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Cao B, Ma T, Zhang Y, Huang L, Lin H, Jiang H, Zhao Y, Geng Y, Yang Y, Cao S, Li J. The effect of food on the pharmacokinetics of Sutetinib maleate capsule, an irreversible EGFR tyrosine kinase inhibitor, in healthy Chinese subjects. Invest New Drugs 2024; 42:289-298. [PMID: 38602625 DOI: 10.1007/s10637-024-01436-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 03/28/2024] [Indexed: 04/12/2024]
Abstract
Sutetinib is an irreversible inhibitor of epidermal growth factor receptor (EGFR) and showed favorable efficacy and safety in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) harbouring nondrug-resistant rare EGFR mutations. To evaluate the potential food effect, eighteen healthy Chinese subjects were enrolled in a single-centre, randomized, open-label, two-sequence, two-period crossover study. Sutetinib was administered as a single oral 100 mg under fasting or fed conditions, and pharmacokinetic sampling was performed following each dose and analysed by a validated liquid chromatography/mass spectrometry method. Safety and tolerability were also evaluated. Food intake slightly decreased maximum plasma concentration (Cmax) and area under the plasma concentration-time curve from time 0 to infinity (AUC0 - inf) of sutetinib (geometric least-squares mean [GLSM] ratio, 80.94% and 86.11%; 90% confidence interval [CI], 68.43-95.72 and 75.88-97.73) and its active metabolite sutetinib N-Oxide (GLSM ratio, 75.58% and 84.00%; 90% CI, 65.69-86.95 and 75.42-93.56), respectively. In addition, the time to maximum plasma concentration (Tmax) of both sutetinib and its metabolite has been prolonged by 2 h under fed conditions. A total of 31 adverse events (AEs) occurred during the study, with no serious adverse events (SAE) reported, and no obvious difference was observed between the fasting and fed groups. Our results demonstrated that a high-fat and high-calorie diet caused a significant delay in drug absorption and a marginal reduction in drug exposure. Sutetinib was generally well tolerated in healthy Chinese subjects. (This trial was registered at http://www.chinadrugtrials.org.cn . The registration No. is CTR20201933, and the date of registration is 2020-10-16).
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Affiliation(s)
- Bei Cao
- Phase I Clinical Trials Unit, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Zhongshan Road 321#, Gulou District, 210008, Nanjing, China
| | - Tingting Ma
- Phase I Clinical Trials Unit, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Zhongshan Road 321#, Gulou District, 210008, Nanjing, China
| | - Yuqiang Zhang
- Clinical Pharmacology Department, Suzhong pharmaceutical group co., LTD, 22550, Taizhou, China
| | - Lei Huang
- Phase I Clinical Trials Unit, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Zhongshan Road 321#, Gulou District, 210008, Nanjing, China
| | - Hui Lin
- Phase I Clinical Trials Unit, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Zhongshan Road 321#, Gulou District, 210008, Nanjing, China
| | - Huanhuan Jiang
- Clinical Pharmacology Department, Suzhong pharmaceutical group co., LTD, 22550, Taizhou, China
| | - Yu Zhao
- Phase I Clinical Trials Unit, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Zhongshan Road 321#, Gulou District, 210008, Nanjing, China
| | - Yan Geng
- Phase I Clinical Trials Unit, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Zhongshan Road 321#, Gulou District, 210008, Nanjing, China
| | - Yuanxun Yang
- Phase I Clinical Trials Unit, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Zhongshan Road 321#, Gulou District, 210008, Nanjing, China
| | - Sumin Cao
- Clinical Pharmacology Department, Suzhong pharmaceutical group co., LTD, 22550, Taizhou, China.
| | - Juan Li
- Phase I Clinical Trials Unit, Affiliated Hospital of Medical School, Nanjing Drum Tower Hospital, Nanjing University, Zhongshan Road 321#, Gulou District, 210008, Nanjing, China.
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Jung J, Park SY, Park JY, Kim D, Lee K, Choi S. Reactivation of Varicella-Zoster Virus in Patients with Lung Cancer Receiving Immune Checkpoint Inhibitors: Retrospective Nationwide Population-Based Cohort Study from South Korea. Cancers (Basel) 2024; 16:1499. [PMID: 38672581 PMCID: PMC11048333 DOI: 10.3390/cancers16081499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 04/04/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND This study aimed to determine the association between immune checkpoint inhibitors (ICIs) and the risk of herpes zoster (HZ) incidence in patients with lung cancer. METHOD We obtained national claims data of 51,021 patients from South Korea with lung cancer between August 2017 and December 2021. The study population was classified into ICI and non-ICI groups based on the prescription of ICIs at least once during the study period. To estimate the effects of ICIs treatment compared with those without ICIs treatment on HZ incidence, we used the Cox proportional hazards model adjusted for sex, age, comorbidities, and concomitant use of immunosuppressive drugs. Stratified analyses based on sex, age, and comorbidities were conducted to identify corresponding risk factors. RESULTS Of the 51,021 study participants, 897 (1.8%) were prescribed ICIs and 2262 (4.4%) were diagnosed with HZ. Approximately 75.6% of the patients receiving ICIs were male, and the prevalence of diabetes, cardiovascular disease, and chronic lung disease in the ICI group was significantly lower than that in the non-ICIs group. The Kaplan-Meier plot showed that the probability of incidence of HZ in the ICIs group was lower than that in the non-ICIs group. Additionally, treatment with ICIs was associated with a 31% lower incidence of developing HZ when compared to that seen without ICIs treatment (95% confidence interval [CI], 0.48-1.00). This association was stronger in females (hazard ratio [HR], 0.42; 95% CI, 0.19-0.94) and those less than 68 years of age (HR, 0.58; 95% CI, 0.34-0.99). CONCLUSIONS In these real-world data from an Asian population with lung cancer, ICIs treatment might be associated with a reduced risk of HZ compared to that without ICIs treatment.
