extraction (Eh). Entero-test bile sampling enabled characterization of biliary elimination pathways.
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Affiliation(s)
- Andrew W Harrell
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - Robert Wilson
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - Yau Lun Man
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - Kylie Riddell
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - Emily Jarvis
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - Graeme Young
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - Robert Chambers
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - Lee Crossman
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - Alex Georgiou
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - Adrian Pereira
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - David Kenworthy
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - Claire Beaumont
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - Miriam Marotti
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - Denisa Wilkes
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - Edith M Hessel
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
| | - William A Fahy
- Drug Metabolism and Pharmacokinetics (A.W.H., G.Y., R.C., D.K.) and Bioanalysis, Immunogenicity and Biomarkers (A.G., A.P.), GlaxoSmithKline R&D, Ware, United Kingdom; RD Projects Clinical Platforms & Sciences (R.W.), Drug Metabolism and Pharmacokinetics (C.B.), Discovery Medicine (Y.L.M.), Biostatistics (E.J.), GlaxoSmithKline R&D and Refractory Respiratory Inflammation Discovery Performance Unit, GlaxoSmithKline, Stevenage, United Kingdom (E.M.H.); Safety and Medical Governance (M.M.) and Discovery Medicine (W.A.F.), GlaxoSmithKline R&D, Stockley Park, Uxbridge, United Kingdom; Global Clinical and Data Operations, GlaxoSmithKline R&D, Ermington, Australia (K.R.); Covance Laboratories, Harrogate, United Kingdom (L.C.); and Hammersmith Medicines Research, London, United Kingdom (D.W.)
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12
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de Vries R, Jacobs F, Mannens G, Snoeys J, Cuyckens F, Chien C, Ward P. Apalutamide Absorption, Metabolism, and Excretion in Healthy Men, and Enzyme Reaction in Human Hepatocytes. Drug Metab Dispos 2019; 47:453-464. [PMID: 30787101 DOI: 10.1124/dmd.118.084517] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 02/04/2019] [Indexed: 12/18/2022] Open
Abstract
In this phase 1 study, the absolute bioavailability and absorption, metabolism, and excretion (AME) of apalutamide, a competitive inhibitor of the androgen receptor, were evaluated in 12 healthy men. Subjects received 240 mg of apalutamide orally plus a 15-minute intravenous infusion of 100 µg of apalutamide containing 9.25 kBq (250 nCi) of 14C-apalutamide (2 hours postdose) for absolute bioavailability assessment or plus one 400-µg capsule containing 37 kBq (1000 nCi) of 14C-apalutamide for AME assessment. Content of 14C and metabolite profiling for whole blood, plasma, urine, feces, and expired air samples were analyzed using accelerator mass spectrometry. Apalutamide absolute oral bioavailability was ≈100%. After oral administration, apalutamide, its N-desmethyl metabolite (M3), and an inactive carboxylic acid metabolite (M4) accounted for most 14C in plasma (45%, 44%, and 3%, respectively). Apalutamide elimination was slow, with a mean plasma half-life of 151-178 hours. The mean cumulative recovery of total 14C over 70 days postdose was 64.6% in urine and 24.3% in feces. The urinary excretion of apalutamide, M3, and M4 was 1.2%, 2.7%, and 31.1% of dose, respectively. Fecal excretion of apalutamide, M3, and M4 was 1.5%, 2.0%, and 2.4% of dose, respectively. Seventeen apalutamide metabolites and six main metabolic clearance pathways were identified. In vitro studies confirmed CYP2C8 and CYP3A4 roles in apalutamide metabolism.
