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1.
Clin Ther ; 42(7): 1317-1329, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32622784

RESUMEN

PURPOSE: Fixed-dose combination glecaprevir (GLE) 300 mg + pibrentasvir (PIB) 120 mg is an orally administered once daily antiviral regimen approved for the treatment of hepatitis C virus (HCV) infection. The objective of this study was to evaluate the potential for cardiac repolarization following GLE + PIB administration in healthy adults. METHODS: This placebo- and active-controlled, randomized, single-dose, 4-period, 4-sequence crossover study enrolled 48 healthy subjects. The doses of GLE 400 mg + PIB 120 mg were selected to provide exposures comparable to those with the doses that are therapeutic in the HCV-infected population, GLE 300 mg + PIB 120 mg. The doses of GLE 600 mg + PIB 240 mg were selected to provide supratherapeutic exposures without exceeding the exposures of the GLE + PIB maximal tolerated doses. Moxifloxacin 400 mg (active control/open label) was used for confirming the sensitivity of the ECG assay in detecting QTc prolongation. Time-matched plasma concentrations and triplicate ECGs were obtained on treatment days -1 and 1. The primary end point was time-matched, placebo-corrected, baseline-adjusted Fridericia-corrected QT interval (ΔΔQTcF). Pharmacokinetic-pharmacodynamic analyses characterized the relationship between GLE and PIB plasma concentrations and ΔΔQTcF using a linear regression model and linear mixed-effects model. Findings from categorical analyses of ECG-interval data were also summarized. Tolerability was evaluated through adverse-events monitoring, physical examination including vital sign measurements, ECGs, and laboratory tests. FINDINGS: A total of 48 subjects (22 women [46%], 26 men [54%]), were enrolled in the study, and 47 subjects completed all 4 periods. None of the subjects had a change from baseline in QTcF interval of >30 msec or an absolute QTcF interval of >450 msec. Peak ΔΔQTcF values observed at 5 h postdose (Tmax) were 2.9 msec (upper 95% confidence limit, 4.9 msec) with the therapeutic dose and 3.1 msec (upper 95% confidence limit, 5.1 msec) with the supratherapeutic dose, with both upper 95% confidence limits well below the 10-msec threshold. Assay sensitivity was confirmed by peak ΔΔQTcF in the positive control (12.8 ms at 2 h postdose). No statistically significant GLE or PIB concentration-dependent effects on ΔΔQTcF were observed. Headache and skin irritation from ECG electrodes were the most commonly reported AEs. No clinically significant vital sign measurements, ECG findings, or laboratory measurements were observed. There were no patterns of T- and U-wave morphologic abnormalities. IMPLICATIONS: The fixed-dose combination regimen of GLE/PIB does not prolong the QTc interval. ClinicalTrials.gov identifier.


Asunto(s)
Ácidos Aminoisobutíricos/administración & dosificación , Bencimidazoles/administración & dosificación , Ciclopropanos/administración & dosificación , Frecuencia Cardíaca/efectos de los fármacos , Corazón/efectos de los fármacos , Lactamas Macrocíclicas/administración & dosificación , Leucina/análogos & derivados , Prolina/análogos & derivados , Quinoxalinas/administración & dosificación , Sulfonamidas/administración & dosificación , Adulto , Ácidos Aminoisobutíricos/sangre , Ácidos Aminoisobutíricos/farmacocinética , Bencimidazoles/sangre , Bencimidazoles/farmacocinética , Estudios Cruzados , Ciclopropanos/sangre , Ciclopropanos/farmacocinética , Método Doble Ciego , Combinación de Medicamentos , Electrocardiografía/efectos de los fármacos , Femenino , Voluntarios Sanos , Corazón/fisiología , Humanos , Lactamas Macrocíclicas/sangre , Lactamas Macrocíclicas/farmacocinética , Leucina/administración & dosificación , Leucina/sangre , Leucina/farmacocinética , Síndrome de QT Prolongado , Masculino , Persona de Mediana Edad , Prolina/administración & dosificación , Prolina/sangre , Prolina/farmacocinética , Pirrolidinas , Quinoxalinas/sangre , Quinoxalinas/farmacocinética , Método Simple Ciego , Sulfonamidas/sangre , Sulfonamidas/farmacocinética , Adulto Joven
2.
J Clin Pharmacol ; 60(9): 1254-1267, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32441835

RESUMEN

While an initial clinical absorption, distribution, metabolism, and excretion (ADME) study (Study 1; N = 6) with 100 mg/100 µCi [14 C]lorlatinib, radiolabeled on the carbonyl carbon, confirmed that the primary metabolic pathways for lorlatinib are oxidation (N-demethylation, N-oxidation) and N-glucuronidation, it also revealed an unanticipated, intramolecular cleavage metabolic pathway of lorlatinib, yielding a major circulating benzoic acid metabolite (M8), and an unlabeled pyrido-pyrazole substructure. Concerns regarding the fate of unknown metabolites associated with this intramolecular cleavage pathway led to conduct of a second ADME study (Study 2; N = 6) of identical design but with the radiolabel positioned on the pyrazole ring. Results were similar with respect to the overall mass balance, lorlatinib plasma exposures, and metabolic profiles in excreta for the metabolites that retained the radiolabel in both studies. Differences were observed in plasma total radioactivity exposures (2-fold area under the plasma concentration-time curve from time 0 to infinity difference) and relative ratios of the percentage of dose recovered in urine vs feces (48% vs 41% in Study 1; 28% vs 64% in Study 2). In addition, an approximately 3-fold difference in the mean molar exposure ratio of M8 to lorlatinib was observed for values derived from metabolic profiling data relative to those derived from specific bioanalytical methods (0.5 vs 1.4 for Studies 1 and 2, respectively). These interstudy differences were attributed to a combination of factors, including alteration of radiolabel position, orthogonal analytical methodologies, and intersubject variability, and illustrate that results from clinical ADME studies are not unambiguous and should be interpreted within the context of the specific study design considerations.


