1. Optimising the combination dosing strategy of abemaciclib and vemurafenib in BRAF-mutated melanoma xenograft tumours
- Author
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Palaniappan Kulanthaivel, Richard P. Beckmann, Damien M. Cronier, Sonya C. Tate, Teresa F. Burke, and Daisy G Hartman
- Subjects
0301 basic medicine ,MAPK/ERK pathway ,Cancer Research ,Indoles ,Aminopyridines ,Drug resistance ,abemaciclib ,Pharmacology ,CDK4/6 inhibitor ,chemistry.chemical_compound ,Mice ,0302 clinical medicine ,Antineoplastic Combined Chemotherapy Protocols ,Vemurafenib ,Abemaciclib ,Melanoma ,Sulfonamides ,biology ,Retinoblastoma protein ,Cell cycle ,Oncology ,030220 oncology & carcinogenesis ,Growth inhibition ,medicine.drug ,BRAF inhibitor ,Proto-Oncogene Proteins B-raf ,Models, Biological ,Drug Administration Schedule ,dose optimisation ,modelling ,resistance ,03 medical and health sciences ,Cell Line, Tumor ,medicine ,Biomarkers, Tumor ,Animals ,Humans ,business.industry ,medicine.disease ,Xenograft Model Antitumor Assays ,030104 developmental biology ,chemistry ,Drug Resistance, Neoplasm ,Mutation ,Cancer research ,biology.protein ,pharmacokinetic/pharmacodynamic ,Benzimidazoles ,business ,Translational Therapeutics - Abstract
Background: Resistance to BRAF inhibition is a major cause of treatment failure for BRAF-mutated metastatic melanoma patients. Abemaciclib, a cyclin-dependent kinase 4 and 6 inhibitor, overcomes this resistance in xenograft tumours and offers a promising drug combination. The present work aims to characterise the quantitative pharmacology of the abemaciclib/vemurafenib combination using a semimechanistic pharmacokinetic/pharmacodynamic modelling approach and to identify an optimum dosing regimen for potential clinical evaluation. Methods: A PK/biomarker model was developed to connect abemaciclib/vemurafenib concentrations to changes in MAPK and cell cycle pathway biomarkers in A375 BRAF-mutated melanoma xenografts. Resultant tumour growth inhibition was described by relating (i) MAPK pathway inhibition to apoptosis, (ii) mitotic cell density to tumour growth and, under resistant conditions, (iii) retinoblastoma protein inhibition to cell survival. Results: The model successfully described vemurafenib/abemaciclib-mediated changes in MAPK pathway and cell cycle biomarkers. Initial tumour shrinkage by vemurafenib, acquisition of resistance and subsequent abemaciclib-mediated efficacy were successfully captured and externally validated. Model simulations illustrate the benefit of intermittent vemurafenib therapy over continuous treatment, and indicate that continuous abemaciclib in combination with intermittent vemurafenib offers the potential for considerable tumour regression. Conclusions: The quantitative pharmacology of the abemaciclib/vemurafenib combination was successfully characterised and an optimised, clinically-relevant dosing strategy was identified.
- Published
- 2016