Application of Physiologically Based Pharmacokinetic Modeling to the Understanding of Bosutinib Pharmacokinetics: Prediction of Drug-Drug and Drug-Disease Interactions.
Bosutinib is an orally available Src/Abl tyrosine kinase inhibitor indicated for the treatment of patients with Philadelphia chromosome-positive chronic myelogenous leukemia. Bosutinib is predominantly metabolized by CYP3A4 as the primary clearance mechanism. The main objectives of this study were to 1) develop physiologically based pharmacokinetic (PBPK) models of bosutinib; 2) verify and refine the PBPK models based on clinical study results of bosutinib single-dose drug-drug interaction (DDI) with ketoconazole and rifampin, as well as single-dose drug-disease interaction (DDZI) in patients with renal and hepatic impairment; 3) apply the PBPK models to predict DDI outcomes in patients with weak and moderate CYP3A inhibitors; and 4) apply the PBPK models to predict DDZI outcomes in renally and hepatically impaired patients after multiple-dose administration. Results showed that the PBPK models adequately predicted bosutinib oral exposures in patients after single- and multiple-dose administrations. The PBPK models also reasonably predicted changes in bosutinib exposures in the single-dose DDI and DDZI results, suggesting that the PBPK models were sufficiently developed and verified based on the currently available data. Finally, the PBPK models predicted 2- to 4-fold increases in bosutinib exposures by moderate CYP3A inhibitors, as well as comparable increases in bosutinib exposures in renally and hepatically impaired patients between single- and multiple-dose administrations. Given the challenges in conducting numerous DDI and DDZI studies of anticancer drugs in patients, we believe that the PBPK models verified in our study would be valuable to reasonably predict bosutinib exposures under various scenarios that have not been tested clinically.
Clinical Pharmacology, Pfizer Japan Inc., Tokyo, Japan (C.O.); Clinical Pharmacology, Pfizer Inc., San Diego, California (P.-H.H.); Clinical Pharmacology, Pfizer Essential Health, Collegeville, Pennsylvania (R.A.); and Pharmacokinetics, Dynamics, and Metabolism, Pfizer Worldwide Research and Development, San Diego, California (C.-M.L., S.Y.).
Chiho
C
Ono
Clinical Pharmacology, Pfizer Japan Inc., Tokyo, Japan (C.O.); Clinical Pharmacology, Pfizer Inc., San Diego, California (P.-H.H.); Clinical Pharmacology, Pfizer Essential Health, Collegeville, Pennsylvania (R.A.); and Pharmacokinetics, Dynamics, and Metabolism, Pfizer Worldwide Research and Development, San Diego, California (C.-M.L., S.Y.).
Poe-Hirr
PH
Hsyu
Clinical Pharmacology, Pfizer Japan Inc., Tokyo, Japan (C.O.); Clinical Pharmacology, Pfizer Inc., San Diego, California (P.-H.H.); Clinical Pharmacology, Pfizer Essential Health, Collegeville, Pennsylvania (R.A.); and Pharmacokinetics, Dynamics, and Metabolism, Pfizer Worldwide Research and Development, San Diego, California (C.-M.L., S.Y.).
Richat
R
Abbas
Clinical Pharmacology, Pfizer Japan Inc., Tokyo, Japan (C.O.); Clinical Pharmacology, Pfizer Inc., San Diego, California (P.-H.H.); Clinical Pharmacology, Pfizer Essential Health, Collegeville, Pennsylvania (R.A.); and Pharmacokinetics, Dynamics, and Metabolism, Pfizer Worldwide Research and Development, San Diego, California (C.-M.L., S.Y.).
Cho-Ming
CM
Loi
Clinical Pharmacology, Pfizer Japan Inc., Tokyo, Japan (C.O.); Clinical Pharmacology, Pfizer Inc., San Diego, California (P.-H.H.); Clinical Pharmacology, Pfizer Essential Health, Collegeville, Pennsylvania (R.A.); and Pharmacokinetics, Dynamics, and Metabolism, Pfizer Worldwide Research and Development, San Diego, California (C.-M.L., S.Y.) shinji.yamazaki@pfizer.com.
Shinji
S
Yamazaki
D000284:Administration, Oral; D000814:Aniline Compounds / Q000008:administration & dosage / Q000493:pharmacokinetics*; D019540:Area Under Curve; D003198:Computer Simulation; D051544:Cytochrome P-450 CYP3A / Q000378:metabolism*; D065701:Cytochrome P-450 CYP3A Inducers / Q000493:pharmacokinetics; D065692:Cytochrome P-450 CYP3A Inhibitors / Q000493:pharmacokinetics; D004347:Drug Interactions; D006801:Humans; D007654:Ketoconazole / Q000493:pharmacokinetics; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy; D008954:Models, Biological; D009570:Nitriles / Q000008:administration & dosage / Q000493:pharmacokinetics*; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000493:pharmacokinetics*; D016315:Proto-Oncogene Proteins c-abl / Q000037:antagonists & inhibitors; D011804:Quinolines / Q000008:administration & dosage / Q000493:pharmacokinetics*; D012293:Rifampin / Q000493:pharmacokinetics; D016896:Treatment Outcome; D019061:src-Family Kinases / Q000037:antagonists & inhibitors
D000814:Aniline Compounds; D065701:Cytochrome P-450 CYP3A Inducers; D065692:Cytochrome P-450 CYP3A Inhibitors; D009570:Nitriles; D047428:Protein Kinase Inhibitors; D011804:Quinolines; C471992:bosutinib; D051544:Cytochrome P-450 CYP3A; D016315:Proto-Oncogene Proteins c-abl; D019061:src-Family Kinases; D007654:Ketoconazole; D012293:Rifampin