1. Pharmacokinetics and Safety of Olaparib in Patients with Advanced Solid Tumours and Renal Impairment
- Author
-
Rolfo, Christian, de Vos-Geelen, Judith, Isambert, Nicolas, Molife, L Rhoda, Schellens, Jan H M, De Grève, Jacques, Dirix, Luc, Grundtvig-Sørensen, Peter, Jerusalem, Guy, Leunen, Karin, Mau-Sørensen, Morten, Plummer, Ruth, Learoyd, Maria, Bannister, Wendy, Fielding, Anitra, Ravaud, Alain, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Afd Pharmacoepi & Clinical Pharmacology, Pharmacoepidemiology and Clinical Pharmacology, Clinical sciences, Medical Genetics, Laboratory for Medical and Molecular Oncology, Interne Geneeskunde, MUMC+: MA Medische Oncologie (9), and RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy
- Subjects
Adult ,Male ,medicine.medical_specialty ,PHARMACOKINETICS ,No-observed-adverse-effect level ,Metabolic Clearance Rate ,Urology ,Renal function ,Administration, Oral ,Poly(ADP-ribose) Polymerase Inhibitors ,Kidney ,olaparib ,Piperazines ,Olaparib ,03 medical and health sciences ,chemistry.chemical_compound ,polymerase inhibitor ,0302 clinical medicine ,Pharmacokinetics ,Neoplasms ,Medicine ,Advanced Solid Tumours ,Humans ,Pharmacology (medical) ,030212 general & internal medicine ,Dosing ,Renal Insufficiency ,Renal impairment ,Aged ,Pharmacology ,Medicine(all) ,No-Observed-Adverse-Effect Level ,business.industry ,Area under the curve ,INHIBITOR ,Middle Aged ,CANCER ,Confidence interval ,chemistry ,Tolerability ,030220 oncology & carcinogenesis ,Phthalazines ,Female ,Safety ,business - Abstract
BACKGROUND: Olaparib, a potent oral poly(ADP-ribose) polymerase inhibitor, is partially renally cleared. We investigated the pharmacokinetics and safety of olaparib in patients with mild or moderate renal impairment to provide dosing recommendations. METHODS: This phase I open-label study assessed the pharmacokinetics, safety and tolerability of single-dose, oral 300-mg olaparib tablets in adults (aged 18-75 years) with solid tumours. Patients had normal renal function, or mild or moderate renal impairment (estimated creatinine clearance ≥ 81, 51-80 or 31-50 mL/min, respectively). Blood was collected for 96 h, and urine samples collected for 24 h post-dose. Patients could continue taking olaparib 300 mg twice daily for a long-term safety assessment. RESULTS: Overall, 44 patients received one or more doses of olaparib and 38 were included in the pharmacokinetic assessment. Patients with mild renal impairment had an area under the curve geometric least-squares mean ratio of 1.24 (90% confidence interval 1.06-1.47) and a geometric least-squares mean maximum plasma concentration ratio of 1.15 (90% confidence interval 1.04-1.27) vs. those with normal renal function. In patients with moderate renal impairment, the geometric least-squares mean ratio for the area under the curve was 1.44 (90% confidence interval 1.10-1.89) and for the maximum plasma concentration was 1.26 (90% confidence interval 1.06-1.48) vs. those with normal renal function. No new safety signals were detected in patients with mild or moderate renal impairment. CONCLUSIONS: In patients with mild renal impairment, the small increase in exposure to olaparib was not considered clinically relevant. In patients with moderate renal impairment, exposure to olaparib increased by 44%; thus, these patients should be carefully monitored and the tablet dose should be adjusted to 200 mg twice daily. CLINICAL TRIALS REGISTRATION: NCT01894256.
- Published
- 2019