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Published on: September 18, 2013
Pharmacokinetics of single-agent axitinib across multiple solid tumor types
Michael A Tortorici1, Ezra E W Cohen, Yazdi K Pithavala
1Department of Clinical Pharmacology, Pfizer Inc, San Diego, CA, USA, Michael.Tortorici@cslbehring.com.
Purpose:
Axitinib, a potent and selective inhibitor of vascular endothelial growth factor receptors, showed antitumor activity as a single agent against several solid tumor types in Phase II and III trials. This study was conducted to evaluate axitinib pharmacokinetics across a variety of solid tumors.
Methods:
The current study analyzed the pharmacokinetics of axitinib in 110 patients with non-small cell lung cancer (NSCLC), thyroid cancer, or melanoma from three Phase II trials plus 127 healthy volunteers, using nonlinear mixed-effects modeling. Boxplots of maximum observed plasma concentration (C max) and area under the plasma concentration-time curve (AUC) of data from these tumor populations was compared to C max and AUC from the final population pharmacokinetic model developed for metastatic renal cell carcinoma (mRCC) to compare axitinib pharmacokinetics across different tumor types.
Results:
Axitinib disposition based on data from 237 subjects was best described using a two-compartment model with first-order absorption and lag time. Population estimates for systemic clearance, central volume of distribution, absorption rate constant, absolute bioavailability, and lag time were 20.1 L/h, 56.2 L, 1.26/h(-1), 0.663, and 0.448 h, respectively. Statistically significant covariates included gender on clearance, and body weight on central volume of distribution. However, predicted changes due to gender and body weight were found not clinically meaningful. The final analysis indicated that the pharmacokinetic model for mRCC was able to successfully describe axitinib pharmacokinetics in patients with NSCLC, thyroid cancer, and melanoma.
Conclusion:
The pharmacokinetics of axitinib appears to be similar across a variety of tumor types.
Insights
Axitinib pharmacokinetics are similar across non-small cell lung cancer, thyroid cancer, and melanoma. This finding supports its use as a single agent in various solid tumors.
Area of Science:
- Pharmacology
- Oncology
- Clinical Pharmacokinetics
Background:
- Axitinib, a vascular endothelial growth factor receptor inhibitor, demonstrates antitumor activity.
- Previous trials established axitinib's efficacy as a single agent in several solid tumors.
Purpose of the Study:
- To evaluate and compare the pharmacokinetics of axitinib in patients with non-small cell lung cancer (NSCLC), thyroid cancer, and melanoma.
- To determine if axitinib pharmacokinetics differ across these tumor types.
Main Methods:
- Population pharmacokinetic analysis using nonlinear mixed-effects modeling in 110 patients with NSCLC, thyroid cancer, or melanoma, plus 127 healthy volunteers.
- Comparison of axitinib maximum observed plasma concentration (C max) and area under the plasma concentration-time curve (AUC) against a model developed for metastatic renal cell carcinoma (mRCC).
Main Results:
- A two-compartment model with first-order absorption and lag time best described axitinib disposition.
- Population pharmacokinetic parameters were estimated, with gender and body weight identified as covariates but not clinically meaningful.
- The established pharmacokinetic model for mRCC successfully described axitinib pharmacokinetics in NSCLC, thyroid cancer, and melanoma patients.
Conclusions:
- Axitinib pharmacokinetics are consistent across diverse solid tumor types, including NSCLC, thyroid cancer, and melanoma.
- This pharmacokinetic similarity supports the potential for axitinib as a single-agent therapy across these indications.
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