Asunto(s)
Radioisótopos de Carbono/metabolismo , Radioisótopos de Carbono/farmacocinética , Lactamas Macrocíclicas/metabolismo , Lactamas Macrocíclicas/farmacocinética , Administración Oral , Adolescente , Adulto , Aminopiridinas , Biotransformación , Radioisótopos de Carbono/administración & dosificación , Radioisótopos de Carbono/química , Vías de Eliminación de Fármacos , Heces/química , Voluntarios Sanos , Humanos , Lactamas , Lactamas Macrocíclicas/administración & dosificación , Lactamas Macrocíclicas/química , Masculino , Persona de Mediana Edad , Modelos Biológicos , Pirazoles , Soluciones , Adulto Joven
3.
Cancer Med ; 9(12): 4350-4359, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-32347012

RESUMEN

OBJECTIVE: To clarify the distribution of lorlatinib in the brain and elucidate the molecular mechanisms of lorlatinib penetration across the blood-brain barrier (BBB). METHODS: Cytological experiments were performed to investigate the growth inhibitory effect of lorlatinib on different cells (endothelial cells HUVEC, HMEC-1, and HCMEC/D3) and to investigate the protective effect of lorlatinib on neuronal cells after SH-SY5Y hypoxia/reoxygenation injury. Furthermore, rat brain tissue was sequenced, and the differentially expressed genes (secreted phosphoprotein 1 (SPP1), vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF-ß), Claudin, ZO-1 and P-gp) in several different drug treatment groups were verified by Real-Time PCR. Lorlatinib brain distribution was predicted by physiologically based pharmacokinetics (PBPK). RESULTS: Lorlatinib and crizotinib both had inhibitory effects on endothelial cells, however lorlatinib inhibited the growth of HCMEC/D3 more efficaciously than crizotinib. In the SH-SY5Y hypoxia model, lorlatinib had a greater protective effect on nerve cell damage caused by hypoxia and reoxygenation than crizotinib. The expression of SPP1, VEGF, TGF-ß, and Claudin in brain tissue was significantly downregulated after lorlatinib administration, and the expression level of early growth transcription factor 1 (Egr-1) was significantly increased. The PBPK model successfully described lorlatinib concentrations in blood and brain tissue in the mouse model and gave a brain tissue partition coefficient of 0.7. CONCLUSION: Lorlatinib can increase the permeability of the blood-brain barrier whereby we suggest its underlying working mechanism is related to downregulating SPP1, inhibiting VEGF, TGF-ß, and Claudin subsequently reducing the number of tight junctions between BBB cells. Lorlatinib plays a protective role on injured nerve cells and does not change the amount of P-gp expression in brain tissue, which may be important for its ability to be efficacious across the BBB with a low incidence of resistance.


Asunto(s)
Barrera Hematoencefálica/metabolismo , Permeabilidad de la Membrana Celular/efectos de los fármacos , Hipoxia/complicaciones , Isquemia/tratamiento farmacológico , Lactamas Macrocíclicas/farmacología , Neuroblastoma/tratamiento farmacológico , Daño por Reperfusión/tratamiento farmacológico , Aminopiridinas , Animales , Transporte Biológico , Barrera Hematoencefálica/efectos de los fármacos , Humanos , Isquemia/etiología , Isquemia/metabolismo , Isquemia/patología , Lactamas , Lactamas Macrocíclicas/farmacocinética , Masculino , Neuroblastoma/metabolismo , Neuroblastoma/patología , Pirazoles , Ratas , Ratas Sprague-Dawley , Daño por Reperfusión/etiología , Daño por Reperfusión/metabolismo , Daño por Reperfusión/patología , Distribución Tisular , Células Tumorales Cultivadas
4.
J Clin Pharmacol ; 60(3): 331-339, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31515816

RESUMEN

Glecaprevir (GLE)/pibrentasvir (PIB) 300 mg/120 mg once daily (Mavyret/Maviret) is an all-oral, pangenotypic, interferon- and ribavirin-free combination regimen approved for the treatment of chronic hepatitis C virus (HCV) infection. The objective of the current analyses was to characterize the pharmacokinetics (PK) of GLE/PIB in HCV-infected Japanese patients. Data from 332 subjects enrolled in 2 Japan phase 3 trials, CERTAIN-1 and CERTAIN-2, were used in the analyses. Pharmacokinetics of GLE/PIB were characterized using a nonlinear mixed-effects modeling. The analyses evaluated the impact of covariates (concomitant medications and demographic and clinical covariates such as renal impairment, effect of cirrhotic status) on GLE/PIB PK. GLE and PIB PK were described by 1- and 2-compartment models, respectively. Presence of cirrhosis, age, and body weight were identified as significant covariates on GLE/PIB PK. A trend toward higher GLE and PIB exposures in older patients and higher PIB exposures in heavier patients was observed; however, these increases were not considered clinically meaningful. GLE and PIB exposures were higher in HCV-infected subjects with cirrhosis (Child-Pugh A; GLE area under the plasma concentration-time curve was 160% higher, and PIB area under the plasma concentration-time curve was 21% higher) compared to subjects without cirrhosis. Renal function (including subjects with end-stage renal disease with dialysis) had no impact on GLE or PIB exposures. The GLE/PIB dose was well tolerated in the Japanese population, and no dose adjustment is needed for the evaluated intrinsic and extrinsic factors.


Asunto(s)
Ácidos Aminoisobutíricos/farmacocinética , Antivirales/farmacocinética , Bencimidazoles/farmacocinética , Ciclopropanos/farmacocinética , Hepatitis C Crónica/tratamiento farmacológico , Lactamas Macrocíclicas/farmacocinética , Leucina/análogos & derivados , Prolina/análogos & derivados , Quinoxalinas/farmacocinética , Sulfonamidas/farmacocinética , Administración Oral , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Ácidos Aminoisobutíricos/administración & dosificación , Ácidos Aminoisobutíricos/efectos adversos , Antivirales/administración & dosificación , Antivirales/efectos adversos , Área Bajo la Curva , Bencimidazoles/administración & dosificación , Bencimidazoles/efectos adversos , Disponibilidad Biológica , Peso Corporal , Ciclopropanos/administración & dosificación , Ciclopropanos/efectos adversos , Esquema de Medicación , Combinación de Medicamentos , Femenino , Hepatitis C Crónica/sangre , Humanos , Japón , Lactamas Macrocíclicas/administración & dosificación , Lactamas Macrocíclicas/efectos adversos , Leucina/administración & dosificación , Leucina/efectos adversos , Leucina/farmacocinética , Cirrosis Hepática/genética , Cirrosis Hepática/metabolismo , Masculino , Persona de Mediana Edad , Modelos Biológicos , Prolina/administración & dosificación , Prolina/efectos adversos , Prolina/farmacocinética , Pirrolidinas , Quinoxalinas/administración & dosificación , Quinoxalinas/efectos adversos , Sulfonamidas/administración & dosificación , Sulfonamidas/efectos adversos , Adulto Joven
5.
Adv Healthc Mater ; 9(2): e1901307, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31814332

