1
|
Lee S, Hong KT, Jang I, Yu K, Kang HJ, Oh J. Semimechanistic pharmacokinetic-pharmacodynamic model of tripegfilgrastim for pediatric patients after chemotherapy. CPT Pharmacometrics Syst Pharmacol 2023; 12:1319-1334. [PMID: 37559343 PMCID: PMC10508573 DOI: 10.1002/psp4.13012] [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: 01/26/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 08/11/2023] Open
Abstract
Tripegfilgrastim is a long-acting granulocyte colony-stimulating factor (G-CSF) that has been used to prevent chemotherapy-induced neutropenia in adults. This study aimed to establish a pharmacokinetic (PK)-pharmacodynamic (PD) model to explore the impact of chemotherapy and tripegfilgrastim on absolute neutrophil counts (ANCs) and to further propose a fixed-dose regimen in pediatric patients. Because neutrophils affect the clearance of tripegfilgrastim, the semimechanistic PK-PD model was developed simultaneously by using data from 40 healthy adults and 27 pediatric patients with solid tumors. Tripegfilgrastim PK and ANC dynamics were described with a pharmacodynamics-mediated drug disposition model assuming quasi-equilibrium with five transit compartments mimicking neutrophil granulopoiesis. The effect of chemotherapy on neutrophils was included by stimulating the elimination of the G-CSF receptor at the mitotic cells. Healthy adult and pediatric patients showed significantly different value for dissociation constant of the tripegfilgrastim-G-CSF receptor complex (Kd ) and apparent volume of distribution (Vd /F). Patients treated with chemotherapy had a higher Vd /F and 62% lower Kd than healthy adults. As the age increased, the absorption rate of tripegfilgrastim was decreased. Body weight affected the G-CSF receptor-mediated internalization of tripegfilgrastim, and the baseline ANC value impacted the production rate of G-CSF receptors. Simulations from the developed model suggested that 1.5, 2.5, 4, and 6 mg single subcutaneous tripegfilgrastim doses for the respective weight groups of 10-20, 21-30, 31-44, and more than 45 kg significantly reduced the duration of Grade 4 neutropenia similar to tripegfilgrastim weight-based treatment with 100 μg/kg.
Collapse
Affiliation(s)
- Soyoung Lee
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
- Kidney Research InstituteSeoul National University Medical Research CenterSeoulKorea
| | - Kyung Taek Hong
- Department of PediatricsSeoul National University College of Medicine, Seoul National University Children's HospitalSeoulKorea
- Seoul National University Cancer Research InstituteSeoulKorea
| | - In‐Jin Jang
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Kyung‐Sang Yu
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| | - Hyoung Jin Kang
- Department of PediatricsSeoul National University College of Medicine, Seoul National University Children's HospitalSeoulKorea
- Seoul National University Cancer Research InstituteSeoulKorea
| | - Jaeseong Oh
- Department of Clinical Pharmacology and TherapeuticsSeoul National University College of Medicine and HospitalSeoulKorea
| |
Collapse
|
2
|
A Pharmacometric Model to Predict Chemotherapy-Induced Myelosuppression and Associated Risk Factors in Non-Small Cell Lung Cancer. Pharmaceutics 2022; 14:pharmaceutics14050914. [PMID: 35631500 PMCID: PMC9145791 DOI: 10.3390/pharmaceutics14050914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 04/15/2022] [Accepted: 04/20/2022] [Indexed: 02/01/2023] Open
Abstract
Chemotherapy often induces severe neutropenia due to the myelosuppressive effect. While predictive pharmacokinetic (PK)/pharmacodynamic (PD) models of absolute neutrophil count (ANC) after anticancer drug administrations have been developed, their deployments to routine clinics have been limited due to the unavailability of PK data and sparseness of PD (or ANC) data. Here, we sought to develop a model describing temporal changes of ANC in non-small cell lung cancer patients receiving (i) combined chemotherapy of paclitaxel and cisplatin and (ii) granulocyte colony stimulating factor (G-CSF) treatment when needed, under such limited circumstances. Maturation of myelocytes into blood neutrophils was described by transit compartments with negative feedback. The K-PD model was employed for drug effects with drug concentration unavailable and the constant model for G-CSF effects. The fitted model exhibited reasonable goodness of fit and parameter estimates. Covariate analyses revealed that ANC decreased in those without diabetes mellitus and female patients. Using the final model obtained, an R Shiny web-based application was developed, which can visualize predicted ANC profiles and associated risk of severe neutropenia for a new patient. Our model and application can be used as a supportive tool to identify patients at the risk of grade 4 neutropenia early and suggest dose reduction.
Collapse
|
3
|
Stewart AW, Shillingburg A, Petros W, Wen S, Piktel D, Moses R, Gibson LF, Craig M, Cumpston A. A prospective study of filgrastim pharmacokinetics in morbidly obese patients compared with non-obese controls. Pharmacotherapy 2021; 42:53-57. [PMID: 34767652 DOI: 10.1002/phar.2646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Filgrastim is a human granulocyte colony-stimulating factor (G-CSF). There are limited data on dosing filgrastim in obesity. The objective of this study was to compare filgrastim pharmacokinetic parameters for morbidly obese and non-obese patients after a single subcutaneous dose of filgrastim dosed per actual body weight. METHODS This prospective, matched-pair study (NCT01719432) included patients ≥18 years of age, receiving filgrastim at 5 μg/kg with a weight >190% of their ideal body weight (IBW) for "morbidly obese" patients or within 80%-124% of IBW for matched-control patients. The control group was prospectively matched for age (within 10 years), degree of neutropenia, and gender. Filgrastim doses were not rounded to vial size, to allow more accurate assessment of exposure. Blood samples were collected at 0 (prior to dose), 2, 4, 6, 8, 12, and 24 h after the first subcutaneous administration of filgrastim. RESULTS A total of 30 patients were enrolled in this prospective pharmacokinetic study, with 15 patients assigned to each arm. Non-compartmental analysis showed that the systemic clearance (Cl) was 0.111 ± 0.041 ml/min in the morbidly obese group versus 0.124 ± 0.045 ml/min in the non-obese group (p = 0.44). Additionally, the mean area under the curve (AUC0-24h ) was 49.3 ± 13.9 ng/ml × min in the morbidly obese group versus 46.3 ± 16.8 ng/mL x min in the non-obese group (p = 0.6). No differences were seen in maximum concentrations (Cmax ) between the two groups (morbidly obese: 48.1 ± 14.7 ng/ml vs. non-obese: 49.2 ± 20.7 ng/ml (p = 0.87)). The morbidly obese group had a numerically higher, but not statistically significant, increase in time to maximum concentration (Tmax ) compared to the non-obese group (544 ± 145 min vs 436 ± 156 min (p = 0.06), respectively). CONCLUSION Calculating subcutaneous filgrastim doses using actual body weight appears to produce similar systemic exposure in morbidly obese and non-obese patients with severe neutropenia.