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Affiliation(s)
- Ronald de Vries
- Janssen Research & Development, Beerse, Belgium (R.d.V., F.J., G.M., J.S., F.C.); Janssen Research & Development, Spring House, Pennsylvania (C.C.); and Janssen Research & Development, San Diego, California (P.W.)
| | - Frank Jacobs
- Janssen Research & Development, Beerse, Belgium (R.d.V., F.J., G.M., J.S., F.C.); Janssen Research & Development, Spring House, Pennsylvania (C.C.); and Janssen Research & Development, San Diego, California (P.W.)
| | - Geert Mannens
- Janssen Research & Development, Beerse, Belgium (R.d.V., F.J., G.M., J.S., F.C.); Janssen Research & Development, Spring House, Pennsylvania (C.C.); and Janssen Research & Development, San Diego, California (P.W.)
| | - Jan Snoeys
- Janssen Research & Development, Beerse, Belgium (R.d.V., F.J., G.M., J.S., F.C.); Janssen Research & Development, Spring House, Pennsylvania (C.C.); and Janssen Research & Development, San Diego, California (P.W.)
| | - Filip Cuyckens
- Janssen Research & Development, Beerse, Belgium (R.d.V., F.J., G.M., J.S., F.C.); Janssen Research & Development, Spring House, Pennsylvania (C.C.); and Janssen Research & Development, San Diego, California (P.W.)
| | - Caly Chien
- Janssen Research & Development, Beerse, Belgium (R.d.V., F.J., G.M., J.S., F.C.); Janssen Research & Development, Spring House, Pennsylvania (C.C.); and Janssen Research & Development, San Diego, California (P.W.)
| | - Peter Ward
- Janssen Research & Development, Beerse, Belgium (R.d.V., F.J., G.M., J.S., F.C.); Janssen Research & Development, Spring House, Pennsylvania (C.C.); and Janssen Research & Development, San Diego, California (P.W.)
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13
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Ambery C, Young G, Fuller T, Lazaar AL, Pereira A, Hughes A, Ramsay D, van den Berg F, Daley-Yates P. Pharmacokinetics, Excretion, and Mass Balance of [ 14 C]-Batefenterol Following a Single Microtracer Intravenous Dose (Concomitant to an Inhaled Dose) or Oral Dose of Batefenterol in Healthy Men. Clin Pharmacol Drug Dev 2018; 7:901-910. [PMID: 30230263 PMCID: PMC6282586 DOI: 10.1002/cpdd.616] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 08/16/2018] [Indexed: 12/16/2022]
Abstract
Inhaled batefenterol is an investigational bifunctional molecule for the treatment of chronic obstructive pulmonary disease. The excretion balance and pharmacokinetics of batefenterol using [14C]‐radiolabeled drug administered orally and as intravenous (IV) infusion were assessed. In this 2‐period, open‐label study, 6 healthy male subjects received a single IV microtracer 1‐hour infusion of 4 μg [14C]‐batefenterol concomitant with inhaled nonradiolabeled batefenterol (1200 μg) followed by oral [14C]‐batefenterol (200 μg) in period 2 after a 14‐day washout. The primary end points included: the area under the concentration‐time curve from time zero to last time of quantifiable concentration (AUC0‐t); maximum observed concentration (Cmax); and time of occurrence of maximum observed concentration. Following IV administration, the geometric mean AUC0‐t of [14C]‐batefenterol was 121.9 pgEq • h/mL; maximum observed concentration and time of occurrence of maximum observed concentration were 92.7 pgEq/mL and 0.8 hours, respectively; absolute oral bioavailability was 0.012%. The mean AUC0‐t ratio indicated that [14C]‐batefenterol accounted for 85% of total circulating radioactivity in the plasma initially and declined rapidly following IV administration, but only ∼0.2% of total circulating radioactivity following oral administration. Cumulative mean recovery of total radioactive [14C]‐batefenterol in urine and feces was 6.31% and 77.6%, respectively. Overall, batefenterol exhibited low systemic bioavailability after inhaled and oral administration, and high fecal excretion and low urinary excretion following IV and oral administration.
