Impact of CYP3A4*22 on Pazopanib Pharmacokinetics in Cancer Patients

Sander Bins, Alwin D.R. Huitema, Pim Laven, Samira el Bouazzaoui, Huixin Yu, Nielka van Erp, Carla van Herpen, Paul Hamberg, Hans Gelderblom, Neeltje Steeghs, Stefan Sleijfer, Ron H.N. van Schaik, Ron H.J. Mathijssen, Stijn L.W. Koolen

Research output: Contribution to journalArticlepeer-review

24 Citations (Scopus)

Abstract

Background and Objective: As pazopanib plasma trough concentrations are correlated with treatment outcome, we explored whether single nucleotide polymorphisms in the elimination pathway of pazopanib affect systemic pazopanib concentrations. Methods: The decreased function alleles CYP3A4 15389 C > T (*22), ABCB1 3435 C >T, ABCG2 421 C >A, and ABCG2 34G >A were analyzed within a recently developed population-pharmacokinetic model. Results: Incorporation of CYP3A4*22 in the model resulted in a 35% lower clearance for variant carriers (0.18 vs. 0.27 L/h; difference in objective function value: − 9.7; p < 0.005). Simulated median trough concentrations of cancer patients with CYP3A4*22 with 600 mg once daily or 800 mg once daily were 31 and 35 mg/L, respectively. The simulated trough concentrations for the population excluding the CYP3A4*22 carriers after 600 mg once daily or 800 mg once daily were 18 and 20 mg/L, respectively. Conclusion: This analysis shows that CYP3A4*22 heterozygotes have a substantial lower pazopanib clearance and that dose adjustments based on CYP3A4*22 status could be considered.

Original languageEnglish
Pages (from-to)651-658
Number of pages8
JournalClinical Pharmacokinetics
Volume58
Issue number5
DOIs
Publication statusPublished - 1 May 2019
Externally publishedYes

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