RESUMEN

A nanoplatform that integrates diagnostic and therapeutic functions with intrinsic tumor microenvironment-responsive biodegradability is highly desired. Herein, a biodegradable nanotheranostic agent based on hollow mesoporous organosilica nanoparticles (HMONs), followed by encapsulating of heat shock protein 90 (Hsp 90) inhibitor is described. Then, the pore-engineering including gating with bovine serum albumin-iridium oxide nanoparticles (BSA-IrO2 ) and conjugation of polyethylene glycol (PEG) is conducted to yield 17AAG@HMONs-BSA-IrO2 -PEG (AHBIP) nanotheranostics for multimode computed tomography (CT)/photoacoustic (PA) imaging-guided photodynamic therapy (PDT) and low-temperature photothermal therapy (PTT). Such nanoplatforms show extraordinary photothermal conversion efficiency, high cargo loading (35.4% for 17AAG), and stimuli-responsive release of 17AAG for inhibition of Hsp90, which induces cell apoptosis at low-temperatures (≈41 °C). Also, the IrO2 simultaneously endows the nanotheranostics with catalytic activity in triggering the decomposition of H2 O2 into O2 and thus reducing the tumor hypoxia, as well as protecting normal tissues against H2 O2 -induced inflammation. AHBIP shows good photocatalysis activity for PDT as a result of the generation of superoxide anion by laser irradiation. The resulting AHBIP-mediated synergistic PTT/PDT offers an outstanding therapeutic outcome both in vitro and in vivo. Overall, the incorporation of the BSA-IrO2 and biodegradable HMONs into one nanoplatform has great potential for clinical applications.


Asunto(s)
Antiinflamatorios no Esteroideos/farmacología , Benzoquinonas/administración & dosificación , Sistemas de Liberación de Medicamentos/métodos , Lactamas Macrocíclicas/administración & dosificación , Nanopartículas/química , Nanomedicina Teranóstica/métodos , Animales , Antiinflamatorios no Esteroideos/química , Benzoquinonas/farmacocinética , Materiales Biocompatibles/química , Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Línea Celular , Femenino , Proteínas HSP90 de Choque Térmico/antagonistas & inhibidores , Humanos , Peróxido de Hidrógeno/química , Iridio/química , Lactamas Macrocíclicas/farmacocinética , Ratones Endogámicos C57BL , Ratones Desnudos , Oxígeno/farmacocinética , Técnicas Fotoacústicas , Fotoquimioterapia/métodos , Polietilenglicoles/química , Albúmina Sérica Bovina/química , Superóxidos/metabolismo , Nanomedicina Teranóstica/instrumentación , Tomografía Computarizada por Rayos X , Microambiente Tumoral , Ensayos Antitumor por Modelo de Xenoinjerto
6.
Adv Ther ; 37(2): 745-758, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31863284

RESUMEN

INTRODUCTION: Lorlatinib is a third-generation tyrosine kinase inhibitor approved for the treatment of anaplastic lymphoma kinase (ALK)-positive metastatic non-small cell lung cancer; cytochrome P450 (CYP) 3A plays an important role in the metabolism of lorlatinib. METHODS: This phase 1, open-label, two-period, crossover study estimated the effect of oral rifampin (a strong CYP3A inducer) on the pharmacokinetics and safety of oral lorlatinib (NCT02804399). Healthy participants received single-dose lorlatinib 100 mg in period 1 followed by rifampin 600 mg/day (days 1-12) and single-dose lorlatinib 100 mg (day 8) in period 2. Blood samples were collected for 120 h after each dose of lorlatinib. RESULTS: When a single dose of lorlatinib was administered during daily dosing with rifampin (period 2), the area under the plasma concentration-time profile extrapolated to infinity (AUCinf) and maximum plasma concentration (Cmax) of lorlatinib were 14.74% [90% confidence interval (CI) 12.78%, 17.01%] and 23.88% (90% CI 21.58%, 26.43%), respectively, of those in period 1 (lorlatinib alone). A single dose of lorlatinib was well tolerated in period 1, but elevations in transaminase values were observed in all participants (grade 2-4 in 11 participants) within 1-3 days after a single dose of lorlatinib was administered with ongoing rifampin in period 2. Rifampin dosing was therefore halted. Transaminase levels subsequently returned to normal (median time to recovery: 15 days). No elevations in bilirubin were observed. CONCLUSIONS: The addition of a single dose of lorlatinib to daily dosing with rifampin significantly reduced lorlatinib plasma exposure relative to a single dose of lorlatinib administered alone and was associated with severe but self-limiting transaminase elevations in all healthy participants. These observations support the contraindication in the product label against concomitant use of lorlatinib with all strong CYP3A inducers. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT02804399.


