Pharmacokinetic study of the phase III, randomized, double-blind, multicenter trial (TRIBUTE) of paclitaxel and carboplatin combined with erlotinib or placebo in patients with advanced Non-small Cell Lung Cancer (NSCLC)

Hai T. Tran, Ralph G. Zinner, George R. Blumenschein, Yun W. Oh, Vassiliki A. Papadimitrakopoulou, Edward S. Kim, Charles Lu, Mubashira Malik, Bert L. Lum, Roy S. Herbst

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18 Scopus citations

Abstract

Purpose: To assess the pharmacokinetics and evaluate potential drug-drug interactions between erlotinib, paclitaxel and carboplatin. Experimental Design: 1,079 previously untreated patients with advanced NSCLC were enrolled and randomized in a phase III trial (TRIBUTE) to receive either erlotinib or placebo in combination with paclitaxel 200 mg/m2 IV over 3 h and carboplatin at a calculated dose to achieve an AUC 6 mg·min/mL. To determine possible drug-drug interaction with this combination, a subset of 24 (12 erlotinib, 12 placebo) patients were enrolled onto an intensive pharmacokinetic (IPK) substudy group at a single site. All IPK patients received either erlotinib 150 mg/day or placebo-controlled tablets. Analyses were completed using validated analytical methodologies. Non-compartmental modeling was utilized to estimate PK parameters. Results: Complete blood sampling for pharmacokinetic analysis was obtained in 21 of 24 patients. Mean AUC0-τ for erlotinib and the OSI-420 metabolite were 29,997 ng·h/mL and 3,020 ng·h/mL, respectively. Mean (SD) paclitaxel clearances (L/h/M2) were 11.7 (3.4) and 12.7 (6.7) in the placebo and erlotinib treatment groups, respectively. The resultant paclitaxel AUC0-∞ (ng·h/mL) was 18,400 (5,300) for the placebo group and 17,800 (5,500) for the erlotinib group. For carboplatin, the mean (SD) clearances (L/h) were 16.8 (3.9) and 16.1 (4.4) for the placebo and erlotinib groups, respectively. The resultant carboplatin AUC0-∞ (ng/mL·h) were 49,900 (9,700) for the placebo group and 48,400 (11,900) for the erlotinib group. No significant differences were observed in these paclitaxel or carboplatin pharmacokinetic group comparisons. Conclusions: The addition of erlotinib to a standard chemotherapy regimen for NSCLC did not alter the systemic exposures (AUC 0-∞) of paclitaxel (p=0.80) and carboplatin (p=0.756) when erlotinib-treated patients were compared to placebo-treated patients. The pharmacokinetics of erlotinib and its metabolite OSI-420 did not appear to be altered by the concomitant administration of paclitaxel and carboplatin.

Original languageEnglish (US)
Pages (from-to)499-505
Number of pages7
JournalInvestigational New Drugs
Volume29
Issue number3
DOIs
StatePublished - Jun 2011

Keywords

  • EGFR inhibitor
  • Erlotinib
  • Lung cancer
  • NSCLC
  • Pharmacokinetics

ASJC Scopus subject areas

  • Oncology
  • Pharmacology
  • Pharmacology (medical)

MD Anderson CCSG core facilities

  • Clinical Trials Office

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