title: Single-dose clinical pharmacokinetic studies of gefitinib.
abstract: BACKGROUND
  The objective of the five clinical studies presented in this article was to investigate the single-dose pharmacokinetics of gefitinib (IRESSA, ZD1839), an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, in healthy volunteers and patients with advanced cancer.
  
  
  METHODS
  Studies 1 and 3-5 recruited healthy male volunteers aged 18-65 years; study 2 recruited male or female patients aged>or=18 years with any solid malignant tumour expressing EGFR and refractory to standard therapy. Gefitinib administration was as follows: study 1 (bioavailability in healthy volunteers; n=12)--intravenous infusion of 50 or 100 mg followed by a single oral dose of 250 mg; study 2 (bioavailability in cancer patients; n=19)--intravenous infusion of 50 mg followed by a single oral dose of 250 mg; study 3 (intrasubject variability; n=24)--two single oral doses of 250 mg; study 4 (dose-proportionality; n=15)--three single oral doses of 50-500 mg; study 5 (effect of food; n=26)--two single doses of 250 mg under either fed or fasted conditions. In all studies, venous blood samples for determination of gefitinib plasma concentrations were collected at predetermined intervals. Plasma concentrations of gefitinib were measured using liquid-liquid extraction after basification followed by high-performance liquid chromatography with tandem mass spectrometric detection. Appropriate pharmacokinetic parameters were determined by noncompartmental methods.
  
  
  RESULTS
  Study 1: Oral bioavailability of a gefitinib 250 mg dose was 57% in healthy volunteers. Absorption was moderately slow, with geometric mean (gmean) peak plasma concentration (Cmax) of 85 ng/mL (range 43.5-110 ng/mL) reached 5 hours following an oral dose of 250 mg. Study 2: Oral bioavailability of a gefitinib 250 mg dose was 59% in patients. Absorption was again moderately slow, with gmean Cmax of 159 ng/mL (range 48.7-324 ng/mL) typically reached 3 hours (range 1-8 hours) following an oral dose of 250 mg. Study 3: Area under the plasma concentration-time curve from time zero to infinity (AUCinfinity) and Cmax were variable--up to 15-fold between subjects and 2-fold within an individual. Study 4: AUCinfinity and Cmax increased with dose across the range of 50-500 mg, and increased dose-proportionally up to 250 mg. Study 5: Small, clinically insignificant increases in AUCinfinity and Cmax were seen in the presence of food (32% and 37%, respectively).
  
  
  CONCLUSIONS
  The gefitinib 250 mg tablet is orally bioavailable in both healthy volunteers and cancer patients; bioavailability is independent of dose and unaffected by food to any clinically significant extent. Gefitinib undergoes rapid plasma clearance and has an extensive volume of distribution, resulting in a pharmacokinetic profile supportive of a once-daily dosage regimen.
authors.affiliation: AstraZeneca Pharmaceuticals, Macclesfield, UK. helen.swaisland@astrazeneca.com
authors.forename: Helen C
authors.initials: HC
authors.lastname: Swaisland
authors.forename: Robert P
authors.initials: RP
authors.lastname: Smith
authors.forename: Alison
authors.initials: A
authors.lastname: Laight
authors.forename: David J
authors.initials: DJ
authors.lastname: Kerr
authors.forename: Malcolm
authors.initials: M
authors.lastname: Ranson
authors.forename: Clive H
authors.initials: CH
authors.lastname: Wilder-Smith
authors.forename: Thierry
authors.initials: T
authors.lastname: Duvauchelle
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics* / Q000627:therapeutic use; D019540:Area Under Curve; D001682:Biological Availability; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004815:Epidermal Growth Factor / Q000037:antagonists & inhibitors; D005215:Fasting / Q000378:metabolism; D005260:Female; D000077156:Gefitinib; D006801:Humans; D007275:Injections, Intravenous; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011799:Quinazolines / Q000008:administration & dosage* / Q000493:pharmacokinetics* / Q000627:therapeutic use; D013535:Suspensions; D013607:Tablets
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D013535:Suspensions; D013607:Tablets; D004815:Epidermal Growth Factor; D000077156:Gefitinib