Asunto(s)
Antineoplásicos/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Lactamas Macrocíclicas/farmacocinética , Lactamas Macrocíclicas/uso terapéutico , Neoplasias Pulmonares/tratamiento farmacológico , Rifampin/farmacocinética , Rifampin/uso terapéutico , Adulto , Aminopiridinas , Área Bajo la Curva , Estudios Cruzados , Interacciones Farmacológicas , Femenino , Voluntarios Sanos , Humanos , Lactamas , Masculino , Persona de Mediana Edad , Pirazoles , Adulto Joven
7.
Invest New Drugs ; 38(1): 131-139, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31728714

RESUMEN

Background The third-generation tyrosine kinase inhibitor lorlatinib is approved for the treatment of ALK-positive metastatic NSCLC. CYP3A plays a major role in lorlatinib metabolism; therefore, a drug-drug interaction study was warranted to evaluate the impact of the strong CYP3A inhibitor, itraconazole, on lorlatinib plasma exposure. Methods This phase 1, open-label, 2-period, crossover study estimated the effects of itraconazole on the plasma pharmacokinetics and safety of lorlatinib in healthy participants (NCT02838264). Single-dose lorlatinib 50 mg (n = 2), 75 mg (n = 2) and 100 mg (n = 12) was administered in Period 1. In Period 2, itraconazole oral solution 200 mg/day was administered on Days 1-11, and single-dose lorlatinib on Day 5. Blood samples were collected up to 168 h after lorlatinib dosing. Results During daily dosing with itraconazole (Period 2), the ratios of the adjusted geometric means for area under the plasma concentration-time profile extrapolated to infinity (AUCinf) and maximum plasma concentration (Cmax) of single-dose lorlatinib 100 mg were 141.79% (90% confidence interval, 128.71%, 156.21%) and 124.39% (110.20%, 140.41%), respectively, compared with Period 1 (lorlatinib alone). Lorlatinib was well tolerated alone and with itraconazole. No serious adverse events or withdrawals were reported. Conclusions Co-administration of itraconazole and lorlatinib increased the plasma exposure of lorlatinib relative to lorlatinib alone in healthy participants. Therefore, concomitant use of lorlatinib with strong CYP3A inhibitors should be avoided. If this combination is unavoidable, the starting dose of lorlatinib should be reduced from 100 mg to 75 mg.


Asunto(s)
Itraconazol/farmacología , Lactamas Macrocíclicas/farmacocinética , Adulto , Aminopiridinas , Antifúngicos/farmacología , Área Bajo la Curva , Estudios Cruzados , Interacciones Farmacológicas , Femenino , Voluntarios Sanos , Humanos , Lactamas , Lactamas Macrocíclicas/farmacología , Masculino , Pirazoles , Distribución Tisular
8.
Clin Pharmacol Ther ; 107(6): 1325-1333, 2020 06.
Artículo en Inglés | MEDLINE | ID: mdl-31868916

RESUMEN

Fine-needle aspiration (FNA) for serial hepatic sampling may be an efficient and less invasive alternative to core needle biopsy (CNB), the current standard for liver tissue sampling. In this randomized, open-label trial in 31 participants with hepatitis C virus genotype 1 infection (NCT01678131/Merck protocol PN048), we evaluated the feasibility of using FNA to obtain human liver tissue samples appropriate for measuring hepatic pharmacokinetics (PK), using vaniprevir as a tool compound. The primary end point was successful retrieval of liver tissue specimens with measurable vaniprevir concentrations at two of three specified FNA time points. Twenty-nine patients met the primary end point and, therefore, were included in the PK analyses. Hepatic vaniprevir concentrations obtained with FNA were consistent with known vaniprevir PK properties. The shape of liver FNA and CNB concentration-time profiles were comparable. In conclusion, FNA may be effective for serial tissue sampling to assess hepatic drug exposure in patients with liver disease.


Asunto(s)
Antivirales/farmacocinética , Biopsia con Aguja Fina/métodos , Ciclopropanos/farmacocinética , Hepatitis C Crónica/tratamiento farmacológico , Isoindoles/farmacocinética , Lactamas Macrocíclicas/farmacocinética , Leucina/análogos & derivados , Hígado/metabolismo , Prolina/análogos & derivados , Sulfonamidas/farmacocinética , Adulto , Antivirales/administración & dosificación , Ciclopropanos/administración & dosificación , Femenino , Genotipo , Hepacivirus/genética , Hepacivirus/aislamiento & purificación , Hepatitis C Crónica/virología , Humanos , Isoindoles/administración & dosificación , Lactamas Macrocíclicas/administración & dosificación , Leucina/administración & dosificación , Leucina/farmacocinética , Hígado/virología , Masculino , Persona de Mediana Edad , Prolina/administración & dosificación , Prolina/farmacocinética , Sulfonamidas/administración & dosificación , Distribución Tisular , Adulto Joven
9.
Biol Pharm Bull ; 43(3): 384-392, 2020 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-31685755

RESUMEN

Transporter gene knockout models are a practical and widely used tool for pharmacokinetic studies in drug discovery. P-glycoprotein (P-gp) and breast cancer resistance protein (Bcrp) are major efflux transporters that control absorption and bioavailability, and are important when determining oral drug disposition. To the best of our knowledge, beyond the rule of five (bRo5) molecules launched on the market to date tend to be substrates for efflux transporters. The purpose of this study is to evaluate in vivo the impact of efflux transporters on the oral absorption process and systemic clearance using rats which lack P-gp and/or Bcrp expression. We administered five bRo5 substrates (asunaprevir, cyclosporine, danoprevir, ledipasvir, and simeprevir) intravenously or orally to wild-type and Mdr1a, Bcrp, and Mdr1a/Bcrp knockout rats, calculated the clearance, oral bioavailability, and absorption rate profile of each substrate, and compared the results. Systemic clearance of the substrates in knockout rats changed within approximately ±40% compared to wild-types, suggesting the efflux transporters do not have a significant influence on clearance in rats. On the other hand, the oral absorption of substrates in the knockout rats, especially those lacking Mdr1a, increased greatly-between 2- and 5-fold more than in wild-types. This suggests that rat efflux transporters, especially P-gp, greatly reduce the oral exposure of these substrates. Moreover, results on the absorption rate-time profile suggest that efflux transporters are constantly active during the absorption period in rats. Transporter knockout rats are a useful in vivo tool for estimating the transporter-mediated disposition of bRo5 molecules in drug discovery.