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Affiliation(s)
- Jiyun Jung
- Clinical Trial Center, Dongguk University Ilsan Hospital, Goyang 10326, Republic of Korea;
- Research Center for Chronic Disease and Environmental Medicine, Dongguk University College of Medicine, Gyeongju 38066, Republic of Korea;
| | - Seong-Yeon Park
- Division of Infectious Diseases, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang 10326, Republic of Korea;
- Department of Internal Medicine, College of Medicine, Dongguk University, Gyeongju 38066, Republic of Korea;
| | - Jae-Yoon Park
- Research Center for Chronic Disease and Environmental Medicine, Dongguk University College of Medicine, Gyeongju 38066, Republic of Korea;
- Department of Internal Medicine, College of Medicine, Dongguk University, Gyeongju 38066, Republic of Korea;
- Division of Nephrology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang 10326, Republic of Korea
| | - Dalyong Kim
- Department of Internal Medicine, College of Medicine, Dongguk University, Gyeongju 38066, Republic of Korea;
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang 10326, Republic of Korea
| | - Kyoungmin Lee
- Division of Hemato-Oncology, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Republic of Korea;
| | - Sungim Choi
- Division of Infectious Diseases, Department of Internal Medicine, Dongguk University Ilsan Hospital, Goyang 10326, Republic of Korea;
- Department of Internal Medicine, College of Medicine, Dongguk University, Gyeongju 38066, Republic of Korea;
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Nagai Y, Sata M, Ohta H, Onuki T, Saito T, Uchiyama A, Kurosaki A, Yoshizumi N, Takigami A, Nakazawa S, Nakayama M, Yamaguchi H, Hagiwara K. Herpes zoster in patients with lung cancer treated with PD-1/PD-L1 antibodies. Immunotherapy 2022; 14:1211-1217. [PMID: 36039980 DOI: 10.2217/imt-2021-0318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Background: There are no available clinical data on immunotherapy and the risk of herpes zoster. Materials & methods: This retrospective study included patients with recurrent or advanced lung cancer who were inoperable and ineligible for radiotherapy and were treated with either a PD-1/PD-L1 antibody (136 patients) or an EGFR tyrosine kinase inhibitor (149 patients) at Jichi Medical University Hospital between January 2016 and December 2018. Results: Herpes zoster-free survival was significantly shorter in the PD-1/PD-L1 antibody-treated group compared with the EGFR tyrosine kinase inhibitor-treated group (hazard ratio: 0.20; 95% CI: 0.048-0.84; p = 0.016). PD-1/PD-L1 antibody administration was independently and significantly associated with herpes zoster occurrence. Conclusion: Clinicians should anticipate herpes zoster in patients with lung cancer during treatment with PD-1/PD-L1 antibodies.