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Affiliation(s)
- Claire Ambery
- Clinical Pharmacology Modelling and Simulation, GSK, Stockley Park West, Uxbridge, Middlesex, UK
| | - Graeme Young
- Bioanalysis, Immunogenicity and Biomarkers (BIB), GSK, Ware, Hertfordshire, UK
| | - Teresa Fuller
- GSK, Medicines Research Centre, Stevenage, Hertfordshire, UK
| | - Aili L Lazaar
- Respiratory Therapy Area Unit, GSK, R&D, King of Prussia, PA, USA
| | - Adrian Pereira
- Bioanalysis, Immunogenicity and Biomarkers (BIB), GSK, Ware, Hertfordshire, UK
| | - Adam Hughes
- Bioanalysis, Immunogenicity and Biomarkers (BIB), GSK, Ware, Hertfordshire, UK
| | | | | | - Peter Daley-Yates
- Clinical Development, GSK, Research and Development, Uxbridge, Middlesex, UK
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14
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Vishwanathan K, So K, Thomas K, Bramley A, English S, Collier J. Absolute Bioavailability of Osimertinib in Healthy Adults. Clin Pharmacol Drug Dev 2018; 8:198-207. [PMID: 29683562 DOI: 10.1002/cpdd.467] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 03/12/2018] [Indexed: 12/19/2022]
Abstract
Osimertinib is a third-generation, central nervous system-active, epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) selective for EGFR-TKI sensitizing and T790M resistance mutations. This phase 1, open-label study (NCT02491944) investigated absolute bioavailability and pharmacokinetics (PK) of oral and intravenous (IV) osimertinib. Ten healthy subjects (21-61 years) received a single oral 80-mg dose concomitantly with a 100 μg (containing 1 μCi) IV microtracer dose of [14 C]osimertinib. Oral and IV PK were determined simultaneously for osimertinib and its active metabolites, AZ5104 and AZ7550. High-performance liquid chromatography and accelerator mass spectrometry were used to characterize IV dose PK. Geometric mean absolute oral bioavailability of osimertinib was 69.8% (90% confidence interval, 66.7, 72.9). Oral osimertinib was slowly absorbed (median time to maximum plasma concentration [tmax ] 7.0 hours). Following tmax , plasma concentrations fell in an apparent monophasic manner. IV clearance and volume of distribution were 16.8 L/h and 1285 L, respectively. Arithmetic mean elimination half-life estimates were 59.7, 52.6, and 72.6 hours for osimertinib, AZ5104, and AZ7550, respectively (oral dosing), and 54.9, 68.4, and 99.7 hours for [14 C]osimertinib, [14 C]AZ5104, and [14 C]AZ7550, respectively (IV dosing). Oral osimertinib was well absorbed. Simultaneous IV and oral PK analysis proved useful for complete understanding of osimertinib PK and showed that the first-pass effect was minimal for osimertinib.
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15
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van Andel L, Rosing H, Zhang Z, Hughes L, Kansra V, Sanghvi M, Tibben MM, Gebretensae A, Schellens JHM, Beijnen JH. Determination of the absolute oral bioavailability of niraparib by simultaneous administration of a 14C-microtracer and therapeutic dose in cancer patients. Cancer Chemother Pharmacol 2017; 81:39-46. [PMID: 29043410 PMCID: PMC5754411 DOI: 10.1007/s00280-017-3455-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/11/2017] [Indexed: 02/07/2023]
Abstract
Introduction Niraparib (Zejula™) is a poly(ADP-ribose) polymerase inhibitor recently approved by the US Food and Drug Administration for the maintenance treatment of patients with recurrent platinum-sensitive epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in a complete or partial response to platinum-based chemotherapy. The pivotal phase III clinical trial has shown improved progression-free survival in patients receiving niraparib compared with those receiving placebo. Purpose Since niraparib is administered orally, it is of interest to investigate the oral bioavailability (Fpo) of this novel compound, which is the aim of this study. Methods Six patients received an oral therapeutic dose of 300 mg niraparib, followed by a 15-min intravenous infusion of 100 µg 14C-niraparib with a radioactivity of approximately 100 nCi. The niraparib therapeutic dose was measured in plasma using a validated liquid chromatography–tandem mass spectrometry method, whereas the total 14C-radioactivity and 14C-niraparib plasma levels were measured by accelerator mass spectrometry and a validated high performance liquid chromatography assay with AMS. Results The Fpo of niraparib was determined to be 72.7% in humans.
