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 journalArticleAcademicpeer-review

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
Early online date2018
DOIs
Publication statusPublished - 1 May 2019

Keywords

  • Journal Article

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