Asunto(s)
Transportadoras de Casetes de Unión a ATP/deficiencia , Bencimidazoles/farmacocinética , Ciclopropanos/farmacocinética , Ciclosporina/farmacocinética , Fluorenos/farmacocinética , Isoindoles/farmacocinética , Isoquinolinas/farmacocinética , Lactamas Macrocíclicas/farmacocinética , Prolina/análogos & derivados , Simeprevir/farmacocinética , Sulfonamidas/farmacocinética , Subfamilia B de Transportador de Casetes de Unión a ATP/genética , Transportador de Casetes de Unión a ATP, Subfamilia G, Miembro 2 , Transportadoras de Casetes de Unión a ATP/genética , Administración Oral , Animales , Bencimidazoles/administración & dosificación , Bencimidazoles/sangre , Disponibilidad Biológica , Ciclopropanos/administración & dosificación , Ciclopropanos/sangre , Ciclosporina/administración & dosificación , Ciclosporina/sangre , Fluorenos/administración & dosificación , Fluorenos/sangre , Técnicas de Inactivación de Genes , Isoindoles/administración & dosificación , Isoindoles/sangre , Isoquinolinas/administración & dosificación , Isoquinolinas/sangre , Lactamas Macrocíclicas/administración & dosificación , Lactamas Macrocíclicas/sangre , Masculino , Tasa de Depuración Metabólica/genética , Absorción por la Mucosa Oral/genética , Prolina/administración & dosificación , Prolina/sangre , Prolina/farmacocinética , Ratas , Ratas Sprague-Dawley , Simeprevir/administración & dosificación , Simeprevir/sangre , Sulfonamidas/administración & dosificación , Sulfonamidas/sangre
10.
Drugs ; 79(1): 93-98, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30604291

RESUMEN

Lorlatinib is an oral small molecule inhibitor of anaplastic lymphoma kinase (ALK) and C-ros oncogene 1 (ROS1) kinase developed by Pfizer for the treatment of ALK-positive non-small cell lung cancer (NSCLC). Based on results from a phase I/II trial, lorlatinib received approval in Japan in September 2018 and in the USA in November 2018 for the treatment of ALK-positive NSCLC. This article summarizes the milestones in the development of lorlatinib leading to the first global approval for this indication.


Asunto(s)
Quinasa de Linfoma Anaplásico/antagonistas & inhibidores , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Lactamas Macrocíclicas , Inhibidores de Proteínas Quinasas , Proteínas Tirosina Quinasas/antagonistas & inhibidores , Proteínas Proto-Oncogénicas/antagonistas & inhibidores , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Aminopiridinas , Niño , Aprobación de Drogas , Humanos , Japón , Lactamas , Lactamas Macrocíclicas/administración & dosificación , Lactamas Macrocíclicas/efectos adversos , Lactamas Macrocíclicas/farmacocinética , Persona de Mediana Edad , Inhibidores de Proteínas Quinasas/administración & dosificación , Inhibidores de Proteínas Quinasas/efectos adversos , Inhibidores de Proteínas Quinasas/farmacocinética , Pirazoles , Estados Unidos , United States Food and Drug Administration
11.
J Med Chem ; 61(19): 8774-8796, 2018 10 11.
Artículo en Inglés | MEDLINE | ID: mdl-30180567

RESUMEN

Bifunctional derivatives of bis(phosphinate)-bearing cyclam (BPC) chelators bearing a carboxylate, amine, isothiocyanate, azide, or cyclooctyne in the BP side chain were synthesized. Conjugations required no protection of phosphinate or ring secondary amine groups. The ring amines were not reactive (proton protected) at pH < ∼8. For isothiocyanate coupling, oligopeptide N-terminal α-amines were more suitable than alkyl amines, e.g., Lys ω-amine (p Ka ∼7.5-8.5 and ∼10-11, respectively) due to lower basicity. The Cu-64 labeling was efficient at room temperature (specific activity ∼100 GBq/µmol; 25 °C, pH 6.2, ∼100 ligand equiv, 10 min). A representative Cu-64-BPC was tested in vivo showing fast clearance and no nonspecific radioactivity deposition. The monoclonal anti-PSCA antibody 7F5 conjugates with thiocyanate BPC derivative or NODAGA were radiolabeled and studied in PC3-PSCA tumor bearing mice by PET. The radiolabeled BPC conjugate was accumulated in the prostate tumor with a low off-target uptake, unlike Cu-64-labeled NODAGA-antibody conjugate. The BPC chelators have a great potential for theranostic applications of the Cu-64/Cu-67 matched pair.


Asunto(s)
Anticuerpos Monoclonales/química , Quelantes/química , Radioisótopos de Cobre/química , Inmunoconjugados/química , Lactamas Macrocíclicas/química , Ácidos Fosfínicos/química , Radiofármacos/química , Animales , Anticuerpos Monoclonales/farmacocinética , Quelantes/farmacocinética , Radioisótopos de Cobre/farmacocinética , Estabilidad de Medicamentos , Inmunoconjugados/farmacocinética , Marcaje Isotópico , Lactamas Macrocíclicas/farmacocinética , Ligandos , Masculino , Ratones , Tomografía de Emisión de Positrones , Neoplasias de la Próstata/diagnóstico , Neoplasias de la Próstata/diagnóstico por imagen , Neoplasias de la Próstata/metabolismo , Radiofármacos/farmacocinética , Ratas Desnudas , Ratas Wistar , Distribución Tisular , Células Tumorales Cultivadas , Ensayos Antitumor por Modelo de Xenoinjerto
12.
J Pharm Biomed Anal ; 161: 136-143, 2018 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-30149189

RESUMEN

Several second and third generation ALK inhibitors have been introduced in recent years. A bioanalytical assay for simultaneous quantification of alectinib, brigatinib, and lorlatinib was developed and validated for human plasma. The method was also partially validated for diluted mouse plasma and tissue homogenates of brain, liver, kidney, and spleen. Samples (40 µl) were pretreated in a 96-well plate by protein precipitation with acetonitrile containing the internal standard [2H8]-alectinib. After chromatographic separation on an ethylene bridged octadecyl silica column by gradient elution at 600 µl/min using 1% (v/v) formic acid (in water) and acetonitrile, compounds were ionized by a turbo electrospray and monitored by selected reaction monitoring on a triple quadrupole mass spectrometer. Validation was performed in a 2-2000 ng/ml concentration range for alectinib and lorlatinib and a 4-4000 ng/ml range for brigatinib. Precisions (within-day and between-day) were in the range 2.2-15.0% and accuracies were in between 87.2 and 110.2% for all matrices and levels. Compounds were sufficiently stable under most investigated conditions. Results of a pilot pharmacokinetic and tissue distribution study for brigatinib in mice are reported. Finally, successful incurred samples reanalysis of tissue homogenate samples containing brigatinib and lorlatinib is presented. Lorlatinib homogenate samples were also successfully reanalyzed using a second independent assay (cross-validation).