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Affiliation(s)
- Yoshiaki Nagai
- Division of Respiratory Medicine, Department of Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushi-ji, Shimotsuke-shi, Tochigi-ken, 329-0431, Japan
| | - Masafumi Sata
- Division of Respiratory Medicine, Department of Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushi-ji, Shimotsuke-shi, Tochigi-ken, 329-0431, Japan
| | - Hiromitsu Ohta
- Department of Respiratory Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Tsugitoshi Onuki
- Division of Respiratory Medicine, Department of Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushi-ji, Shimotsuke-shi, Tochigi-ken, 329-0431, Japan
| | - Tatsuya Saito
- Division of Respiratory Medicine, Department of Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushi-ji, Shimotsuke-shi, Tochigi-ken, 329-0431, Japan
| | - Ayumi Uchiyama
- Division of Respiratory Medicine, Department of Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushi-ji, Shimotsuke-shi, Tochigi-ken, 329-0431, Japan
| | - Ayako Kurosaki
- Division of Respiratory Medicine, Department of Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushi-ji, Shimotsuke-shi, Tochigi-ken, 329-0431, Japan
| | - Naoko Yoshizumi
- Division of Respiratory Medicine, Department of Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushi-ji, Shimotsuke-shi, Tochigi-ken, 329-0431, Japan
| | - Ayako Takigami
- Division of Respiratory Medicine, Department of Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushi-ji, Shimotsuke-shi, Tochigi-ken, 329-0431, Japan
| | - Shoko Nakazawa
- Division of Respiratory Medicine, Department of Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushi-ji, Shimotsuke-shi, Tochigi-ken, 329-0431, Japan
| | - Masayuki Nakayama
- Division of Respiratory Medicine, Department of Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushi-ji, Shimotsuke-shi, Tochigi-ken, 329-0431, Japan
| | - Hironori Yamaguchi
- Department of Clinical Oncology, Jichi Medical University Hospital, 3311-1 Yakushi-ji, Shimotsuke-shi, Tochigi-ken, 329-0431, Japan
| | - Koichi Hagiwara
- Division of Respiratory Medicine, Department of Internal Medicine, Jichi Medical University Hospital, 3311-1 Yakushi-ji, Shimotsuke-shi, Tochigi-ken, 329-0431, Japan
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Yasokawa N, Yasuda Y, Chin H, Kurose K, Aoyama Y, Oga T. Generalized herpes zoster and cutaneous metastasis during chemotherapy for non-small cell lung cancer: A case report. Thorac Cancer 2020; 12:117-121. [PMID: 33118287 PMCID: PMC7779188 DOI: 10.1111/1759-7714.13722] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 01/05/2023] Open
Abstract
Although herpes zoster is known to occur in some patients with lung cancer, generalized (disseminated) herpes zoster is an uncommon form whereby hematogenous dissemination of the virus occurs and leads to the development of widespread cutaneous lesions. Similarly, skin is an uncommon site of metastasis in patients with lung cancer. Here, we report a clinical case of a 53‐year‐old male patient who developed generalized herpes zoster during chemotherapy for non‐small cell lung cancer (squamous cell carcinoma) and subsequently developed cutaneous metastasis of lung cancer after generalized herpes zoster was cured by treatment with intravenous aciclovir. The coincidence of these two conditions, generalized herpes zoster and cutaneous metastasis, in the patient during lung cancer treatment might be associated with an impaired or dysregulated immune system partly due to repeated chemotherapy, indicating a poor prognosis. Close observation and accurate diagnosis of changes in the skin of patients with lung cancer are important when evaluating their immune status and considering their therapy and prognosis.
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Affiliation(s)
- Naoya Yasokawa
- Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Yuri Yasuda
- Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Houhi Chin
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - Koji Kurose
- Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Japan
| | - Yumi Aoyama
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - Toru Oga
- Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Japan
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Wang S, Wei JCC, Huang JY, Perng WT, Zhang Z. The risk of herpes zoster among patients with ankylosing spondylitis: A population-based cohort study in Taiwan. Int J Rheum Dis 2019; 23:181-188. [PMID: 31334604 DOI: 10.1111/1756-185x.13650] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 05/19/2019] [Accepted: 06/13/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The incident rate of herpes zoster (HZ) is higher in some autoimmune diseases; however the relationship of HZ and ankylosing spondylitis (AS) is still unclear. This research aims to determine the incidence of HZ in Taiwan AS patients. METHODS This study included 2819 AS patients and 11 276 non-AS controls between 2003 and 2013. All participants were selected from the Longitudinal Health Insurance Database 2000 Taiwan. The endpoint was diagnosis of HZ by International Classification of Diseases, Ninth Revision, Clinical Modification coding for at least 3 outpatient visits or one admission until the end of 2013. We used Chi-square test, Cox proportional hazard models and a Kaplan-Meier analysis to calculate the hazards ratio (HR), disease-free survival and incidental density of HZ. Subgroup analysis and sensitivity tests were also done. RESULTS Comorbidities such as chronic urticaria, inflammatory bowel disease, thyroid disorders, hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, cerebrovascular accident, were higher in patients with AS than that in controls. Patients age ≥60 or comorbid disease such as thyroid disorders or cancer had a higher HR of HZ; the adjusted HRs were 2.273 (95% CI 1.314-3.931), 1.577 (95% CI 1.008-2.466) and 1.855 (95% CI 1.248-2.758) respectively, on multivariable modeling. The crude HR for HZ among AS patient was 1.178 (95% CI 0.953-1.455, P > 0.05), and the adjust HZ was 1.070 (95% CI 0.835-1.371, P > 0.05), compared to non-AS controls. CONCLUSIONS There is no difference in incidence rate of HZ between Taiwan AS patients and non-AS controls. Among AS patients, age and cancer were major risk factors for incidental HZ.
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Affiliation(s)
- Shuya Wang
- Department of Rheumatology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - James Cheng-Chung Wei
- Department of Rheumatology, BenQ Medical Center, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.,Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Wuu-Tsun Perng
- Department of Recreation Sport & Health Promotion, National Pingtung University of Science and Technology, Neipu, Taiwan
| | - Zhiyi Zhang
- Department of Rheumatology, The First Affiliated Hospital of Harbin Medical University, Harbin, China
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