ソトラジブとその主要代謝産物に対する肝障害の臨床的影響: 投与量調整への影響
Mason McComb1, Panli Cardona1, Caitlin Sampson1
1Amgen Inc., Thousand Oaks, CA, USA.
Journal of clinical pharmacology
|August 20, 2025
まとめ
非小細胞肺がんのKRAS G12C阻害剤であるソトラジブは,中度または重度の肝機能障害の患者で有意な薬理学的な変化を示さなかった. これらの患者群では用量調整は不要です.
科学分野:
- 腫瘍学
- 薬理学について
- 臨床試験
背景:
- ソトラジブは,KRAS G12C変異性非小細胞肺がんに対する承認された標的療法です.
- 肝機能は薬物の代謝と暴露に影響を与える.
- 肝障害におけるソトラジブの薬理学を理解することは,安全で効果的な使用に不可欠です.
研究 の 目的:
- ソトラジブとその代謝産物に対する中度重度の肝機能低下の効果を評価する.
- 肝障害の患者におけるソトラジブの安全性と耐容性を評価する.
主な方法:
- 第1段階 オープン・マルチセンター試験
- 肝機能が正常か中度か重度の患者に対して,単一の口服用960mgのソトラジブを投与した.
- ソトラジブおよびメタボリート (M10,M18,M24) の薬理学パラメータ (AUC,Cmax,t1/ 2) を測定した.
- 副作用はモニタリングされた.
主要な成果:
- 中度または重度の肝機能不全により,ソトラジブ暴露 (AUCinfおよびCmax) は有意に変化しませんでした.
- ソトラジブの平均半減期 (t1/ 2) は,肝機能群において類似した.
- メタボリートM10とM24の曝露は増加し,M18は肝障害の重度が増加するにつれて減少した.
- 治療による有害事象は軽度で,重篤な事象は報告されていません.
結論:
- 中度または重度の肝機能低下は,ソトラジブ曝露に有意な影響を与えない.
- 中度または重度の肝機能不全の患者では,ソトラジブの投与量を調整する必要はありません.
- ソトラジブは一般的に安全で,肝機能障害の患者ではよく耐えます.
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