Population Pharmacokinetic Analysis of Bortezomib in Pediatric Leukemia Patients : Model-Based Support for Body Surface Area-Based Dosing Over the 2- to 16-Year Age Range

© 2017, The Authors. The Journal of Clinical Pharmacology published by Wiley Periodicals, Inc. on behalf of American College of Clinical Pharmacology..

This population analysis described the pharmacokinetics of bortezomib after twice-weekly, repeat-dose, intravenous administration in pediatric patients participating in 2 clinical trials: the phase 2 AALL07P1 (NCT00873093) trial in relapsed acute lymphoblastic leukemia and the phase 3 AAML1031 (NCT01371981) trial in de novo acute myelogenous leukemia. The sources of variability in the pharmacokinetic parameters were characterized and quantified to support dosing recommendations. Patients received intravenous bortezomib 1.3 mg/m2 twice-weekly, on days 1, 4, and 8 during specific blocks or cycles of both trials and on day 11 of block 1 of study AALL07P1, in combination with multiagent chemotherapy. Blood samples were obtained and the plasma was harvested on day 8 over 0-72 hours postdose to measure bortezomib concentrations by liquid chromatography-tandem mass spectrometry. Concentration-time data were analyzed by nonlinear mixed-effects modeling. Covariates were examined using forward addition (P < .01)/backward elimination (P < .001). Data were included from 104 patients (49%/51% acute lymphoblastic leukemia/acute myelogenous leukemia; 60%/40% aged 2-11 years/12-16 years). Bortezomib pharmacokinetics were described by a 3-compartment model with linear elimination. Body surface area adequately accounted for variability in clearance (exponent 0.97), supporting body surface area-based dosing. Stratified visual predictive check simulations verified that neither age group nor patient population represented sources of meaningful pharmacokinetic heterogeneity not accounted for by the final population pharmacokinetic model. Following administration of 1.3 mg/m2 intravenous bortezomib doses, body surface area-normalized clearance in pediatric patients was similar to that observed in adult patients, thereby indicating that this dose achieves similar systemic exposures in pediatric patients.

Medienart:

E-Artikel

Erscheinungsjahr:

2017

Erschienen:

2017

Enthalten in:

Zur Gesamtaufnahme - volume:57

Enthalten in:

Journal of clinical pharmacology - 57(2017), 9 vom: 05. Sept., Seite 1183-1193

Sprache:

Englisch

Beteiligte Personen:

Hanley, Michael J [VerfasserIn]
Mould, Diane R [VerfasserIn]
Taylor, Timothy J [VerfasserIn]
Gupta, Neeraj [VerfasserIn]
Suryanarayan, Kaveri [VerfasserIn]
Neuwirth, Rachel [VerfasserIn]
Esseltine, Dixie-Lee [VerfasserIn]
Horton, Terzah M [VerfasserIn]
Aplenc, Richard [VerfasserIn]
Alonzo, Todd A [VerfasserIn]
Lu, Xiaomin [VerfasserIn]
Milton, Ashley [VerfasserIn]
Venkatakrishnan, Karthik [VerfasserIn]

Links:

Volltext

Themen:

69G8BD63PP
Antineoplastic Agents
Bortezomib
Clinical Trial, Phase II
Clinical Trial, Phase III
Journal Article
Leukemia
Multiple myeloma
Pediatric pharmacokinetics
Population pharmacokinetics
Proteasome inhibitor
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 15.05.2018

Date Revised 13.11.2018

published: Print-Electronic

ClinicalTrials.gov: NCT00873093, NCT01371981

Citation Status MEDLINE

doi:

10.1002/jcph.906

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM271063173