Collapse
Affiliation(s)
- Aaron W Stewart
- Department of Pharmacy, West Virginia University Hospital, Morgantown, West Virginia, USA
| | - Alexandra Shillingburg
- Department of Pharmacy, West Virginia University Hospital, Morgantown, West Virginia, USA
| | - William Petros
- School of Pharmacy, West Virginia University, Morgantown, West Virginia, USA
| | - Sijin Wen
- Department of Biostatistics, West Virginia University, Morgantown, West Virginia, USA
| | - Debra Piktel
- West Virginia University Cancer Institute, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA
| | - Rebecca Moses
- West Virginia University Cancer Institute, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA
| | - Laura F Gibson
- West Virginia University Cancer Institute, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA.,Department of Microbiology, Immunology and Cell Biology, West Virginia University School of Medicine, Morgantown, West Virginia, USA
| | - Michael Craig
- West Virginia University Cancer Institute, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA.,Osborn Hematopoietic Malignancy and Transplantation Program, West Virginia University, Morgantown, West Virginia, USA
| | - Aaron Cumpston
- Department of Pharmacy, West Virginia University Hospital, Morgantown, West Virginia, USA.,Osborn Hematopoietic Malignancy and Transplantation Program, West Virginia University, Morgantown, West Virginia, USA
| |
Collapse
|
4
|
Paredes Bonilla RV, Nekka F, Craig M. A Quantitative Systems Pharmacology Framework for Optimal Doxorubicin Granulocyte Colony-Stimulating Factor Regimens in Triple-Negative Breast Cancer. Pharmacology 2021; 106:542-550. [PMID: 34350894 DOI: 10.1159/000518037] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/18/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION To mitigate the risk of neutropenia during chemotherapy treatment of triple-negative breast cancer, prophylactic and supportive therapy with granulocyte colony-stimulating factor (G-CSF) is administered concomitant to chemotherapy. The proper timing of combined chemotherapy and G-CSF is crucial for treatment outcomes. METHODS Leveraging our established mathematical model of neutrophil production by G-CSF, we developed quantitative systems pharmacology (QSP) framework to investigate how modulating chemotherapy dose frequency and intensity can maximize antitumour effects. To establish schedules that best control tumour size while minimizing neutropenia, we combined Gompertzian tumour growth with pharmacokinetic/pharmacodynamic models of doxorubicin and G-CSF, and our QSP model of neutrophil production. RESULTS We optimized a range of chemotherapeutic cycle lengths and dose sizes to establish regimens that simultaneously reduced tumour burden while minimizing neutropenia. Our results suggest that cytotoxic chemotherapy with doxorubicin 45 mg/m2 every 14 days provides effective control of tumour growth while mitigating neutropenic risks. CONCLUSION This work suggests future avenues for optimal regimens of chemotherapy with prophylactic G-CSF support. Importantly, the algorithmic approach that we developed can aid in balancing the anticancer and the neutropenic effects of both drugs, and therefore contributes to rational considerations in clinical decision-making in triple-negative breast cancer.
Collapse
Affiliation(s)
| | - Fahima Nekka
- Faculty of Pharmacy, Université de Montréal, Montreal, Québec, Canada.,Centre de recherches mathématiques, Université de Montréal, Montreal, Québec, Canada
| | - Morgan Craig
- Centre de recherches mathématiques, Université de Montréal, Montreal, Québec, Canada.,Sainte-Justine University Hospital Research Centre, Montreal, Québec, Canada.,Department of Mathematics and Statistics, Université de Montréal, Montreal, Québec, Canada
| |
Collapse
|
5
|
Chen W, Boras B, Sung T, Hu W, Spilker ME, D’Argenio DZ. A whole-body circulatory neutrophil model with application to predicting clinical neutropenia from in vitro studies. CPT Pharmacometrics Syst Pharmacol 2021; 10:671-683. [PMID: 33793091 PMCID: PMC8302245 DOI: 10.1002/psp4.12620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 02/16/2021] [Accepted: 03/03/2021] [Indexed: 11/23/2022] Open
Abstract
A circulatory model of granulopoiesis and its regulation is presented that includes neutrophil trafficking in the lungs, liver, spleen, bone marrow, lymph nodes, and blood. In each organ, neutrophils undergo transendothelial migration from vascular to interstitial space, clearance due to apoptosis, and recycling via the lymphatic flow. The model includes cell cycling of progenitor cells in the bone marrow, granulocyte colony-stimulating factor (G-CSF) kinetics and its neutrophil regulatory action, as well as neutrophil margination in the blood. From previously reported studies, 111 In-labeled neutrophil kinetic data in the blood and sampled organs were used to estimate the organ trafficking parameters in the model. The model was further developed and evaluated using absolute neutrophil count (ANC), band cell, and segmented neutrophil time course data from healthy volunteers following four dose levels of pegfilgrastim (r2 = 0.77-0.99), along with ANC time course responses following filgrastim (r2 = 0.96). The baseline values of various cell types in bone marrow and blood, as well as G-CSF concentration in the blood, predicted by the model are consistent with available literature reports. After incorporating the mechanism of action of both paclitaxel and carboplatin, as determined from an in vitro bone marrow studies, the model reliably predicted the observed ANC time course following paclitaxel plus carboplatin observed in a phase I trial of 46 patients (r2 = 0.70). The circulatory neutrophil model may provide a mechanistic framework for predicting multi-organ neutrophil homeostasis and dynamics in response to therapeutic agents that target neutrophil dynamics and trafficking in different organs.
Collapse
Affiliation(s)
- Wenbo Chen
- Department of Biomedical EngineeringUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Britton Boras
- Pfizer Worldwide Research, Development and MedicineSan DiegoCaliforniaUSA
| | - Tae Sung
- Pfizer Worldwide Research, Development and MedicineSan DiegoCaliforniaUSA
| | - Wenyue Hu
- Pfizer Worldwide Research, Development and MedicineSan DiegoCaliforniaUSA
| | - Mary E. Spilker
- Pfizer Worldwide Research, Development and MedicineSan DiegoCaliforniaUSA
| | - David Z. D’Argenio
- Department of Biomedical EngineeringUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| |
Collapse
|
6
|
Continuous Intravenous Administration of Granulocyte-Colony-Stimulating Factors-A Breakthrough in the Treatment of Cancer Patients with Febrile Neutropenia. ACTA ACUST UNITED AC 2021; 57:medicina57070675. [PMID: 34208815 PMCID: PMC8305666 DOI: 10.3390/medicina57070675] [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: 04/06/2021] [Revised: 05/17/2021] [Accepted: 06/21/2021] [Indexed: 11/16/2022]
Abstract
Background: Febrile neutropenia (FN) remains one of the most challenging problems in medical oncology and is a very severe side effect of chemotherapy. Its late consequences, when it is recurrent or of a severe grade, are dose reduction and therapy delays. Current guidelines allow the administration of granulocyte-colony-stimulating factors (G-CSF) for profound FN (except for the case when a pegylated form of G-CSF is administrated with prophylactic intention) in addition to antibiotics and supportive care. Methods: This is a prospective study that included 96 patients with confirmed malignancy, treated with chemotherapy, who developed FN during their oncological therapy, and were hospitalized. They received standard treatment plus a dose of G-CSF of 16 µg/Kg/day IV continuous infusion. Results: The gender distribution was almost symmetrical: Male patients made up 48.96% and 51.04% were female patients, with no significance on recovery from FN (p = 1.00). The patients who received prophylactic G-CSF made up 20.21%, but this was not a predictive or prognostic factor for the recovery time from aplasia (p = 0.34). The median chemotherapy line where patients with FN were included was two and the number of previous chemotherapy cycles before FN was three. The median serological number of neutrophils (PMN) was 450/mm3 and leucocytes (WBC) 1875/mm3 at the time of FN. Ten patients possess PMN less than 100/mm3. The median time to recovery was 25.5 h for 96 included patients, with one failure in which the patient possessed grade 5 FN. Predictive factors for shorter recovery time were lower levels of C reactive protein (p < 0.001) and procalcitonin (p = 0.002) upon hospital admission and higher WBC (p = 0.006) and PMN (p < 0.001) at the time of the provoking cycle of chemotherapy for FN. The best chance for a shorter duration of FN was a short history of chemotherapy regarding the number of cycles) (p < 0.0001). Conclusions: Continuous IV administration of G-CSF could be an alternative salvage treatment for patients with profound febrile neutropenia, with a very fast recovery time for neutrophiles.
