Population pharmacokinetic analysis of pexidartinib in healthy subjects and patients with tenosynovial giant cell tumor or other solid tumors Journal Article


Authors: Yin, O.; Wagner, A. J.; Kang, J.; Knebel, W.; Zahir, H.; van de Sande, M.; Tap, W. D.; Gelderblom, H.; Healey, J. H.; Shuster, D.; Stacchiotti, S.
Article Title: Population pharmacokinetic analysis of pexidartinib in healthy subjects and patients with tenosynovial giant cell tumor or other solid tumors
Abstract: Pexidartinib is a kinase inhibitor that induces tumor response and improvements in symptoms and functional outcomes in adult patients with symptomatic tenosynovial giant cell tumor (TGCT). A population pharmacokinetic (PK) model for pexidartinib and its metabolite, ZAAD, was developed, and effects of demographic and clinical factors on the PK of pexidartinib and ZAAD were estimated. The analysis included pooled data from 7 studies in healthy volunteers (N = 159) and 2 studies in patients with TGCT or other solid tumors (N = 216). A structural 2-compartment model with sequential zero- and first-order absorption and lag time, and linear elimination from the central compartment adequately described pexidartinib and ZAAD PKs. Clearance of pexidartinib was estimated at 5.83 L/h in a typical patient with reference covariates (male, non-Asian, weight = 80 kg, creatinine clearance ≥90 mL/min, aspartate aminotransferase ≤80 U/L, and total bilirubin ≤20.5 μmol/L). In the covariate analysis, Asians and healthy subjects had modestly lower pexidartinib exposure (21% decrease each) in terms of steady-state area under the curve values from 0 to 24 hours (AUC0-24,ss). Effects of body weight, sex, and hepatic function parameters on pexidartinib AUC0-24,ss were generally <20%. Patients with TGCT with mild renal impairment were predicted to have approximately 23% higher AUC0-24,ss than those with normal renal function. The effects of covariates on ZAAD exposure were similar to those on pexidartinib. These results indicate small and generally clinically nonmeaningful effects of patient demographic and clinical characteristics on pexidartinib and ZAAD PK profiles. © 2020 Daiichi Sankyo, Inc. The Journal of Clinical Pharmacology published by Wiley Periodicals LLC on behalf of American College of Clinical Pharmacology
Keywords: pharmacokinetics; population pharmacokinetics; pk; pexidartinib; tgct; zaad
Journal Title: Journal of Clinical Pharmacology
Volume: 61
Issue: 4
ISSN: 0091-2700
Publisher: Sage Publications  
Date Published: 2021-04-01
Start Page: 480
End Page: 492
Language: English
DOI: 10.1002/jcph.1753
PUBMED: 33043474
PROVIDER: scopus
PMCID: PMC7969430
DOI/URL:
Notes: Article -- Export Date: 1 April 2021 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. John H Healey
    550 Healey
  2. William Douglas Tap
    374 Tap