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Affiliation(s)
- L van Andel
- Department of Pharmacy and Pharmacology, Antoni van Leeuwenhoek/The Netherlands Cancer Institute and MC Slotervaart, PO Box 90440, 1006 BK, Amsterdam, The Netherlands.
| | - H Rosing
- Department of Pharmacy and Pharmacology, Antoni van Leeuwenhoek/The Netherlands Cancer Institute and MC Slotervaart, PO Box 90440, 1006 BK, Amsterdam, The Netherlands
| | - Z Zhang
- TESARO, Inc., Waltham, MA, USA
| | | | | | - M Sanghvi
- Xceleron, Inc., A Pharmaron Company, Germantown, MD, USA
| | - M M Tibben
- Department of Pharmacy and Pharmacology, Antoni van Leeuwenhoek/The Netherlands Cancer Institute and MC Slotervaart, PO Box 90440, 1006 BK, Amsterdam, The Netherlands
| | - A Gebretensae
- Department of Pharmacy and Pharmacology, Antoni van Leeuwenhoek/The Netherlands Cancer Institute and MC Slotervaart, PO Box 90440, 1006 BK, Amsterdam, The Netherlands
| | - J H M Schellens
- Division of Clinical Pharmacology, Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.,Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - J H Beijnen
- Department of Pharmacy and Pharmacology, Antoni van Leeuwenhoek/The Netherlands Cancer Institute and MC Slotervaart, PO Box 90440, 1006 BK, Amsterdam, The Netherlands.,Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science, Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
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16
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Barbour AM, Fossler MJ. Infusions Are the Optimal Dosing Method in Intravenous ADME Studies Rather Than Bolus Dosing. J Clin Pharmacol 2017; 58:25-28. [DOI: 10.1002/jcph.991] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 07/04/2017] [Indexed: 12/11/2022]
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17
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Helmer E, Nicolas JM, Long J, Roffel AF, Jones E, Chanteux H, Diaz N, Garratt H, Bosje T. A Dual-Administration Microtracer Technique to Characterize the Absorption, Distribution, Metabolism, and Excretion of [14
C]Seletalisib (UCB5857) in Healthy Subjects. J Clin Pharmacol 2017. [DOI: 10.1002/jcph.954] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Tjerk Bosje
- PRA Health Sciences; Groningen The Netherlands
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18
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Overcoming interference with the detection of a stable isotopically labeled microtracer in the evaluation of beclabuvir absolute bioavailability using a concomitant microtracer approach. J Pharm Biomed Anal 2017; 143:9-16. [PMID: 28544885 DOI: 10.1016/j.jpba.2017.04.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 04/19/2017] [Accepted: 04/20/2017] [Indexed: 01/30/2023]
Abstract
The oral absolute bioavailability of beclabuvir in healthy subjects was determined using a microdose (100μg) of the stable isotopically labeled tracer via intravenous (IV) infusion started after oral dosing of beclabuvir (150mg). To simultaneously analyze the concentrations of the IV microtracer ([13C6]beclabuvir) and beclabuvir in plasma samples, a liquid chromatography-triple quadrupole mass spectrometry (LC-MS/MS) method was initially developed. Surprisingly beclabuvir significantly interfered with the IV microtracer detection when using the selected reaction monitoring (SRM) in the assay. An interfering component from the drug substance was observed using a high resolution mass spectrometer (HRMS). The mass-to-charge (m/z) of the interfering component was -32ppm different from the nominal value for the IV microtracer and thus could not be differentiated in the SRM assay by the unit mass resolution. To overcome this interference, we evaluated two approaches by either monitoring an alternative product ion using the SRM assay or isolating the interfering component using the parallel reaction monitoring (PRM) assay on the HRMS. This case study has demonstrated two practical approaches for overcoming interferences with the detection of stable isotopically labeled IV microtracers in the evaluation of absolute bioavailability, which provides users the flexibility in using either LC-MS/MS or HRMS to mitigate unpredicted interferences in the assay to support microtracer absolute bioavailability studies.