Collapse
|
7
|
Cassidy T, Humphries AR. A mathematical model of viral oncology as an immuno-oncology instigator. MATHEMATICAL MEDICINE AND BIOLOGY-A JOURNAL OF THE IMA 2021; 37:117-151. [PMID: 31329873 DOI: 10.1093/imammb/dqz008] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 02/15/2019] [Accepted: 03/26/2019] [Indexed: 12/14/2022]
Abstract
We develop and analyse a mathematical model of tumour-immune interaction that explicitly incorporates heterogeneity in tumour cell cycle duration by using a distributed delay differential equation. We derive a necessary and sufficient condition for local stability of the cancer-free equilibrium in which the amount of tumour-immune interaction completely characterizes disease progression. Consistent with the immunoediting hypothesis, we show that decreasing tumour-immune interaction leads to tumour expansion. Finally, by simulating the mathematical model, we show that the strength of tumour-immune interaction determines the long-term success or failure of viral therapy.
Collapse
Affiliation(s)
- Tyler Cassidy
- Department of Mathematics and Statistics, McGill University, Montreal, Canada
| | - Antony R Humphries
- Department of Mathematics and Statistics, McGill University, Montreal, Canada.,Department of Physiology, McGill University, Montreal, Canada
| |
Collapse
|
8
|
Chen W, Boras B, Sung T, Hu W, Spilker ME, D'Argenio DZ. Predicting Chemotherapy-Induced Neutropenia and Granulocyte Colony-Stimulating Factor Response Using Model-Based In Vitro to Clinical Translation. AAPS J 2020; 22:143. [PMID: 33156437 PMCID: PMC7764847 DOI: 10.1208/s12248-020-00529-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 10/20/2020] [Indexed: 11/30/2022] Open
Abstract
The ability to predict the incidence of chemotherapy-induced neutropenia in early drug development can inform risk monitoring and mitigation strategies, as well as decisions on advancing compounds to clinical trials. In this report, a physiological model of granulopoiesis that incorporates the drug's mechanism of action on cell cycle proliferation of bone marrow progenitor cells was extended to include the action of the cytotoxic agents paclitaxel, carboplatin, doxorubicin, and gemcitabine. In vitro bone marrow studies were conducted with each compound, and results were used to determine the model's drug effect parameters. Population simulations were performed to predict the absolute neutrophil count (ANC) and incidence of neutropenia for each compound, which were compared to results reported in the literature. In addition, using the single agent in vitro study results, the model was able to predict ANC time course in response to paclitaxel plus carboplatin in combination, which compared favorably to the results reported in a phase 1 clinical trial of 46 patients (r2 = 0.70). Model simulations were used to compare the relative risk (RR) of neutropenia in patients with high baseline ANCs for five chemotherapeutic regimens: doxorubicin (RR = 0.59), paclitaxel plus carboplatin combination (RR = 0.079), carboplatin (RR = 0.047), paclitaxel (RR = 0.031), and gemcitabine (RR = 0.013). Finally, the model was applied to quantify the reduced incidence of neutropenia with coadministration of pegfilgrastim or filgrastim, for both paclitaxel and the combination of paclitaxel plus carboplatin. The model provides a framework for predicting clinical neutropenia using in vitro bone marrow studies of anticancer agents that may guide drug development decisions.
Collapse
Affiliation(s)
- Wenbo Chen
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California, 90089, USA
| | - Britton Boras
- Pfizer Worldwide Research, Development and Medicine, San Diego, California, USA
| | - Tae Sung
- Pfizer Worldwide Research, Development and Medicine, San Diego, California, USA
| | - Wenyue Hu
- Pfizer Worldwide Research, Development and Medicine, San Diego, California, USA
| | - Mary E Spilker
- Pfizer Worldwide Research, Development and Medicine, San Diego, California, USA
| | - David Z D'Argenio
- Department of Biomedical Engineering, University of Southern California, Los Angeles, California, 90089, USA.
| |
Collapse
|
9
|
Macaire P, Paris J, Vincent J, Ghiringhelli F, Bengrine-Lefevre L, Schmitt A. Impact of granulocyte colony-stimulating factor on FOLFIRINOX-induced neutropenia prevention: A population pharmacokinetic/pharmacodynamic approach. Br J Clin Pharmacol 2020; 86:2473-2485. [PMID: 32386071 DOI: 10.1111/bcp.14356] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/21/2020] [Accepted: 04/30/2020] [Indexed: 12/18/2022] Open
Abstract
AIMS Granulocyte colony-stimulating factor (G-CSF) is frequently prescribed to prevent chemotherapy-induced neutropenia, but the administration schedule remains empirical in case of bimonthly chemotherapy such as FOLFIRINOX regimen. This pharmacokinetic/pharmacodynamic (PK/PD) study was performed to determine the effect of different G-CSF regimens on the incidence and duration of neutropenia following FOLFIRINOX administration in order to propose an optimal G-CSF dosing schedule. METHODS A population PK/PD model was developed to describe individual neutrophil time course from absolute neutrophil counts (ANC) obtained in 40 advanced cancer patients receiving FOLFIRINOX regimen. The structural model considered ANC dynamics, neutropenic effect of cytotoxics and the stimulating effect of G-CSF on neutrophils. Final model estimates were used to simulate different G-CSF dosing schedules for 1000 virtual subjects. The incidence and duration of neutropenia were then calculated for different G-CSF dosing schedules. RESULTS The final model successfully described the myelosuppressive effect induced by the 3 cytotoxics for all patients. Simulations showed that pegfilgrastim administration reduced the risk of severe neutropenia by 22.9% for subjects with low ANC at the start of chemotherapy. Median duration in this group was also shortened by 3.1 days when compared to absence of G-CSF. Delayed G-CSF administration was responsible for higher incidence and longer duration of neutropenia compared to absence of administration. CONCLUSION The PK/PD model well described our population's ANC data. Simulations showed that pegylated-G-CSF administration 24 hours after the end of chemotherapy seems to be the optimal schedule to reduce FOLFIRINOX-induced neutropenia. We also underline the potential negative effect of G-CSF maladministration.