Asunto(s)
Carbazoles/sangre , Carbazoles/farmacocinética , Cromatografía Liquida/métodos , Lactamas Macrocíclicas/sangre , Lactamas Macrocíclicas/farmacocinética , Compuestos Organofosforados/sangre , Compuestos Organofosforados/farmacocinética , Piperidinas/sangre , Piperidinas/farmacocinética , Pirimidinas/sangre , Pirimidinas/farmacocinética , Espectrometría de Masas en Tándem/métodos , Aminopiridinas , Animales , Estabilidad de Medicamentos , Humanos , Lactamas , Masculino , Ratones , Inhibidores de Proteínas Quinasas/farmacocinética , Pirazoles , Distribución Tisular
13.
Artículo en Inglés | MEDLINE | ID: mdl-29866861

RESUMEN

Hsp90 inhibitors, well studied in the laboratory and clinic for antitumor indications, have promising activity against protozoan pathogens, including Trypanosoma brucei which causes African sleeping sickness, and the malaria parasite, Plasmodium falciparum To progress these experimental drugs toward clinical use, we adapted an in vitro dynamic hollow-fiber system and deployed artificial pharmacokinetics to discover the driver of their activity: either concentration or time. The activities of compounds from three major classes of Hsp90 inhibitors in development were evaluated against trypanosomes. In all circumstances, the activities of the tested Hsp90 inhibitors were concentration driven. By optimally deploying the drug to match its kinetic driver, the efficacy of a given dose was improved up to 5-fold, and maximal efficacy was achieved with a significantly lower drug exposure. The superiority of concentration-driven regimens was evident in vitro over several logs of drug exposure and was predictive of efficacy in a mouse model of African trypanosomiasis. In studies with P. falciparum, antimalarial activity was similarly concentration driven. This experimental strategy offers an expedient and versatile translational tool to assess the impact of pharmacokinetics on antiprotozoal activity. Knowing kinetic governance early in drug development provides an additional metric for judging lead compounds and allows the incisive design of animal efficacy studies.


Asunto(s)
Antiprotozoarios/farmacocinética , Proteínas HSP90 de Choque Térmico/antagonistas & inhibidores , Malaria Falciparum/tratamiento farmacológico , Plasmodium falciparum/efectos de los fármacos , Proteínas Protozoarias/antagonistas & inhibidores , Trypanosoma brucei brucei/efectos de los fármacos , Tripanosomiasis Africana/tratamiento farmacológico , Animales , Antineoplásicos/sangre , Antineoplásicos/farmacocinética , Antineoplásicos/farmacología , Antiprotozoarios/sangre , Antiprotozoarios/farmacología , Área Bajo la Curva , Benzodioxoles/sangre , Benzodioxoles/farmacocinética , Benzodioxoles/farmacología , Benzoquinonas/sangre , Benzoquinonas/farmacocinética , Benzoquinonas/farmacología , Bioensayo , Modelos Animales de Enfermedad , Reposicionamiento de Medicamentos , Femenino , Expresión Génica , Proteínas HSP90 de Choque Térmico/genética , Proteínas HSP90 de Choque Térmico/metabolismo , Imidazoles/sangre , Imidazoles/farmacocinética , Imidazoles/farmacología , Isoxazoles/sangre , Isoxazoles/farmacocinética , Isoxazoles/farmacología , Lactamas Macrocíclicas/sangre , Lactamas Macrocíclicas/farmacocinética , Lactamas Macrocíclicas/farmacología , Malaria Falciparum/parasitología , Ratones , Modelos Biológicos , Plasmodium falciparum/crecimiento & desarrollo , Proteínas Protozoarias/genética , Proteínas Protozoarias/metabolismo , Resorcinoles/sangre , Resorcinoles/farmacocinética , Resorcinoles/farmacología , Trypanosoma brucei brucei/crecimiento & desarrollo , Tripanosomiasis Africana/parasitología
14.
Anticancer Drugs ; 29(8): 774-785, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29878901

RESUMEN

Triple-negative breast cancer (TNBC) is typically aggressive, difficult to treat, and commonly metastasizes to the visceral organs and soft tissues, including the lungs and the brain. Taxanes represent the most effective and widely used therapeutic class in metastatic TNBC but possess limiting adverse effects that often result in a delay, reduction, or cessation of their use. DZ-2384 is a candidate microtubule-targeting agent with a distinct mechanism of action and strong activity in several preclinical cancer models, with reduced toxicities. DZ-2384 is highly effective in patient-derived taxane-sensitive and taxane-resistant xenograft models of TNBC at lower doses and over a wider range relative to paclitaxel. When comparing compound exposure at minimum effective doses relative to safe exposure levels, the therapeutic window for DZ-2384 is 14-32 compared with 2.0 and less than 2.8 for paclitaxel and docetaxel, respectively. DZ-2384 is effective at reducing brain metastatic lesions when used at maximum tolerated doses and is equivalent to paclitaxel. Drug distribution experiments indicate that DZ-2384 is taken up more efficiently by tumor tissue but at equivalent levels in the brain compared with paclitaxel. Selective DZ-2384 uptake by tumor tissue may in part account for its wider therapeutic window compared with taxanes. In view of the current clinical efforts to combine chemotherapy with immune checkpoint inhibitors, we demonstrate that DZ-2384 acts synergistically with anti-CTLA-4 immunotherapy in a syngeneic murine model. These results demonstrate that DZ-2384 has a superior pharmacologic profile over currently used taxanes and is a promising therapeutic agent for the treatment of metastatic TNBC.