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19
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Kim A, Yu BY, Dueker SR, Shin KH, Kim HS, Ahn H, Cho JY, Yu KS, Jang IJ, Lee H. An Accelerator Mass Spectrometry-Enabled Microtracer Study to Evaluate the First-Pass Effect on the Absorption of YH4808. Clin Pharmacol Ther 2017; 102:537-546. [PMID: 28214288 DOI: 10.1002/cpt.672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/23/2017] [Accepted: 02/14/2017] [Indexed: 12/25/2022]
Abstract
14 C-labeled YH4808, a novel potassium-competitive acid blocker, was intravenously administered as a microtracer at 80 μg (11.8 kBq or 320 nCi) concomitantly with the nonradiolabeled oral drug at 200 mg to determine the absolute bioavailability and to assess the effect of pharmacogenomics on the oral absorption of YH4808. The absolute bioavailability was low and highly variable (mean, 10.1%; range, 2.3-19.3%), and M3 and M8, active metabolites of YH4808, were formed 22.6- and 38.5-fold higher after oral administration than intravenous administration, respectively. The product of the fraction of an oral YH4808 dose entering the gut wall and the fraction of YH4808 passing on to the portal circulation was larger in subjects carrying the variants of the CHST3, SLC15A1, and SULT1B1 genes. A combined LC+AMS is a useful tool to construct a rich and highly informative pharmacokinetic knowledge core in early clinical drug development at a reasonable cost.
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Affiliation(s)
- A Kim
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea.,Clinical Trial Center, Ajou University Medical Center, Suwon, Korea
| | - B-Y Yu
- Korea Institute of Science and Technology, Seoul, Korea
| | | | - K-H Shin
- College of Pharmacy, Research Institute of Pharmaceutical Sciences, Kyungpook National University, Daegu, Korea
| | - H S Kim
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - H Ahn
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - J-Y Cho
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - K-S Yu
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - I-J Jang
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea
| | - H Lee
- Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, Korea.,Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
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20
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Nijenhuis CM, Schellens JHM, Beijnen JH. Regulatory aspects of human radiolabeled mass balance studies in oncology: concise review. Drug Metab Rev 2016; 48:266-80. [PMID: 27186889 DOI: 10.1080/03602532.2016.1181081] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Human radiolabeled mass balance studies are performed to obtain information about the absorption, distribution, metabolism, and excretion of a drug in development. The main goals are to determine the route of elimination and major metabolic pathways. This review provides an overview of the current regulatory guidelines concerning human radiolabeled mass balance studies and discusses scientific trends seen in the last decade with a focus on mass balance studies of anticancer drugs. This paper also provides an overview of mass balance studies of anticancer agents that were executed in the last 10 years.
