当前位置: X-MOL 学术Eur. J. Cancer › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Concomitant intake of abiraterone acetate and food to increase pharmacokinetic exposure: real life data from a therapeutic drug monitoring programme.
European Journal of Cancer ( IF 7.6 ) Pub Date : 2020-03-13 , DOI: 10.1016/j.ejca.2020.02.012
Stefanie L Groenland 1 , Merel van Nuland 2 , Andries M Bergman 3 , Jeantine M de Feijter 3 , Vincent O Dezentje 3 , Hilde Rosing 2 , Jos H Beijnen 4 , Alwin D R Huitema 5 , Neeltje Steeghs 1 ,
Affiliation  

AIM Abiraterone acetate is approved for the treatment of metastatic prostate cancer. At the currently used fixed dose of 1000 mg once daily in modified fasting state, 40% of patients do not reach the efficacy threshold of a minimum plasma concentration (Cmin) ≥ 8.4 ng/mL and are thereby at risk of decreased treatment efficacy. This study aims to evaluate whether pharmacokinetically (PK) guided abiraterone acetate dosing with a food intervention is feasible and results in an increased percentage of patients with concentrations above the target. METHODS Patients starting regular treatment with abiraterone acetate in modified fasting state were included. Pharmacokinetic analysis was performed 4, 8 and 12 weeks after start of treatment and every 12 weeks thereafter. In case of Cmin < 8.4 ng/mL and acceptable toxicity, a PK-guided intervention was recommended. The first step was concomitant intake of abiraterone acetate with a light meal or a snack. RESULTS In total, 32 evaluable patients were included, of which 20 patients (63%) had a Cmin < 8.4 ng/mL at a certain time point during treatment. These patients were recommended to take abiraterone acetate concomitantly with food, after which Cmin increased from 6.9 ng/mL to 27 ng/mL (p < 0.001) without additional toxicities. This intervention led to adequate exposure in 28 patients (87.5%). CONCLUSION Therapeutic drug monitoring of abiraterone was applied in clinical practice and proved to be feasible. Concomitant intake with food resulted in a significant increase in Cmin and offers a cost-neutral opportunity to optimise exposure in patients with low Cmin.

中文翻译:

同时摄入乙酸阿比特龙酯和食物以增加药代动力学暴露:来自治疗药物监测计划的真实生活数据。

AIM醋酸阿比特龙酯被批准用于治疗转移性前列腺癌。在目前以固定禁食状态每天服用1000毫克的固定剂量下,有40%的患者未达到最低血浆浓度(Cmin)≥8.4 ng / mL的功效阈值,因此有降低疗效的风险。这项研究旨在评估通过药代动力学(PK)引导的醋酸阿比特龙与食品干预一起给药是否可行,并导致浓度高于目标值的患者百分比增加。方法纳入开始以禁食状态改善的醋酸阿比特龙开始常规治疗的患者。在治疗开始后的第4、8和12周及其后每12周进行一次药代动力学分析。如果Cmin <8.4 ng / mL,且毒性可接受,建议采用PK引导的干预措施。第一步是与便餐或零食同时摄入乙酸阿比特龙酯。结果总共包括32位可评估患者,其中20位患者(63%)在治疗过程中的某个时间点Cmin <8.4 ng / mL。建议这些患者与食物同时服用乙酸阿比特龙,之后Cmin从6.9 ng / mL增加到27 ng / mL(p <0.001),而没有其他毒性。这项干预措施使28名患者获得了足够的暴露(87.5%)。结论阿比特龙的治疗性药物监测已在临床实践中被证明是可行的。随食物一起摄入会导致Cmin显着增加,并为中度Cmin低的患者提供了成本中立的机会,以优化暴露。第一步是与便餐或零食同时摄入乙酸阿比特龙酯。结果总共包括32位可评估患者,其中20位患者(63%)在治疗期间的某个时间点Cmin <8.4 ng / mL。建议这些患者与食物同时服用乙酸阿比特龙,之后Cmin从6.9 ng / mL增加到27 ng / mL(p <0.001),而没有其他毒性。这项干预措施使28名患者获得了足够的暴露(87.5%)。结论阿比特龙的治疗性药物监测已在临床实践中被证明是可行的。随食物一起摄入会导致Cmin显着增加,并提供成本中立的机会来优化Cmin低的患者的暴露。第一步是与便餐或零食同时摄入乙酸阿比特龙酯。结果总共包括32位可评估患者,其中20位患者(63%)在治疗过程中的某个时间点Cmin <8.4 ng / mL。建议这些患者与食物同时服用乙酸阿比特龙,之后Cmin从6.9 ng / mL增加到27 ng / mL(p <0.001),而没有其他毒性。这项干预措施使28名患者获得了足够的暴露(87.5%)。结论阿比特龙的治疗性药物监测已在临床实践中被证明是可行的。随食物一起摄入会导致Cmin显着增加,并为中度Cmin低的患者提供了成本中立的机会,以优化暴露。包括32位可评估患者,其中20位患者(63%)在治疗期间的某个时间点Cmin <8.4 ng / mL。建议这些患者与食物同时服用乙酸阿比特龙,之后Cmin从6.9 ng / mL增加到27 ng / mL(p <0.001),而没有其他毒性。这项干预措施使28名患者获得了足够的暴露(87.5%)。结论阿比特龙的治疗性药物监测已在临床实践中被证明是可行的。随食物一起摄入会导致Cmin显着增加,并为中度Cmin低的患者提供了成本中立的机会,以优化暴露。包括32位可评估患者,其中20位患者(63%)在治疗期间的某个时间点Cmin <8.4 ng / mL。建议这些患者与食物同时服用乙酸阿比特龙,之后Cmin从6.9 ng / mL增加到27 ng / mL(p <0.001),而没有其他毒性。这项干预措施使28名患者获得了足够的暴露(87.5%)。结论阿比特龙的治疗性药物监测已在临床实践中被证明是可行的。随食物一起摄入会导致Cmin显着增加,并为中度Cmin低的患者提供了成本中立的机会,以优化暴露。之后Cmin从6.9 ng / mL增加到27 ng / mL(p <0.001),且无其他毒性。这项干预措施使28名患者获得了足够的暴露(87.5%)。结论阿比特龙的治疗性药物监测已在临床实践中被证明是可行的。随食物一起摄入会导致Cmin显着增加,并为中度Cmin低的患者提供了成本中立的机会,以优化暴露。之后Cmin从6.9 ng / mL增加到27 ng / mL(p <0.001),且无其他毒性。这项干预措施使28名患者获得了足够的暴露(87.5%)。结论阿比特龙的治疗性药物监测已在临床实践中被证明是可行的。随食物一起摄入会导致Cmin显着增加,并为中度Cmin低的患者提供了成本中立的机会,以优化暴露。
更新日期:2020-03-16
down
wechat
bug