对Adagrasib药物相互作用的临床和生理学基础的药物动力学模型评估
Cornelius Cilliers1, Eleanor Howgate2, Hannah M Jones2
1Clinical Pharmacology and Nonclinical Development, Mirati Therapeutics Inc. (A Bristol Myers Squib Company), San Diego, California, USA.
阿达格拉西布是一种KRAS G12C抑制剂,由于抑制CYP3A4,具有药物相互作用的风险. 一个PBPK模型预测了adapgrasib.
科学领域:
- 药理动力学和药物新陈代谢
- 瘤学 药物开发 药物开发
- 计算药理学计算药理学
背景情况:
- 阿达格拉西布是一种口服可用的选择性共价抑制剂,向KRAS G12C突变.
- 阿达格拉西布是一种基质和细胞染色体P450 (CYP) 3A4的抑制剂,具有潜在的药物相互作用 (DDI) 风险.
研究的目的:
- 开发和验证一个基于生理学的药理动力学 (PBPK) 模型,用于阿达格拉西布.
- 为了预测阿达格拉西布的DDI责任,作为受害者和事者,在批准的600毫克每天两次 (b.i.d.) 癌症患者的剂量方案.
主要方法:
- 使用物理化学,体外和临床药理动力学 (PK) 数据开发和验证PBPK模型.
- 模拟DDI场景,涉及Adagrasib与各种CYP3A4抑制剂和诱导剂以及其他药物.
- 预测阿达格拉西布对CYP3A4,CYP2C9,CYP2D6和P-糖蛋白 (P-gp) 的行为者影响.
主要成果:
- 该PBPK模型准确地描述了阿达格拉西布的单剂和多剂PK和DDI数据 (比观察到的临床数据的1.5倍之内).
- 预计阿达格拉西布的稳定状态暴露受到CYP3A4抑制剂的微不足道影响,但受到强 (68%) 和中度 (22%) 的CYP3A4诱导剂的减少.
- 阿达格拉西布 (每天两次600毫克) 预计是强大的CYP3A4抑制剂,中度的CYP2C9和CYP2D6抑制剂,以及P-gp的抑制剂.
结论:
- 经过验证的PBPK模型有效地预测了阿达格拉西布的PK和DDI配置文件.
- 模型预测支持监管相互作用,并为同时服用药物的剂量建议提供信息,减少了对广泛临床DDI试验的需求.
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