Asunto(s)
Antineoplásicos Inmunológicos/farmacología , Protocolos de Quimioterapia Combinada Antineoplásica/farmacología , Antígeno CTLA-4/antagonistas & inhibidores , Lactamas Macrocíclicas/farmacología , Oxazoles/farmacología , Neoplasias de la Mama Triple Negativas/tratamiento farmacológico , Animales , Antineoplásicos Inmunológicos/administración & dosificación , Encéfalo/metabolismo , Antígeno CTLA-4/inmunología , Línea Celular Tumoral , Sinergismo Farmacológico , Femenino , Humanos , Lactamas Macrocíclicas/administración & dosificación , Lactamas Macrocíclicas/farmacocinética , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos NOD , Ratones SCID , Metástasis de la Neoplasia , Oxazoles/administración & dosificación , Oxazoles/farmacocinética , Distribución Aleatoria , Neoplasias de la Mama Triple Negativas/inmunología , Neoplasias de la Mama Triple Negativas/metabolismo , Neoplasias de la Mama Triple Negativas/patología , Ensayos Antitumor por Modelo de Xenoinjerto
15.
J Med Chem ; 61(8): 3350-3369, 2018 04 26.
Artículo en Inglés | MEDLINE | ID: mdl-29590750

RESUMEN

Rhodesain (RD) is a parasitic, human cathepsin L (hCatL) like cysteine protease produced by Trypanosoma brucei ( T. b.) species and a potential drug target for the treatment of human African trypanosomiasis (HAT). A library of hCatL inhibitors was screened, and macrocyclic lactams were identified as potent RD inhibitors ( Ki < 10 nM), preventing the cell-growth of Trypanosoma brucei rhodesiense (IC50 < 400 nM). SARs addressing the S2 and S3 pockets of RD were established. Three cocrystal structures with RD revealed a noncovalent binding mode of this ligand class due to oxidation of the catalytic Cys25 to a sulfenic acid (Cys-SOH) during crystallization. The P-glycoprotein efflux ratio was measured and the in vivo brain penetration in rats determined. When tested in vivo in acute HAT model, the compounds permitted up to 16.25 (vs 13.0 for untreated controls) mean days of survival.


Asunto(s)
Catepsina L/antagonistas & inhibidores , Cisteína Endopeptidasas/metabolismo , Inhibidores de Cisteína Proteinasa/farmacología , Lactamas Macrocíclicas/farmacología , Tripanocidas/farmacología , Trypanosoma brucei rhodesiense/efectos de los fármacos , Animales , Sitios de Unión , Barrera Hematoencefálica/metabolismo , Línea Celular , Cisteína Endopeptidasas/química , Inhibidores de Cisteína Proteinasa/síntesis química , Inhibidores de Cisteína Proteinasa/química , Inhibidores de Cisteína Proteinasa/farmacocinética , Reposicionamiento de Medicamentos , Humanos , Lactamas Macrocíclicas/síntesis química , Lactamas Macrocíclicas/química , Lactamas Macrocíclicas/farmacocinética , Ligandos , Masculino , Ratones Endogámicos C57BL , Estructura Molecular , Ratas , Relación Estructura-Actividad , Porcinos , Tripanocidas/síntesis química , Tripanocidas/química , Tripanocidas/farmacocinética
16.
Nat Commun ; 8: 15761, 2017 06 08.
Artículo en Inglés | MEDLINE | ID: mdl-28594000

RESUMEN

Lorlatinib (PF-06463922) is a next-generation small-molecule inhibitor of the orphan receptor tyrosine kinase c-ros oncogene 1 (ROS1), which has a kinase domain that is physiologically related to anaplastic lymphoma kinase (ALK), and is undergoing Phase I/II clinical trial investigations for non-small cell lung cancers. An early goal is to measure the concentrations of this drug in brain tumour lesions of lung cancer patients, as penetration of the blood-brain barrier is important for optimal therapeutic outcomes. Here we prepare both 11C- and 18F-isotopologues of lorlatinib to determine the biodistribution and whole-body dosimetry assessments by positron emission tomography (PET). Non-traditional radiolabelling strategies are employed to enable an automated multistep 11C-labelling process and an iodonium ylide-based radiofluorination. Carbon-11-labelled lorlatinib is routinely prepared with good radiochemical yields and shows reasonable tumour uptake in rodents. PET imaging in non-human primates confirms that this radiotracer has high brain permeability.


Asunto(s)
Radioisótopos de Carbono/farmacocinética , Radioisótopos de Flúor/farmacología , Lactamas Macrocíclicas/química , Lactamas Macrocíclicas/farmacología , Tomografía de Emisión de Positrones/métodos , Aminopiridinas , Quinasa de Linfoma Anaplásico/antagonistas & inhibidores , Animales , Radioisótopos de Carbono/química , Técnicas de Química Sintética , Medios de Contraste/síntesis química , Medios de Contraste/farmacocinética , Radioisótopos de Flúor/química , Humanos , Marcaje Isotópico/métodos , Lactamas , Lactamas Macrocíclicas/farmacocinética , Macaca mulatta , Masculino , Ratones , Proteínas Tirosina Quinasas/antagonistas & inhibidores , Proteínas Proto-Oncogénicas/antagonistas & inhibidores , Pirazoles , Distribución Tisular , Ensayos Antitumor por Modelo de Xenoinjerto
17.
Colloids Surf B Biointerfaces ; 155: 83-92, 2017 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-28410515

RESUMEN

When exposed to cancer cells, cytotoxic drugs such as doxorubicin (DOX) can lead to the induction of heat shock protein 90 (Hsp90), a molecular chaperone associated with a number of cancer-related client proteins, and result in cell survival. Co-administration of DOX with tanespimycin (TNP), an Hsp90 inhibitor, can sensitize the cancer cells to the cytotoxic effects of DOX. The effect of such a combination has been found to depend on the schedule of administration. Sequential administration of DOX and TNP has been linked to highly synergistic combination effects. Therefore, we aimed to develop folate-receptor targeted hybrid lipid-core nanocapsules comprising a hybrid lipid core lodging TNP and a polymeric corona lodging DOX (F-DTN). These nanocarriers were capable of delivering DOX and TNP sequentially, which was well demonstrated by an in vitro release study. The in vitro release profiles displayed pH-dependent and sustained release features. F-DTN exhibited excellent morphological characteristics with highly monodispersed particles. In vitro tests with F-DTN in MCF-7 cell line demonstrated exceptional cytotoxicity, with high cellular uptake and apoptosis. These findings were appreciably more assertive than tests with free individual drugs (DOX, TNP), free drug combination (DOX/TNP), or non-folate receptor-targeted hybrid lipid-core nanocapsules (DTN). In vivo pharmacokinetic study revealed noticeable enhancement of bioavailability and plasma circulation time of the drugs when encapsulated in the carrier system. Therefore, hybrid lipid-core nanocapsules have the potential to be utilized for application in folate receptor-targeted combination chemotherapy.


