title: Plasma and cerebrospinal fluid pharmacokinetics of thalidomide and lenalidomide in nonhuman primates.
abstract: OBJECTIVE
  Thalidomide, originally developed as a sedative, was subsequently identified to have antiangiogenic properties. Lenalidomide is an antiangiogenic and immunomodulatory agent that has been utilized in the treatment of patients with brain tumors. We studied the pharmacokinetics and cerebrospinal fluid (CSF) penetration of thalidomide and lenalidomide in a nonhuman primate model.
  
  
  METHODS
  A dose of 50 mg of thalidomide or 20 mg of lenalidomide was administered once orally to each of three rhesus monkeys. Plasma and CSF samples were obtained at specified intervals, and the thalidomide or lenalidomide concentrations were determined by high-performance liquid chromatography with tandem mass spectrometry. Pharmacokinetic parameters were estimated using noncompartmental methods. CSF penetration was calculated as area under the concentration-time curve (AUC) CSF/AUC plasma.
  
  
  RESULTS
  For thalidomide, the median apparent clearance (Cl/F) was 2.9 mL/min/kg, the median plasma AUC was 80 μM h, and the median terminal half-life (t(½)) was 13.3 h. For lenalidomide, the median Cl/F was 8.7 mL/min/kg, the median AUC was 9 μM h, and the median t(½) was 5.6 h. Thalidomide was detected in the CSF of all animals, with a median penetration of 42%. Lenalidomide was detected in the CSF of 2 of 3 animals, with a CSF penetration of 11% in each.
  
  
  CONCLUSIONS
  Thalidomide and lenalidomide penetrate into the CSF after oral administration of clinically relevant doses. Plasma exposure to lenalidomide was similar in our model to that observed in studies involving children who have brain tumors. These results support further development of lenalidomide for the treatment of central nervous system malignancies.
authors: Texas Children's Cancer Center, Baylor College of Medicine, 1102 Bates Street, Suite 1220, Houston, TX 77030, USA.
authors: Jodi A
authors: JA
authors: Muscal
authors: Yongkai
authors: Y
authors: Sun
authors: Jed G
authors: JG
authors: Nuchtern
authors: Robert C
authors: RC
authors: Dauser
authors: Leticia H
authors: LH
authors: McGuffey
authors: Brian W
authors: BW
authors: Gibson
authors: Stacey L
authors: SL
authors: Berg
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000097:blood / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics; D002851:Chromatography, High Pressure Liquid / Q000379:methods; D000077269:Lenalidomide; D008253:Macaca mulatta; D008297:Male; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000097:blood* / Q000134:cerebrospinal fluid* / Q000493:pharmacokinetics
chemical_list: D000970:Antineoplastic Agents; D013792:Thalidomide; D000077269:Lenalidomide