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Pharmacokinetics of Erlotinib for the Treatment of High‐Grade Glioma in a Pediatric Patient with Cystic Fibrosis: Case Report and Review of the Literature
Author(s) -
Christiansen Shan R.,
Broniscer Alberto,
Panetta J. Carl,
Stewart Clinton F.
Publication year - 2009
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.29.7.858
Subject(s) - erlotinib , medicine , pharmacokinetics , cystic fibrosis , erlotinib hydrochloride , gastroenterology , glioma , drug , pharmacology , malabsorption , cancer , epidermal growth factor receptor , cancer research
A 12‐year‐old girl with cystic fibrosis was diagnosed with a high‐grade glioma after radiographic and biopsy results confirmed the primary intracranial lesion. She was treated with single‐agent erlotinib during and after daily localized radiation therapy. Pharmacokinetic studies were conducted to assess the effect of pancreatic enzyme deficiency and intestinal malabsorption secondary to cystic fibrosis on the bioavailability of orally administered erlotinib, a lipophilic drug. Pharmacokinetic analysis of plasma samples from days 1 and 8 demonstrated that absorption of oral erlotinib was not affected by the patient's cystic fibrosis when the drug was given concomitantly with pancreatic enzyme replacement. When pediatric patients with cystic fibrosis are receiving erlotinib or other lipophilic oral drugs, continued supplementation of pancreatic enzymes is recommended, with therapeutic drug monitoring of plasma drug concentrations when feasible, and close observation for therapeutic responses and adverse effects.