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The Effect of Food or Omeprazole on the Pharmacokinetics of Osimertinib in Patients With Non‐Small‐Cell Lung Cancer and in Healthy Volunteers
Author(s) -
Vishwanathan Karthick,
Dickinson Paul A.,
Bui Khanh,
Cassier Philippe A.,
Greystoke Alastair,
Lisbon Eleanor,
Moreno Victor,
So Karen,
Thomas Karen,
Weilert Doris,
Yap Timothy A.,
Plummer Ruth
Publication year - 2018
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1002/jcph.1035
Subject(s) - tolerability , pharmacokinetics , crossover study , omeprazole , osimertinib , medicine , cmax , volunteer , confidence interval , bioequivalence , area under the curve , gastroenterology , pharmacology , pharmacodynamics , lung cancer , adverse effect , cancer , adenocarcinoma , placebo , pathology , ros1 , alternative medicine , agronomy , biology
Two phase 1, open‐label studies assessed the impact of food or gastric pH modification (omeprazole) on the exposure and safety/tolerability of osimertinib and its metabolites. The food effect study was an open‐label, 2‐period crossover study in patients with advanced non‐small‐cell lung cancer, randomized into 2 treatment sequences: single‐dose osimertinib 80 mg in a fed then fasted state or fasted then fed. The gastric pH study was an open‐label, 2‐period fixed sequence study assessing the effect of omeprazole on osimertinib exposure in healthy male volunteers. In period 1, volunteers received omeprazole 40 mg (days 1‐4), then omeprazole 40 mg plus osimertinib 80 mg (day 5). In period 2, volunteers received osimertinib 80 mg alone (single dose). Blood samples were collected at prespecified time points for pharmacokinetic analyses. Safety/tolerability was also assessed. In the food effect study 38 patients were randomized to fed/fasted (n = 18) or fasted/fed (n = 20) sequences with all patients completing treatment. Coadministration with food did not affect osimertinib exposure (geometric least‐squares mean ratios [90% confidence intervals]: 106.05% [94.82%, 118.60%] [area under the plasma concentration time curve from zero to 72 hours] and 92.75% [81.40%, 105.68%] [maximum plasma concentration]). In the gastric pH study (n = 68 received treatment, n = 47 completed the study), coadministration with omeprazole did not affect osimertinib exposure (geometric least‐squares mean ratios 106.66% [100.26%, 113.46%] [area under the concentration‐time curve], 101.65% [94.65%, 109.16%] [peak concentration]). Osimertinib was well tolerated in both studies. Osimertinib may be administered without regard to food. Dose restriction is not required in patients whose gastric pH may be altered by concomitant agents or medical conditions. ClinicalTrials.gov: NCT02224053, NCT02163733.