1
|
Wang L, Qiu Q, Yang D, Cao C, Lu Y, Zeng Y, Jiang W, Shen Y, Ye Y. Clinical research progress of ridaforolimus (AP23573, MK8668) over the past decade: a systemic review. Front Pharmacol 2024; 15:1173240. [PMID: 38584599 PMCID: PMC10995224 DOI: 10.3389/fphar.2024.1173240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 01/19/2024] [Indexed: 04/09/2024] Open
Abstract
Rapamycin, an established mTOR inhibitor in clinical practice, is widely recognized for its therapeutic efficacy. Ridaforolimus, a non-prodrug rapalog, offers improved aqueous solubility, stability, and affinity compared to rapamycin. In recent years, there has been a surge in clinical trials involving ridaforolimus. We searched PubMed for ridaforolimus over the past decade and selected clinical trials of ridaforolimus to make a summary of the research progress of ridaforolimus in clinical trials. The majority of these trials explored the application of ridaforolimus in treating various tumors, including endometrial cancer, ovarian cancer, prostate cancer, breast cancer, renal cell carcinoma, and other solid tumors. These trials employed diverse drug combinations, incorporating agents such as ponatinib, bicalutamide, dalotuzumab, MK-2206, MK-0752, and taxanes. The outcomes of these trials unveiled the diverse potential applications of ridaforolimus in disease treatment. Our review encompassed analyses of signaling pathways, ridaforolimus as a single therapeutic agent, its compatibility in combination with other drugs, and an assessment of adverse events (AEs). We conclude by recommending further research to advance our understanding of ridaforolimus's clinical applications.
Collapse
Affiliation(s)
- Lumin Wang
- Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian Province, China
| | - Qining Qiu
- Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian Province, China
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Dawei Yang
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chang Cao
- Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian Province, China
| | - Yanqin Lu
- Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian Province, China
| | - Yulan Zeng
- Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian Province, China
| | - Weiwen Jiang
- Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian Province, China
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yun Shen
- Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian Province, China
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yanrong Ye
- Zhongshan Hospital (Xiamen), Fudan University, Xiamen, Fujian Province, China
- Zhongshan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
2
|
Schamroth Pravda N, Houri O, Kornowski R, Porter A. Clinical considerations during spontaneous coronary artery dissection in the post-partum period: a case report. Eur Heart J Case Rep 2023; 7:ytad406. [PMID: 37637097 PMCID: PMC10448854 DOI: 10.1093/ehjcr/ytad406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 08/03/2023] [Accepted: 08/15/2023] [Indexed: 08/29/2023]
Abstract
Background Spontaneous coronary artery dissection (SCAD) is a common and under-recognized cause of myocardial infarction during the post-partum period. Case summary We report a case of a young women presenting with chest pain in the post-partum period. Her clinical appearance was that of a myocardial infarction, and angiography was indicative of a Type 2 SCAD. The patients had persistent chest pain, reduced left ventricular function, and critical left anterior descending artery stenosis. Percutaneous coronary intervention was done with caution. Shared decision-making with the patient helped guide the medical treatment plan and follow-up. Discussion We discuss the clinical considerations surrounding the management of this patient.
Collapse
Affiliation(s)
- Nili Schamroth Pravda
- Department of Cardiology, Rabin Medical Center, Beilinson Hospital, 39 Jabotinsky Street, Petach Tikva 49100, Israel
- The Faculty of Medicine, Tel Aviv University, 35 Klatchkin Street, Tel Aviv 6997801, Israel
| | - Ohad Houri
- The Faculty of Medicine, Tel Aviv University, 35 Klatchkin Street, Tel Aviv 6997801, Israel
- Department of Obstetrics and Gynecology, Rabin Medical Center, 39 Jabotinsky Street, Petach Tikva 49100, Israel
| | - Ran Kornowski
- Department of Cardiology, Rabin Medical Center, Beilinson Hospital, 39 Jabotinsky Street, Petach Tikva 49100, Israel
- The Faculty of Medicine, Tel Aviv University, 35 Klatchkin Street, Tel Aviv 6997801, Israel
| | - Avital Porter
- Department of Cardiology, Rabin Medical Center, Beilinson Hospital, 39 Jabotinsky Street, Petach Tikva 49100, Israel
- The Faculty of Medicine, Tel Aviv University, 35 Klatchkin Street, Tel Aviv 6997801, Israel
| |
Collapse
|
3
|
Stroh M, Talaty J, Sandhu P, McCrea J, Patnaik A, Tolcher A, Palcza J, Orford K, Breidinger S, Narasimhan N, Panebianco D, Lush R, Papadopoulos KP, Wagner JA, Trucksis M, Agrawal N. Lack of meaningful effect of ridaforolimus on the pharmacokinetics of midazolam in cancer patients: model prediction and clinical confirmation. J Clin Pharmacol 2014; 54:1256-62. [PMID: 24827931 DOI: 10.1002/jcph.331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 05/13/2014] [Indexed: 11/11/2022]
Abstract
Ridaforolimus, a unique non-prodrug analog of rapamycin, is a potent inhibitor of mTOR under development for cancer treatment. In vitro data suggest ridaforolimus is a reversible and time-dependent inhibitor of CYP3A. A model-based evaluation suggested an increase in midazolam area under the curve (AUC(0- ∞)) of between 1.13- and 1.25-fold in the presence of therapeutic concentrations of ridaforolimus. The pharmacokinetic interaction between multiple oral doses of ridaforolimus and a single oral dose of midazolam was evaluated in an open-label, fixed-sequence study, in which cancer patients received a single oral dose of 2 mg midazolam followed by 5 consecutive daily single oral doses of 40 mg ridaforolimus with a single dose of 2 mg midazolam with the fifth ridaforolimus dose. Changes in midazolam exposure were minimal [geometric mean ratios and 90% confidence intervals: 1.23 (1.07, 1.40) for AUC(0-∞) and 0.92 (0.82, 1.03) for maximum concentrations (C(max)), respectively]. Consistent with model predictions, ridaforolimus had no clinically important effect on midazolam pharmacokinetics and is not anticipated to be a perpetrator of drug-drug interactions (DDIs) when coadministered with CYP3A substrates. Model-based approaches can provide reasonable estimates of DDI liability, potentially obviating the need to conduct dedicated DDI studies especially in challenging populations like cancer patients.
Collapse
Affiliation(s)
- Mark Stroh
- Clinical PK/PD, Merck & Co., Inc., Whitehouse Station, NJ, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Mita MM, Gong J, Chawla SP. Ridaforolimus in advanced or metastatic soft tissue and bone sarcomas. Expert Rev Clin Pharmacol 2013; 6:465-82. [PMID: 23971829 DOI: 10.1586/17512433.2013.827397] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Patient outcomes remain poor for advanced or metastatic soft tissue sarcomas (STS) and bone sarcomas despite a growing number of clinical trials involving single- and multi-agent chemotherapy. mTOR is an intracellular kinase that plays a central role in regulating cell growth, metabolism, survival and proliferation. mTOR inhibitors including temsirolimus, everolimus and ridaforolimus have demonstrated broad anticancer activity. Ridaforolimus is a non-prodrug analog of rapamycin (sirolimus) with conserved affinity for mTOR but improved solubility, stability and bioavailability when compared with sirolimus. Early clinical trials reveal a reproducible and predictable pharmacokinetic profile, a potent, rapid and prolonged target inhibition and an acceptable safety and tolerability profile. Phase II and III trials of ridaforolimus have produced promising clinical activity against advanced sarcomas and will be presented.
Collapse
Affiliation(s)
- Monica M Mita
- Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | | | | |
Collapse
|