Collapse
Affiliation(s)
- Pauline Macaire
- Pharmacy Department, Centre Georges-François Leclerc, Dijon, France.,INSERM U1231, University of Burgundy Franche-Comté, Dijon, France
| | - Justine Paris
- Pharmacy Department, Centre Georges-François Leclerc, Dijon, France.,INSERM U1231, University of Burgundy Franche-Comté, Dijon, France
| | - Julie Vincent
- Oncology Department, Centre Georges-François Leclerc, Dijon, France
| | - François Ghiringhelli
- INSERM U1231, University of Burgundy Franche-Comté, Dijon, France.,Oncology Department, Centre Georges-François Leclerc, Dijon, France
| | | | - Antonin Schmitt
- Pharmacy Department, Centre Georges-François Leclerc, Dijon, France.,INSERM U1231, University of Burgundy Franche-Comté, Dijon, France
| |
Collapse
|
10
|
Jost F, Schalk E, Weber D, Dohner H, Fischer T, Sager S. Model-Based Optimal AML Consolidation Treatment. IEEE Trans Biomed Eng 2020; 67:3296-3306. [PMID: 32406820 DOI: 10.1109/tbme.2020.2982749] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Neutropenia is an adverse event commonly arising during intensive chemotherapy of acute myeloid leukemia (AML). It is often associated with infectious complications. Mathematical modeling, simulation, and optimization of the treatment process would be a valuable tool to support clinical decision making, potentially resulting in less severe side effects and deeper remissions. However, until now, there has been no validated mathematical model available to simulate the effect of chemotherapy treatment on white blood cell (WBC) counts and leukemic cells simultaneously. METHODS We developed a population pharmacokinetic/pharmacodynamic (PK/PD) model combining a myelosuppression model considering endogenous granulocyte-colony stimulating factor (G-CSF), a PK model for cytarabine (Ara-C), a subcutaneous absorption model for exogenous G-CSF, and a two-compartment model for leukemic blasts. This model was fitted to data of 44 AML patients during consolidation therapy with a novel Ara-C plus G-CSF schedule from a phase II controlled clinical trial. Additionally, we were able to optimize treatment schedules with respect to disease progression, WBC nadirs, and the amount of Ara-C and G-CSF. RESULTS The developed PK/PD model provided good prediction accuracies and an interpretation of the interaction between WBCs, G-CSF, and blasts. For 14 patients (those with available bone marrow blast counts), we achieved a median 4.2-fold higher WBC count at nadir, which is the most critical time during consolidation therapy. The simulation results showed that relative bone marrow blast counts remained below the clinically important threshold of 5%, with a median of 60% reduction in Ara-C. CONCLUSION These in silico findings demonstrate the benefits of optimized treatment schedules for AML patients. SIGNIFICANCE Until 2017, no new drug had been approved for the treatment of AML, fostering the optimal use of currently available drugs.
Collapse
|
11
|
Chen W, Boras B, Sung T, Yu Y, Zheng J, Wang D, Hu W, Spilker ME, D'Argenio DZ. A physiological model of granulopoiesis to predict clinical drug induced neutropenia from in vitro bone marrow studies: with application to a cell cycle inhibitor. J Pharmacokinet Pharmacodyn 2020; 47:163-182. [PMID: 32162138 DOI: 10.1007/s10928-020-09680-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 02/28/2020] [Indexed: 01/15/2023]
Abstract
Neutropenia is one of the most common dose-limiting toxocities associated with anticancer drug therapy. The ability to predict the probability and severity of neutropenia based on in vitro studies of drugs in early drug development will aid in advancing safe and efficacious compounds to human testing. Toward this end, a physiological model of granulopoiesis and its regulation is presented that includes the bone marrow progenitor cell cycle, allowing for a mechanistic representation of the action of relevant anticancer drugs based on in vitro studies. Model development used data from previously reported tracer kinetic studies of granulocyte disposition in healthy humans to characterize the dynamics of neutrophil margination in the presence of endogenous granulocyte-colony stimulating factor (G-CSF). In addition, previously published data from healthy volunteers following pegfilgrastim and filgrastim were used to quantify the regulatory effects of support G-CSF therapies on granulopoiesis. The model was evaluated for the cell cycle inhibitor palbociclib, using an in vitro system of human bone marrow mononuclear cells to quantify the action of palbociclib on proliferating progenitor cells, including its inhibitory effect on G1 to S phase transition. The in vitro results were incorporated into the physiological model of granulopoiesis and used to predict the time course of absolute neutrophil count (ANC) and the incidence of neutropenia observed in three previously reported clinical trials of palbociclib. The model was able to predict grade 3 and 4 neutropenia due to palbociclib treatment with 86% accuracy based on in vitro data.
Collapse
Affiliation(s)
- Wenbo Chen
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, 90089, USA
| | - Britton Boras
- Pfizer Worldwide Research, Development and Medicine, San Diego, CA, USA
| | - Tae Sung
- Pfizer Worldwide Research, Development and Medicine, San Diego, CA, USA
| | - Yanke Yu
- Pfizer Global Product Development, San Diego, CA, USA
| | - Jenny Zheng
- Pfizer Global Product Development, Collegeville, PA, USA
| | - Diane Wang
- Pfizer Global Product Development, San Diego, CA, USA
| | - Wenyue Hu
- Pfizer Worldwide Research, Development and Medicine, San Diego, CA, USA
| | - Mary E Spilker
- Pfizer Worldwide Research, Development and Medicine, San Diego, CA, USA
| | - David Z D'Argenio
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, 90089, USA.
| |
Collapse
|
12
|
Wu X, Nekka F, Li J. Mathematical analysis and drug exposure evaluation of pharmacokinetic models with endogenous production and simultaneous first-order and Michaelis-Menten elimination: the case of single dose. J Pharmacokinet Pharmacodyn 2018; 45:693-705. [PMID: 29987574 DOI: 10.1007/s10928-018-9599-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 06/30/2018] [Indexed: 01/06/2023]
Abstract
Drugs with an additional endogenous source often exhibit simultaneous first-order and Michaelis-Menten elimination and are becoming quite common in pharmacokinetic modeling. In this paper, we investigate the case of single dose intravenous bolus administration for the one-compartment model. Relying on a formerly introduced transcendent function, we were able to analytically express the concentration time course of this model and provide the pharmacokinetic interpretation of its components. Using the concept of the corrected concentration, the mathematical expressions for the partial and total areas under the concentration time curve (AUC) were also given. The impact on the corrected concentration and AUC is discussed as well as the relative contribution of the exogenous part in presence of endogenous production. The present findings theoretically elucidate several pharmacokinetic issues for the considered drug compounds and provide guidance for the rational estimation of their pharmacokinetic parameters.
Collapse
Affiliation(s)
- Xiaotian Wu
- Department of Mathematics, Shanghai Maritime University, Shanghai, 201306, People's Republic of China.,Faculté de pharmacie, Université de Montréal, Montréal, QC, H3C 3J7, Canada
| | - Fahima Nekka
- Faculté de pharmacie, Université de Montréal, Montréal, QC, H3C 3J7, Canada. .,Centre de recherches mathématiques, Université de Montréal, Montréal, QC, H3C 3J7, Canada.
| | - Jun Li
- Faculté de pharmacie, Université de Montréal, Montréal, QC, H3C 3J7, Canada.,Centre de recherches mathématiques, Université de Montréal, Montréal, QC, H3C 3J7, Canada
| |
Collapse
|
13
|
Melhem M, Delor I, Pérez-Ruixo JJ, Harrold J, Chow A, Wu L, Jacqmin P. Pharmacokinetic-pharmacodynamic modelling of neutrophil response to G-CSF in healthy subjects and patients with chemotherapy-induced neutropenia. Br J Clin Pharmacol 2018; 84:911-925. [PMID: 29318653 DOI: 10.1111/bcp.13504] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 11/30/2017] [Accepted: 12/23/2017] [Indexed: 12/19/2022] Open
Abstract
AIM The objective of the present study was to use pharmacokinetic-pharmacodynamic modelling to characterize the effects of chemotherapy on the granulopoietic system and to predict the absolute neutrophil counts (ANCs) for patients with chemotherapy-induced neutropenia treated with filgrastim and pegfilgrastim. METHODS Data were extracted from 10 phase I-III studies conducted in 110 healthy adults, and 618 adult and 52 paediatric patients on chemotherapy following administration of filgrastim or pegfilgrastim. The structural model accounted for ANC dynamics and the effects of filgrastim and pegfilgrastim, chemotherapy and corticosteroids. The impact of neutrophils on drug disposition was based on a drug receptor-binding model that assumed quasi-equilibrium and stimulation of the production and maturation of neutrophils upon treatment. The chemotherapy and corticosteroid effects were represented by kinetic-pharmacodynamic-type models, where chemotherapy stimulated elimination of neutrophil precursors at the mitotic stage, and corticosteroids stimulated neutrophil production. RESULTS The systemic half-lives of filgrastim (2.6 h) and pegfilgrastim (10.1 h) were as expected. The effective half-life of chemotherapy was 9.6 h, with a 2-day killing effect. The rate of receptor elimination from mitotic compartments exhibited extreme interindividual variability (% coefficient of variation >200), suggesting marked differences in sensitivity to chemotherapy effects on ANCs. The stimulatory effects of pegfilgrastim were significantly greater than those of filgrastim. Model qualification confirmed the predictive capability of this model. CONCLUSION This qualified model simulates the time course of ANC in the absence or presence of chemotherapy and predicts nadir, time to nadir and time of recovery from different grades of neutropenia upon treatment with filgrastim and pegfilgrastim.
