Oxaliplatin in patients with metastatic colorectal cancer: efficacy and pharmacokinetics parameters

PURPOSE

The aim of this study was to investigate the efficiency of the FOLFOX-4 regimen and to evaluate the pharmacokinetics of oxaliplatin in untreated patients with metastatic colorectal cancer.

METHODS

43 patients were enrolled in the study. Patients received oxaliplatin 85 mg/m(2) as 2-h i.v. infusion, on day 1, and bolus 5-fluorouracil (5FU) 400 mg/m(2) plus leucovorin (LV) 200 mg/m(2) followed by 5FU 600 mg/m(2) as 22-h infusion on day 1 and 2, every 2 weeks. The pharmacokinetics of oxaliplatin evaluated in 4 patients was performed in blood, plasma and ultrafiltered plasma (UFT) by Inductively Coupled Plasma Mass Spectrometry (ICP-MS).

RESULTS

The overall response rate and the median time to progression (TTP) were 53.49% and 7.1 months, respectively. Grade 3-4 toxic effects were observed in 11 (25.5%) patients. Grade 3 neuropathy was observed in 13.95% of the cases. In univariate analysis only Eastern Cooperative Oncology Group (ECOG) performance status (PS) was correlated with response. No correlation was found between grade 3-4 adverse events and the patient characteristics. The area under the time-concentration curve (AUC) in UFT was 4.8 + or - 0.72 standard deviation (SD) microg h/ml and the total clearance 30.17 + or - 7.75 l/min. The values for volume of distribution and the maximum concentration were 567 + or - 20 liters and 0.38 + or - 0.17 ug/ml, respectively.

CONCLUSION

FOLFOX-4 was an effective regimen with good tolerability in previously untreated metastatic colorectal cancer patients. The pharmacokinetics of oxaliplatin was triphasic with a short initial distribution phase and a long terminal elimination phase.

Optimization of Propranolol Hydrochloride Sustained-Release Pellets Using Box-Behnken Design and Desirability Function

The objective of the present study was to evaluate three process parameters for the application of ethylcellulose films from organic solutions to obtain multi-particulate controlled drug delivery of propranolol hydrochloride. The coating process was developed in a classical coating pan. A Box-Behnken central composite design was used to evaluate the effect of the film thickness (expressed as the amount of lacquer applied on pellets' surface unit), concentration of lacquer in the coating dispersion, and the plasticizer concentration on the independent variables. Those were t85, the degree of sticking in the coating pan, and the duration of the coating process. Contour and response surface plots were depicted based on the equation given by the model. Because the results were competitive, i.e., improving one response had an opposite effect on another one, an overall desirability function was described to ameliorate the interpretation of the results. The optimization procedure generated the maximum overall desirability value. A formulation was prepared under the optimized conditions yielding response values which were close to the predicted values. To understand the mechanism of drug release from the optimized pellets various models were used to fit the dissolution data. The Higuchi model appears to provide the best correlation.

The Influence of Formulation Factors on the Kinetic Release of Metoprolol Tartrate from Prolong Release Coated Minitablets

The aim of this work was to study the possibility to obtain an oral extended-release dosage forms with zero order kinetic release by coating minitablets (containing metoprolol tartrate) with insoluble methacrylate film coating (Eudragit NE 40D) in a fluidized bed system. To achieve this aim a full factorial experimental design with two factors and three levels was used in order to study de influence of the amount of polymer film formatting (Eudragit NE 40D) and the amount of pore generating excipient in polymeric insoluble film (low viscosity hydroxypropyl methylcellulose-Methocel E 15LV) on the in vitro drug release profile.

Oxprenolol-loaded bioadhesive microspheres: preparation and in vitro/in vivo characterization

Biologically adhesive delivery systems offer important advantages over conventional drug-delivery systems. In this paper, microspheres intended as a sustained release carrier for oral or nasal administration have been prepared by associating a known bioadhesive polymer, poly(acrylic acid), in gelatin microspheres. A model drug oxprenolol hydrochloride was chosen. It was found that some of the formulation variables can influence the characteristics of the beads in a controlled manner. The internal structure of the microspheres studied by X-ray diffraction, thermal analysis and optical microscopy showed the absence of drug crystals in microspheres and a lowering in the glass transition temperature. The dynamic swelling of the beads obeyed the square root of time and a shift from the diffusional to the relaxational process dependent on the content of poly(acrylic acid) in gelatin microspheres was observed. As expected, drug release from gelatin/poly(acrylic acid) microspheres was influenced by the poly(acrylic acid) content in beads, by the particle size of microspheres and by the pH of the medium. The mechanism of release was analysed by applying the empirical exponential equation and by calculation of the approximate contribution of the diffusional and relaxational mechanisms to the anomalous release process by fitting the data to the coupled Fickian/Case II equation. In vitro and in vivo experiments in rats showed good adhesive characteristics of the gelatin/poly(acrylic acid) microspheres, which were greater if the poly(acrylic acid) content was greater. A significant retardation in gastric and intestinal emptying time of the beads was observed. This was also suggested by the bioavailability of the model drug after intragastric and intranasal administration of the microspheres. The pharmacokinetic parameters after microsphere administration were more appropriate to a slow release drug-delivery system. The work suggests the potential of this pharmaceutical delivery system as an alternative controlled-release dosage form, either for oral or nasal administration.