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Affiliation(s)
- C M Nijenhuis
- a Department of Pharmacy & Pharmacology , Antoni Van Leeuwenhoek/the Netherlands Cancer Institute and MC Slotervaart , Amsterdam , The Netherlands
| | - J H M Schellens
- b Department of Medical Oncology, Division of Clinical Pharmacology , The Netherlands Cancer Institute , Amsterdam , The Netherlands ;,c Department of Pharmaceutical Sciences, Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science , Utrecht University , Utrecht , The Netherlands
| | - J H Beijnen
- a Department of Pharmacy & Pharmacology , Antoni Van Leeuwenhoek/the Netherlands Cancer Institute and MC Slotervaart , Amsterdam , The Netherlands ;,c Department of Pharmaceutical Sciences, Division of Pharmacoepidemiology and Clinical Pharmacology, Faculty of Science , Utrecht University , Utrecht , The Netherlands
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21
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Morcos PN, Yu L, Bogman K, Sato M, Katsuki H, Kawashima K, Moore DJ, Whayman M, Nieforth K, Heinig K, Guerini E, Muri D, Martin-Facklam M, Phipps A. Absorption, distribution, metabolism and excretion (ADME) of the ALK inhibitor alectinib: results from an absolute bioavailability and mass balance study in healthy subjects. Xenobiotica 2016; 47:217-229. [PMID: 27180975 DOI: 10.1080/00498254.2016.1179821] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
1. Alectinib is a highly selective, central nervous system-active small molecule anaplastic lymphoma kinase inhibitor. 2. The absolute bioavailability, metabolism, excretion and pharmacokinetics of alectinib were studied in a two-period single-sequence crossover study. A 50 μg radiolabelled intravenous microdose of alectinib was co-administered with a single 600 mg oral dose of alectinib in the first period, and a single 600 mg/67 μCi oral dose of radiolabelled alectinib was administered in the second period to six healthy male subjects. 3. The absolute bioavailability of alectinib was moderate at 36.9%. Geometric mean clearance was 34.5 L/h, volume of distribution was 475 L and the hepatic extraction ratio was low (0.14). 4. Near-complete recovery of administered radioactivity was achieved within 168 h post-dose (98.2%) with excretion predominantly in faeces (97.8%) and negligible excretion in urine (0.456%). Alectinib and its major active metabolite, M4, were the main components in plasma, accounting for 76% of total plasma radioactivity. In faeces, 84% of dose was excreted as unchanged alectinib with metabolites M4, M1a/b and M6 contributing to 5.8%, 7.2% and 0.2% of dose, respectively. 5. This novel study design characterised the full absorption, distribution, metabolism and excretion properties in each subject, providing insight into alectinib absorption and disposition in humans.
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Affiliation(s)
- Peter N Morcos
- a Roche Innovation Center , New York , NY , United States
| | - Li Yu
- a Roche Innovation Center , New York , NY , United States
| | | | - Mika Sato
- c Chugai Pharmaceuticals, Co. Ltd , Shizuoka , Japan
| | | | | | - David J Moore
- a Roche Innovation Center , New York , NY , United States
| | | | | | | | | | - Dieter Muri
- b Roche Innovation Center , Basel , Switzerland
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22
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The use of stable isotope-labeled drug as microtracers with conventional LC–MS/MS to support human absolute bioavailability studies: are we there yet? Bioanalysis 2016; 8:731-3. [DOI: 10.4155/bio.16.25] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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23
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The impact of early human data on clinical development: there is time to win. Drug Discov Today 2016; 21:873-9. [PMID: 27046542 DOI: 10.1016/j.drudis.2016.03.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 02/18/2016] [Accepted: 03/23/2016] [Indexed: 12/16/2022]
Abstract
Modern accelerator mass spectrometry (AMS) methods enable the routine application of this technology in drug development. By the administration of a (14)C-labelled microdose or microtrace, pharmacokinetic (PK) data, such as mass balance, metabolite profiling, and absolute bioavailability (AB) data, can be generated easier, faster, and at lower costs. Here, we emphasize the advances and impact of this technology for pharmaceutical companies. The availability of accurate intravenous (iv) PK and human absorption, distribution, metabolism, and excretion (ADME) information, even before or during Phase I trials, can improve the clinical development plan. Moreover, applying the microtrace approach during early clinical development might impact the number of clinical pharmacology and preclinical safety pharmacology studies required, and shorten the overall drug discovery program.
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