Open AccessPhysiologically Based Pharmacokinetic Models for Adults and Children Reveal a Role of Intracellular Tubulin Binding in Vincristine Disposition
Author(s) -
Lee Christine M.,
Zane Nicole R.,
Veal Gareth,
Thakker Dhiren R.
Publication year - 2019
Publication title -
cpt: pharmacometrics and systems pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 37
ISSN - 2163-8306
DOI - 10.1002/psp4.12453
Subject(s) - physiologically based pharmacokinetic modelling , pharmacokinetics , vincristine , pharmacology , efflux , intracellular , transporter , clearance , chemistry , volume of distribution , cyp3a4 , p glycoprotein , tubulin , disposition , medicine , metabolism , biology , biochemistry , chemotherapy , cytochrome p450 , multiple drug resistance , microtubule , psychology , social psychology , antibiotics , urology , gene , microbiology and biotechnology , cyclophosphamide
Vincristine is a cytotoxic chemotherapeutic agent used as first‐line therapy for pediatric acute lymphocytic leukemia. It is cleared by hepatic oxidative metabolism by CYP 3A4 and CYP 3A5 and via hepatic (biliary) efflux mediated by P‐glycoprotein (P‐gp) transporter. Bottom‐up physiologically based pharmacokinetic ( PBPK ) models were developed to predict vincristine disposition in pediatric and adult populations. The models incorporated physicochemical properties, metabolism by CYP 3A4/5, efflux by P‐gp, and intracellular binding to β‐tubulin. The adult and pediatric PBPK models predicted pharmacokinetics ( PK ) within twofold of the observed PK parameters (area under the curve, terminal half‐life, volume of distribution, and clearance). Simulating a higher hypothetical (4.9‐fold) pediatric expression of β‐tubulin relative to adult improved predictions of vincristine PKs . To our knowledge, this is the first time that intracellular binding has been incorporated into a pediatric PBPK model. Utilizing this PBPK modeling approach, safe and effective doses of vincristine could be predicted.