Relative bioavailability of different oral sustained release oxprenolol tablets

The bioequivalence of oral dosage forms of oxprenolol was assessed in a triple crossover study on two groups of 12 volunteers each. Single 160 mg doses of oxprenolol hydrochloride were given after an overnight fast of either oxprenolol sustained-release tablets in a megaloporous system, a hydrophil matrix and Slow-Trasicor (Ciba-Geigy) in the first group, or floating slow-release tablets administered with food or in absence of food, and rapid release Oxprenolol (Terapia, Cluj-Napoca) tablets, in the second group. Serum oxprenolol concentrations were measured by a gas chromatographic method. Pharmacokinetic parameters which describe bioavailability and general kinetic behavior of the drug were calculated from individual serum profiles. They were subjected to statistical analysis (paired Student's t test, p < 0.05). The customary bioequivalence criterion was used: 0.8 < parameter ratio(tested/standard) < 1.2. Megaloporous tablets showed bioequivalence with the reference sustained release product Slow-Trasicor. Hydrophil tablets showed moderate sustained-release characteristics. Floating tablets showed significantly greater oxprenolol absorption when taken with food and were non-bioequivalent with floating tablets without food, as well as with the reference rapid release tablets, of oxprenolol. However, fasting tablets were bioequivalent to the Slow-Trasicor product, when taken with food.

Dynamic swelling behaviour of gelatin/poly(acrylic acid) bioadhesive microspheres loaded with oxprenolol

The dynamic swelling of gelatin/poly(acrylic acid) microspheres loaded with oxprenolol has been evaluated. The movement of two distinct and characteristic swelling boundaries was measured directly using an optical microscope. Swelling rate constants associated with the inner moving front and the outer swelling boundary were determined. A polynomial equation incorporating both Fickian diffusion and case II relaxational models was used to fit the kinetics of liquid uptake. The influence of the concentration of the cross-linking agent, the poly(acrylic acid) load, the pH of the swelling medium and the particle size of the microspheres, on the swelling kinetics, was evaluated and discussed.

Oxprenolol release from bioadhesive gelatin/poly(acrylic acid) microspheres

Drug release from gelatin/poly(acrylic acid) oxprenolol-loaded microspheres has been evaluated using an in situ sink immersion method and a wetting method. The kinetics of drug release were analysed by applying the empirical exponential equation and by the calculation of the approximate contribution of the diffusional and relaxational mechanism to the anomalous release process by fitting the data to the coupled Fickian/Case II equation. The influence of glutaraldehyde cross-linking agent concentration, the poly(acrylic acid) content, the pH of the release medium and the particle size of the beads on the drug release kinetics were evaluated and discussed.

The kinetics of nifedipine release from porous hydrophilic matrices and the pharmacokinetics in man

Porous hydrophilic tablets of nifedipine were prepared with hydroxypropyl methylcellulose as swellable polymer, as well as with the addition of a solid dispersion of the drug in polyethylene glycol, a water soluble system. The kinetic data conformed with the Higuchi square root equation and first order release for in vitro release from a single planar surface of the tablet, as well as release from the whole tablet. The addition of a soluble fraction to the porous swellable release system increased the nifedipine release rate constant. This shows that the dosage form may be formulated as a drug-polymer system which exhibits constant release at a desired rate. In the bioequivalence study with five volunteers, the pharmacokinetic parameters of a sustained release hydrophilic tablet of nifedipine and of immediate release capsules were determined. Although the bioavailability of the two preparations is similar, the therapeutic effects may differ. The rate of absorption, the maximum concentration levels, the time of the peak and the period of maintenance of the therapeutic serum levels after single oral doses are different after the administration of the two tested formulations. The hydrophilic tablets of nifedipine may be useful as a sustained release formulation for long term treatment of hypertension.