Collapse
Affiliation(s)
- Murad Melhem
- Department of Clinical Pharmacology, Modeling and Simulation, Amgen Inc., Thousand Oaks, CA, USA
| | | | | | - John Harrold
- Department of Clinical Pharmacology, Modeling and Simulation, Amgen Inc., Thousand Oaks, CA, USA
| | - Andrew Chow
- Department of Clinical Pharmacology, Modeling and Simulation, Amgen Inc., Thousand Oaks, CA, USA
| | - Liviawati Wu
- Alios BioPharma Inc., South San Francisco, CA, USA
| | | |
Collapse
|
14
|
Craig M. Towards Quantitative Systems Pharmacology Models of Chemotherapy-Induced Neutropenia. CPT Pharmacometrics Syst Pharmacol 2017; 6:293-304. [PMID: 28418603 PMCID: PMC5445232 DOI: 10.1002/psp4.12191] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/21/2017] [Accepted: 02/21/2017] [Indexed: 12/22/2022] Open
Abstract
Neutropenia is a serious toxic complication of chemotherapeutic treatment. For years, mathematical models have been developed to better predict hematological outcomes during chemotherapy in both the traditional pharmaceutical sciences and mathematical biology disciplines. An increasing number of quantitative systems pharmacology (QSP) models that combine systems approaches, physiology, and pharmacokinetics/pharmacodynamics have been successfully developed. Here, I detail the shift towards QSP efforts, emphasizing the importance of incorporating systems-level physiological considerations in pharmacometrics.
Collapse
Affiliation(s)
- M Craig
- Program for Evolutionary Dynamics, Harvard UniversityCambridgeMassachusettsUSA
| |
Collapse
|
15
|
Stein AM, Ramakrishna R. AFIR: A Dimensionless Potency Metric for Characterizing the Activity of Monoclonal Antibodies. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2017; 6:258-266. [PMID: 28375563 PMCID: PMC5397564 DOI: 10.1002/psp4.12169] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 12/06/2016] [Accepted: 01/03/2017] [Indexed: 12/14/2022]
Abstract
For monoclonal antibody (mAb) drugs, soluble targets may accumulate several thousand fold after binding to the drug. Time course data of mAb and total target is often collected and, although free target is more closely related to clinical effect, it is difficult to measure. Therefore, mathematical models of this data are used to predict target engagement. In this article, a “potency factor” is introduced as an approximation for the model‐predicted target inhibition. This potency factor is defined to be the time‐Averaged Free target concentration to Initial target concentration Ratio (AFIR), and it depends on three key quantities: the average drug concentration at steady state; the binding affinity; and the degree of target accumulation. AFIR provides the intuition for how changes in dosing regimen and binding affinity affect target capture and AFIR can be used to predict the druggability of new targets and the expected benefits of more potent, second‐generation mAbs.
Collapse
Affiliation(s)
- A M Stein
- Novartis Institute for BioMedical Research, Cambridge, Massachusetts, USA
| | - R Ramakrishna
- Novartis Institute for BioMedical Research, Cambridge, Massachusetts, USA
| |
Collapse
|
16
|
Craig M, Humphries AR, Mackey MC. An upper bound for the half-removal time of neutrophils from circulation. Blood 2016; 128:1989-1991. [PMID: 27578816 PMCID: PMC5064720 DOI: 10.1182/blood-2016-07-730325] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Morgan Craig
- Program for Evolutionary Dynamics, Harvard University, Cambridge, MA; Centre for Applied Mathematics in Bioscience and Medicine, Montreal, QC, Canada
| | - Antony R Humphries
- Centre for Applied Mathematics in Bioscience and Medicine, Montreal, QC, Canada; Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada; and
| | - Michael C Mackey
- Centre for Applied Mathematics in Bioscience and Medicine, Montreal, QC, Canada; Department of Physiology, McGill University, Montreal, QC, Canada
| |
Collapse
|
17
|
Krzyzanski W, Harrold JM, Wu LS, Perez-Ruixo JJ. A cell-level model of pharmacodynamics-mediated drug disposition. J Pharmacokinet Pharmacodyn 2016; 43:513-27. [PMID: 27612462 DOI: 10.1007/s10928-016-9491-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 09/02/2016] [Indexed: 01/22/2023]
Abstract
We aimed to develop a cell-level pharmacodynamics-mediated drug disposition (PDMDD) model to analyze in vivo systems where the PD response to a drug has an appreciable effect on the pharmacokinetics (PK). An existing cellular level model of PD stimulation was combined with the standard target-mediated drug disposition (TMDD) model and the resulting model structure was parametrically identifiable from typical in vivo PK and PD data. The PD model of the cell population was controlled by the production rate k in and elimination rate k out which could be stimulated or inhibited by the number of bound receptors on a single cell. Simulations were performed to assess the impact of single and repeated dosing on the total drug clearance. The clinical utility of the cell-level PDMDD model was demonstrated by fitting published data on the stimulatory effects of filgrastim on absolute neutrophil counts in healthy subjects. We postulated repeated dosing as a means of detecting and quantifying PDMDD as a single dose might not be sufficient to elicit the cellular response capable of altering the receptor pool to visibly affect drug disposition. In the absence of any PD effect, the model reduces down to the standard TMDD model. The applications of this model can be readily extended to include chemotherapy-induced cytopenias affecting clearance of endogenous hematopoietic growth factors, different monoclonal antibodies and immunogenicity effects on PK.
Collapse
Affiliation(s)
| | - John M Harrold
- Clinical Pharmacology, Modeling, and Simulation, Amgen Inc., One Amgen Center Dr, Thousand Oaks, CA, 91320, USA.
| | - Liviawati S Wu
- Clinical Pharmacology, Modeling, and Simulation, Amgen Inc., One Amgen Center Dr, Thousand Oaks, CA, 91320, USA
| | - Juan Jose Perez-Ruixo
- Clinical Pharmacology, Modeling, and Simulation, Amgen Inc., One Amgen Center Dr, Thousand Oaks, CA, 91320, USA.,Janssen Research & Development, Beerse, Antwerp, Belgium
| |
Collapse
|
18
|
Craig M, Humphries AR, Mackey MC. A Mathematical Model of Granulopoiesis Incorporating the Negative Feedback Dynamics and Kinetics of G-CSF/Neutrophil Binding and Internalization. Bull Math Biol 2016; 78:2304-2357. [PMID: 27324993 DOI: 10.1007/s11538-016-0179-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 05/19/2016] [Indexed: 11/24/2022]
Abstract
We develop a physiological model of granulopoiesis which includes explicit modelling of the kinetics of the cytokine granulocyte colony-stimulating factor (G-CSF) incorporating both the freely circulating concentration and the concentration of the cytokine bound to mature neutrophils. G-CSF concentrations are used to directly regulate neutrophil production, with the rate of differentiation of stem cells to neutrophil precursors, the effective proliferation rate in mitosis, the maturation time, and the release rate from the mature marrow reservoir into circulation all dependent on the level of G-CSF in the system. The dependence of the maturation time on the cytokine concentration introduces a state-dependent delay into our differential equation model, and we show how this is derived from an age-structured partial differential equation model of the mitosis and maturation and also detail the derivation of the rest of our model. The model and its estimated parameters are shown to successfully predict the neutrophil and G-CSF responses to a variety of treatment scenarios, including the combined administration of chemotherapy and exogenous G-CSF. This concomitant treatment was reproduced without any additional fitting to characterize drug-drug interactions.