Asunto(s)
Antineoplásicos/farmacología , Benzoquinonas/farmacología , Doxorrubicina/farmacología , Sistemas de Liberación de Medicamentos/métodos , Receptor 1 de Folato/metabolismo , Lactamas Macrocíclicas/farmacología , Nanocápsulas/química , Proteínas de Neoplasias/metabolismo , Células A549 , Animales , Antineoplásicos/química , Antineoplásicos/farmacocinética , Apoptosis/efectos de los fármacos , Benzoquinonas/química , Benzoquinonas/farmacocinética , Biomarcadores/metabolismo , Dimetilsulfóxido/química , Doxorrubicina/química , Doxorrubicina/farmacocinética , Ácidos Grasos Monoinsaturados/química , Receptor 1 de Folato/genética , Ácido Fólico/química , Ácido Fólico/metabolismo , Expresión Génica , Humanos , Inyecciones Intravenosas , Lactamas Macrocíclicas/química , Lactamas Macrocíclicas/farmacocinética , Células MCF-7 , Masculino , Micelas , Nanocápsulas/administración & dosificación , Nanocápsulas/ultraestructura , Proteínas de Neoplasias/genética , Fosfatidiletanolaminas/química , Compuestos de Amonio Cuaternario/química , Ratas , Ratas Sprague-Dawley
19.
Drug Dev Ind Pharm ; 42(1): 91-98, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25853294

RESUMEN

In this study, the PEGylated nanostructured lipid carriers (PEG-NLC) were constructed for the intravenous delivery of 17-allylamino-17-demethoxygeldanamycin (17AAG). 17AAG-PEG-NLC was successfully prepared by the method of emulsion evaporation at a high temperature and solidification at a low temperature using a mixture of glycerol monostearate and PEG2000-stearate as solid lipids, and medium-chain triglyceride as the liquid lipid. The results revealed that the morphology of the NLC was spheroidal. The particle size, zeta potential and entrapment efficiency for 17AAG-PEG-NLC were observed as 189.4 nm, -20.2 mV and 83.42%, respectively. X-ray diffraction analysis revealed that 17AAG existed as amorphous structures in the nanoparticles. In the in vitro release study, the 17AAG from 17AAG-PEG-NLC exhibited a biphasic release pattern with burst release initially and sustained release afterwards. In addition, 17AAG-PEG-NLC showed a significantly higher in vitro antitumor efficacy and longer retention time in vivo than 17AAG solution. These results indicated that 17AAG-PEG-NLC may offer a promising alternative to the current 17AAG formulations for the treatment of solid tumors.


Asunto(s)
Antibióticos Antineoplásicos/administración & dosificación , Benzoquinonas/administración & dosificación , Portadores de Fármacos/química , Composición de Medicamentos/métodos , Liberación de Fármacos , Lactamas Macrocíclicas/administración & dosificación , Administración Intravenosa , Animales , Antibióticos Antineoplásicos/farmacocinética , Benzoquinonas/farmacocinética , Rastreo Diferencial de Calorimetría , Evaluación Preclínica de Medicamentos , Emulsiones , Glicerol/química , Humanos , Lactamas Macrocíclicas/farmacocinética , Lípidos/química , Células MCF-7 , Nanopartículas/química , Tamaño de la Partícula , Polietilenglicoles/química , Ratas , Ratas Sprague-Dawley , Solubilidad , Estearatos/química , Triglicéridos/química , Difracción de Rayos X
20.
Bioorg Med Chem Lett ; 25(17): 3744-7, 2015 Sep 01.
Artículo en Inglés | MEDLINE | ID: mdl-26159484

RESUMEN

Biodegradable vehicles that degrade specifically at tumor sites are highly desirable since they can cause selective exposure of highly toxic drugs at tumor sites whereas keep the conjugates stable during blood circulation. Here, we evaluate the utility of a dendritic hexadecapeptide comprised of four arms, each having a tetrapeptide sequence recognized by an enzyme cathepsin B as a carrier system for heat shock protein 90 (HSP90) inhibitor geldanamycin (GDM). We report the synthesis of a carrier having GDM conjugated to the terminal end of each arm (>55% wt/wt drug). We further report the stability of the GDM containing peptidic dendrimer in various buffers and in the presence of serum along with its ability to release free drug in the presence of cathepsin B, the enzyme overexpressed in a variety of tumors. Using androgen-independent prostate cancer cell line (DU-145) we further demonstrate that the geldanamycin containing peptidic dendrimer has antiproliferative property similar to the free drug derivative.


Asunto(s)
Benzoquinonas/administración & dosificación , Catepsina B/metabolismo , Dendrímeros/administración & dosificación , Portadores de Fármacos/administración & dosificación , Proteínas HSP90 de Choque Térmico/antagonistas & inhibidores , Lactamas Macrocíclicas/administración & dosificación , Péptidos/administración & dosificación , Péptidos/química , Antibióticos Antineoplásicos/administración & dosificación , Antibióticos Antineoplásicos/farmacocinética , Benzoquinonas/farmacocinética , Catepsina B/administración & dosificación , Catepsina B/química , Línea Celular Tumoral/efectos de los fármacos , Dendrímeros/química , Portadores de Fármacos/química , Portadores de Fármacos/farmacocinética , Estabilidad de Medicamentos , Humanos , Concentración 50 Inhibidora , Lactamas Macrocíclicas/farmacocinética , Masculino , Péptidos/farmacocinética , Neoplasias de la Próstata/tratamiento farmacológico , Neoplasias de la Próstata/patología
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