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An Evaluation of the Drug Interaction Potential of Pazopanib, an Oral Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitor, Using a Modified Cooperstown 5+1 Cocktail in Patients With Advanced Solid Tumors
Author(s) -
Goh B C,
Reddy N J,
Dandamudi U B,
Laubscher K H,
Peckham T,
Hodge J P,
Suttle A B,
Arumugham T,
Xu Y,
Xu CF,
Lager J,
Dar M M,
Lewis L D
Publication year - 2010
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.2010.158
Subject(s) - pazopanib , pharmacology , dextromethorphan , cyp2c9 , cyp3a , cyp1a2 , tyrosine kinase inhibitor , pharmacokinetics , cyp2d6 , omeprazole , dextrorphan , cyp2c19 , medicine , chemistry , cancer , cytochrome p450 , sunitinib , metabolism
Pazopanib, an oral inhibitor of vascular endothelial growth factor receptor, platelet‐derived growth factor receptor, and c‐kit kinases, inhibits multiple cytochrome P450 (CYP450) enzymes in vitro . This study in patients with advanced cancer evaluated the effect of pazopanib on CYP450 function by comparing the pharmacokinetics of CYP‐specific probe drugs in the presence and absence of pazopanib. The probes used included midazolam (CYP3A specific), warfarin (CYP2C9 specific), omeprazole (CYP2C19 specific), caffeine (CYP1A2 specific), and dextromethorphan (CYP2D6 specific). The estimated ratios of the geometric means (90% confidence interval (CI)) for the area under the curve to the last measurable point (AUC 0–t ) for these probe drugs with/without pazopanib were as follows: midazolam, 1.35 (1.18–1.54); omeprazole, 0.81 (0.59–1.12); caffeine, 1.00 (0.77–1.30); and S‐warfarin, 0.93 (0.84–1.03). The geometric least‐squares (LS) mean ratio of urine dextromethorphan:dextrorphan ranged from 1.33 (0–4‐h interval) to 1.64 (4–8‐h interval). The data suggest that pazopanib is a weak inhibitor of CYP3A4 and CYP2D6 and has no effect on CYP1A2, CYP2C9, and CYP2C19 in patients with advanced cancer. Clinical Pharmacology & Therapeutics (2010) 88 5, 652–659. doi: 10.1038/clpt.2010.158