Collapse
Affiliation(s)
- M Craig
- Faculté de Pharmacie, Université de Montréal, Montréal, QC, H3T 1J4, Canada.
- Program for Evolutionary Dynamics, Harvard University, Cambridge, MA, 02138, USA.
| | - A R Humphries
- Department of Mathematics and Statistics, McGill University, Montréal, QC, H3A 0B9, Canada
| | - M C Mackey
- Departments of Mathematics, Physics and Physiology, McGill University, Montréal, QC, H3G 1Y6, Canada
| |
Collapse
|
19
|
Craig M, González-Sales M, Li J, Nekka F. Impact of Pharmacokinetic Variability on a Mechanistic Physiological Pharmacokinetic/Pharmacodynamic Model: A Case Study of Neutrophil Development, PM00104, and Filgrastim. SPRINGER PROCEEDINGS IN MATHEMATICS & STATISTICS 2016. [DOI: 10.1007/978-3-319-31323-8_6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
20
|
Craig M, Humphries AR, Nekka F, Bélair J, Li J, Mackey MC. Neutrophil dynamics during concurrent chemotherapy and G-CSF administration: Mathematical modelling guides dose optimisation to minimise neutropenia. J Theor Biol 2015; 385:77-89. [PMID: 26343861 DOI: 10.1016/j.jtbi.2015.08.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 06/10/2015] [Accepted: 08/20/2015] [Indexed: 11/18/2022]
Abstract
The choice of chemotherapy regimens is often constrained by the patient's tolerance to the side effects of chemotherapeutic agents. This dose-limiting issue is a major concern in dose regimen design, which is typically focused on maximising drug benefits. Chemotherapy-induced neutropenia is one of the most prevalent toxic effects patients experience and frequently threatens the efficient use of chemotherapy. In response, granulocyte colony-stimulating factor (G-CSF) is co-administered during chemotherapy to stimulate neutrophil production, increase neutrophil counts, and hopefully avoid neutropenia. Its clinical use is, however, largely dictated by trial and error processes. Based on up-to-date knowledge and rational considerations, we develop a physiologically realistic model to mathematically characterise the neutrophil production in the bone marrow which we then integrate with pharmacokinetic and pharmacodynamic (PKPD) models of a chemotherapeutic agent and an exogenous form of G-CSF (recombinant human G-CSF, or rhG-CSF). In this work, model parameters represent the average values for a general patient and are extracted from the literature or estimated from available data. The dose effect predicted by the model is confirmed through previously published data. Using our model, we were able to determine clinically relevant dosing regimens that advantageously reduce the number of rhG-CSF administrations compared to original studies while significantly improving the neutropenia status. More particularly, we determine that it could be beneficial to delay the first administration of rhG-CSF to day seven post-chemotherapy and reduce the number of administrations from ten to three or four for a patient undergoing 14-day periodic chemotherapy.
Collapse
Affiliation(s)
- Morgan Craig
- Faculté de Pharmacie, Université de Montréal, Montréal, QC, Canada H3C 3J7; Centre for Applied Mathematics in Bioscience and Medicine (CAMBAM), McGill University, Montreal, QC, Canada H3G 1Y6.
| | - Antony R Humphries
- Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada H3A 0B9; Centre for Applied Mathematics in Bioscience and Medicine (CAMBAM), McGill University, Montreal, QC, Canada H3G 1Y6; Centre de recherches mathématiques, Université de Montréal, Montréal, QC, Canada H3C 3J7.
| | - Fahima Nekka
- Centre for Applied Mathematics in Bioscience and Medicine (CAMBAM), McGill University, Montreal, QC, Canada H3G 1Y6; Centre de recherches mathématiques, Université de Montréal, Montréal, QC, Canada H3C 3J7.
| | - Jacques Bélair
- Département de mathématiques et de statistique, Université de Montréal, Montréal, QC, Canada H3C 3J7; Centre for Applied Mathematics in Bioscience and Medicine (CAMBAM), McGill University, Montreal, QC, Canada H3G 1Y6; Centre de recherches mathématiques, Université de Montréal, Montréal, QC, Canada H3C 3J7.
| | - Jun Li
- Faculté de Pharmacie, Université de Montréal, Montréal, QC, Canada H3C 3J7; Centre for Applied Mathematics in Bioscience and Medicine (CAMBAM), McGill University, Montreal, QC, Canada H3G 1Y6; Centre de recherches mathématiques, Université de Montréal, Montréal, QC, Canada H3C 3J7.
| | - Michael C Mackey
- Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada H3A 0B9; Centre for Applied Mathematics in Bioscience and Medicine (CAMBAM), McGill University, Montreal, QC, Canada H3G 1Y6; Departments of Physiology and Physics, McGill University, Montreal, QC, Canada H3G 1Y6.
| |
Collapse
|
21
|
Wu X, Li J, Nekka F. Closed form solutions and dominant elimination pathways of simultaneous first-order and Michaelis-Menten kinetics. J Pharmacokinet Pharmacodyn 2015; 42:151-61. [PMID: 25678215 DOI: 10.1007/s10928-015-9407-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 02/04/2015] [Indexed: 11/29/2022]
Abstract
The current study aims to provide the closed form solutions of one-compartment open models exhibiting simultaneous linear and nonlinear Michaelis-Menten elimination kinetics for single- and multiple-dose intravenous bolus administrations. It can be shown that the elimination half-time ([Formula: see text]) has a dose-dependent property and is upper-bounded by [Formula: see text] of the first-order elimination model. We further analytically distinguish the dominant role of different elimination pathways in terms of model parameters. Moreover, for the case of multiple-dose intravenous bolus administration, the existence and local stability of the periodic solution at steady state are established. The closed form solutions of the models are obtained through a newly introduced function motivated by the Lambert W function.
Collapse
Affiliation(s)
- Xiaotian Wu
- Department of Mathematics, Shanghai Maritime University, Shanghai, 201306, China
| | | | | |
Collapse
|
22
|
Matsuguma K, Matsuki S, Sakamoto K, Shiramoto M, Nakagawa M, Kimura M, Irie S, Kaneko D, Ohnishi A. A comparative pharmacokinetic and pharmacodynamic study of FSK0808 versus reference filgrastim after repeated subcutaneous administration in healthy Japanese men. Clin Pharmacol Drug Dev 2015; 4:99-104. [DOI: 10.1002/cpdd.178] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 11/12/2014] [Accepted: 11/18/2014] [Indexed: 11/10/2022]
Affiliation(s)
- Kyoko Matsuguma
- From the LTA Medical Corporation Kyushu Clinical Pharmacology Research Clinic; 2-13-16; Jigyo Chuo-ku Fukuoka 810-0064 Japan
| | - Shunji Matsuki
- From the LTA Medical Corporation Kyushu Clinical Pharmacology Research Clinic; 2-13-16; Jigyo Chuo-ku Fukuoka 810-0064 Japan
| | - Kei Sakamoto
- From the LTA Medical Corporation Kyushu Clinical Pharmacology Research Clinic; 2-13-16; Jigyo Chuo-ku Fukuoka 810-0064 Japan
| | - Masanari Shiramoto
- From the LTA Medical Corporation Kyushu Clinical Pharmacology Research Clinic; 2-13-16; Jigyo Chuo-ku Fukuoka 810-0064 Japan
| | - Misato Nakagawa
- From the LTA Medical Corporation Kyushu Clinical Pharmacology Research Clinic; 2-13-16; Jigyo Chuo-ku Fukuoka 810-0064 Japan
| | - Miyuki Kimura
- From the LTA Medical Corporation Kyushu Clinical Pharmacology Research Clinic; 2-13-16; Jigyo Chuo-ku Fukuoka 810-0064 Japan
| | - Shin Irie
- From the LTA Medical Corporation Kyushu Clinical Pharmacology Research Clinic; 2-13-16; Jigyo Chuo-ku Fukuoka 810-0064 Japan
| | - Daiki Kaneko
- Fuji Pharma Co., Ltd.; 5-7 Sanban-cho Chiyoda-ku Tokyo 102-0075 Japan
| | - Akihiro Ohnishi
- Department of Laboratory Medicine; The Jikei University School of Medicine; 4-11-1 Izumihoncho Komae Tokyo 201-8601 Japan
| |
Collapse
|
23
|
Model-Based Approach to Early Predict Prolonged High Grade Neutropenia in Carboplatin-Treated Patients and Guide G-CSF Prophylactic Treatment. Pharm Res 2014; 32:654-64. [DOI: 10.1007/s11095-014-1493-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 08/15/2014] [Indexed: 02/05/2023]
|
24
|
Koch G, Krzyzanski W, Pérez-Ruixo JJ, Schropp J. Modeling of delays in PKPD: classical approaches and a tutorial for delay differential equations. J Pharmacokinet Pharmacodyn 2014; 41:291-318. [DOI: 10.1007/s10928-014-9368-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 06/26/2014] [Indexed: 01/09/2023]
|
25
|
Kagan L. Pharmacokinetic Modeling of the Subcutaneous Absorption of Therapeutic Proteins. Drug Metab Dispos 2014; 42:1890-905. [DOI: 10.1124/dmd.114.059121] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
|
26
|
Quartino AL, Karlsson MO, Lindman H, Friberg LE. Characterization of Endogenous G-CSF and the Inverse Correlation to Chemotherapy-Induced Neutropenia in Patients with Breast Cancer Using Population Modeling. Pharm Res 2014; 31:3390-403. [DOI: 10.1007/s11095-014-1429-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2014] [Accepted: 06/03/2014] [Indexed: 11/30/2022]
|
27
|
Matsuguma K, Matsuki S, Eunhee C, Watanabe A, Tanaka A, Sakamoto K, Takeshita H, Hitaka A, Shigetome K, Kimura M, Miyamoto A, Irie S, Kaneko D, Ohnishi A. Pharmacokinetics and pharmacodynamics of FSK0808 and Gran after single intravenous drip administration or single subcutaneous administration: comparative study in healthy Japanese adult male subjects. Drug Dev Ind Pharm 2014; 41:470-5. [PMID: 24471477 DOI: 10.3109/03639045.2013.879721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
FSK0808 is a recombinant human granulocyte colony-stimulating factor developed by Fuji Pharma Co., Ltd and Mochida Pharmaceutical Co., Ltd. as a biosimilar product of Gran®. We verified the pharmacokinetic/pharmacodynamic equivalence of FSK0808 and commercially available Gran® by a randomized crossover study of single intravenous dose (200 µg/m(2)) and single subcutaneous dose (400 µg/m(2)) in healthy Japanese adult male subjects. According to the bioequivalence guidelines, the area under the blood concentration - time curve by 48 hours after administration (AUC0-48) in a single intravenous drip (IVD) study, and AUC0-48 and maximum blood concentration (Cmax) in a single subcutaneous (SC) dose study were used as primary endpoints, and the pharmacodynamic parameters including absolute neutrophil count (ANC) or number of CD34 positive cells (CD34(+) cells) as secondary endpoints. The safety was evaluated based on the characteristics and incidence of adverse reactions. As a result, the 90% confidence interval (CI) of the difference in mean value for AUC0-48 among drugs ranged from log(0.8) to log(1.25), in the IVD study, and those for Cmax and AUC0-48 were within the range of log(0.8)-log(1.25) in the SC study. Those for secondary endpoints were all within the range of log(0.8)-log(1.25). Thus, the pharmacokinetics/pharmacodynamics of both drugs were considered equivalent for all routes of administration, and the profiles of adverse reactions were also very similar.
Collapse
Affiliation(s)
- Kyoko Matsuguma
- LTA Medical Corporation Kyushu Clinical Pharmacology Research Clinic , Jigyo Chuo-ku, Fukuoka , Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Basic concepts in population modeling, simulation, and model-based drug development: part 3-introduction to pharmacodynamic modeling methods. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2014; 3:e88. [PMID: 24384783 PMCID: PMC3917320 DOI: 10.1038/psp.2013.71] [Citation(s) in RCA: 168] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Accepted: 10/22/2013] [Indexed: 12/16/2022]
Abstract
Population pharmacodynamic (PD) models describe the time course of drug effects, relating exposure to response, and providing a more robust understanding of drug action than single assessments. PD models can test alternative dose regimens through simulation, allowing for informed assessment of potential dose regimens and study designs. This is the third paper in a three-part series, providing an introduction into methods for developing and evaluating population PD models. Example files are available in the Supplementary Data.
Collapse
|
29
|
Neutrophil Dynamics in Peritoneal Carcinomatosis Patients Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Oxaliplatin. Clin Pharmacokinet 2013; 52:1111-25. [DOI: 10.1007/s40262-013-0092-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
30
|
Model-Based Approach to Describe G-CSF Effects in Carboplatin-Treated Cancer Patients. Pharm Res 2013; 30:2795-807. [DOI: 10.1007/s11095-013-1099-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 06/04/2013] [Indexed: 11/25/2022]
|
31
|
Savkovic B, Macpherson JL, Zaunders J, Kelleher AD, Knop AE, Pond S, Evans L, Symonds G, Murray JM. T-lymphocyte perturbation following large-scale apheresis and hematopoietic stem cell transplantation in HIV-infected individuals. Clin Immunol 2012; 144:159-71. [PMID: 22772031 DOI: 10.1016/j.clim.2012.06.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 05/18/2012] [Accepted: 06/07/2012] [Indexed: 02/06/2023]
Abstract
Analysis and mathematical modeling of T-lymphocyte perturbation following administration of granulocyte colony stimulating factor (G-CSF) and two large-scale aphereses are reported. 74 HIV-1 positive antiretroviral-treated individuals were infused with gene- or sham-transduced CD34+ hematopoietic stem cells (HSC) in a Phase II clinical trial. T cell numbers were examined in four phases: 1) during steady state; 2) increases in peripheral blood (PB) following G-CSF administration; 3) depletion post-aphereses and 4) reconstitution post HSC infusion. The present analysis provides the first direct estimate of CD4+ T cell distribution and trafficking in HIV-infected individuals on stable HAART, indicating that CD4+ T lymphocytes in PB represent 5.5% of the pool of CD4+ T lymphocytes that traffic to PB.
Collapse
Affiliation(s)
- Borislav Savkovic
- School of Mathematics and Statistics, University of New South Wales, Sydney 2052, Australia
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Krzyzanski W, Perez Ruixo JJ. Lifespan based indirect response models. J Pharmacokinet Pharmacodyn 2012; 39:109-23. [PMID: 22212685 PMCID: PMC3684441 DOI: 10.1007/s10928-011-9236-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 12/15/2011] [Indexed: 01/18/2023]
Abstract
In the field of hematology, several mechanism-based pharmacokinetic-pharmacodynamic models have been developed to understand the dynamics of several blood cell populations under different clinical conditions while accounting for the essential underlying principles of pharmacology, physiology and pathology. In general, a population of blood cells is basically controlled by two processes: the cell production and cell loss. The assumption that each cell exits the population when its lifespan expires implies that the cell loss rate is equal to the cell production rate delayed by the lifespan and justifies the use of delayed differential equations for compartmental modeling. This review is focused on lifespan models based on delayed differential equations and presents the structure and properties of the basic lifespan indirect response (LIDR) models for drugs affecting cell production or cell lifespan distribution. The LIDR models for drugs affecting the precursor cell production or decreasing the precursor cell population are also presented and their properties are discussed. The interpretation of transit compartment models as LIDR models is reviewed as the basis for introducing a new LIDR for drugs affecting the cell lifespan distribution. Finally, the applications and limitations of the LIDR models are discussed.
Collapse
Affiliation(s)
- Wojciech Krzyzanski
- Department of Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, USA.
| | | |
Collapse
|
33
|
Yang BB, Savin MA, Green M. Prevention of Chemotherapy-Induced Neutropenia with Pegfilgrastim: Pharmacokinetics and Patient Outcomes. Chemotherapy 2012; 58:387-98. [DOI: 10.1159/000345626] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 11/05/2012] [Indexed: 12/21/2022]
|
34
|
Yan X, Lowe PJ, Fink M, Berghout A, Balser S, Krzyzanski W. Population pharmacokinetic and pharmacodynamic model-based comparability assessment of a recombinant human Epoetin Alfa and the Biosimilar HX575. J Clin Pharmacol 2011; 52:1624-44. [PMID: 22162538 DOI: 10.1177/0091270011421911] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to develop an integrated pharmacokinetic and pharmacodynamic (PK/PD) model and assess the comparability between epoetin alfa HEXAL/Binocrit (HX575) and a comparator epoetin alfa by a model-based approach. PK/PD data-including serum drug concentrations, reticulocyte counts, red blood cells, and hemoglobin levels-were obtained from 2 clinical studies. In sum, 149 healthy men received multiple intravenous or subcutaneous doses of HX575 (100 IU/kg) and the comparator 3 times a week for 4 weeks. A population model based on pharmacodynamics-mediated drug disposition and cell maturation processes was used to characterize the PK/PD data for the 2 drugs. Simulations showed that due to target amount changes, total clearance may increase up to 2.4-fold as compared with the baseline. Further simulations suggested that once-weekly and thrice-weekly subcutaneous dosing regimens would result in similar efficacy. The findings from the model-based analysis were consistent with previous results using the standard noncompartmental approach demonstrating PK/PD comparability between HX575 and comparator. However, due to complexity of the PK/PD model, control of random effects was not straightforward. Whereas population PK/PD model-based analyses are suited for studying complex biological systems, such models have their limitations (statistical), and their comparability results should be interpreted carefully.
Collapse
Affiliation(s)
- Xiaoyu Yan
- Department of Pharmaceutical Sciences, 565 B Hochstetter Hall, State University of New York at Buffalo, Buffalo, NY 14260, USA
| | | | | | | | | | | |
Collapse
|
35
|
Ma P. Theoretical considerations of target-mediated drug disposition models: simplifications and approximations. Pharm Res 2011; 29:866-82. [PMID: 22130732 DOI: 10.1007/s11095-011-0615-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Accepted: 10/20/2011] [Indexed: 01/12/2023]
Abstract
PURPOSE To clarify relationships among various types of target-mediated disposition (TMD) models including the Michaelis-Menten, quasi-steady-state (Qss), and rapid binding models and propose measures for the closeness of some models as approximations to the general TMD model (Mager and Jusko, J Pharmacokinet Pharmacodyn 28(6):507-532, 2001). METHODS Based on the classic singular perturbation theory by selecting appropriate scales of time, we derive requirements with which the Michaelis-Menten and Qss models are suitable approximations. Under the Qss assumption we show that other simplifications of the general TMD model can be similarly obtained as the Michaelis-Menten and Qss models. We compare these models by simulations using known application examples. RESULTS The Michaelis-Menten and Qss models are direct simplifications of the general TMD model and, moreover, suitable approximations if certain specific requirements on the parameters are met. CONCLUSIONS As a first attempt to quantify the closeness of some simplifications to the general TMD model, our work should provide a more rigorous basis for the theoretical and practical research of TMD models, which are important for investigating the pharmacokinetic-pharmacodynamic relationships of many biological compounds.
Collapse
Affiliation(s)
- Peiming Ma
- Department of Pharmacokinetics and Drug Metabolism, Amgen Inc., Thousand Oaks, California 91320, USA.
| |
Collapse
|
36
|
Krzyzanski W. Interpretation of transit compartments pharmacodynamic models as lifespan based indirect response models. J Pharmacokinet Pharmacodyn 2011; 38:179-204. [PMID: 21107661 PMCID: PMC3177953 DOI: 10.1007/s10928-010-9183-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2010] [Accepted: 11/08/2010] [Indexed: 11/26/2022]
Abstract
Transit compartments (TC) models are used to describe pharmacodynamic responses that involve drug action on cells undergoing differentiation and maturation. Such pharmacodynamic systems can also be described by lifespan based indirect response (LIDR) models. The purpose of this report is to investigate conditions under which the transit compartments models can be considered a special case of LIDR models. An integral representation of a solution to TC model has been used to determine the lifespan distribution for cell population described by this model. The distribution served as a basis for definition of new LIDRE (lifespan based indirect response with an effect on the lifespan distribution) models. Time courses of responses described by both types of models were simulated for a monoexponential pharmacokinetic function. The limit response was calculated as the number of transit compartments approached infinity. The difference between the limit response and TC responses were evaluated by computer simulations using MATLAB 7.7. TC models are a special case of LIDR models with the lifespan distribution described by the gamma function. If drug affects only the production of cells, then the cell lifespan distribution is time invariant. In this case an increase in the number of compartments results in a basic LIDR model with a point lifespan distribution. When the drug inhibits or stimulates cell aging, the cell lifespan distribution becomes time dependent revealing a new mechanism for drug effect on the gamma probability density function. The TC model with a large number of transit compartments converges to an LIDRE model. The limit LIDR models are approximated by the TC models when the number of compartments is at least 5. A moderate improvement in the approximation is observed if this number exceeds 20. The lifespan distribution for a cell population described by a TC model is described by the gamma probability density function. A drug affects this distribution only if it stimulates or inhibits the rate of cell maturation. If the number of transit compartments increases, then the TC model converges to a new type of LIDR model.
Collapse
Affiliation(s)
- Wojciech Krzyzanski
- Department of Pharmaceutical Sciences, University at Buffalo, 565B Hochstetter Hall, Buffalo, NY 14260, USA.
| |
Collapse
|