典型文献
Rational application of gefitinib in NSCLC patients with sensitive EGFR mutations based on pharmacokinetics and metabolomics
文献摘要：
Gefitinib has been available in the market for 20 years,but its pharmacokinetic mechanism of response is little known.In this study,we examined the pharmacokinetic and metabolomic profiles in non-small cell lung cancer(NSCLC)patients with sensitive EGFR mutations.A total of 216 advanced NSCLC patients were enrolled,and administered gefitinib at the standard dosage of 250 mg/day,which was established in heterogeneous subjects with non-sensitive mutations.We identified and quantified three main metabolites(named as M1,M2 and M3)in the plasma of patients,the correlations between the concentration of gefitinib/metabolites and efficacy were analyzed.In exploratory and validation set,gefitinib concentration was not correlated with clinical effects.Considering the result that the therapeutic effects of 250 mg/2-day was better than that of 250 mg/day in a multiple center clinical trial,the standard dose might be higher than that for maximal efficacy according to the hypothetical dose-response curve.Among the three metabolites,the IC50 of M2 in HCC827 and PC9 cell lines was significantly lower,and Conc.brain/Conc.plasma of M2 in mice was significantly higher than those of gefitinib,suggesting its higher potential to penetrate blood-brain barrier and might be more effective in the treatment of brain metastatic tumor than gefitinib.Consistently and attractively,higher M2 plasma concentration was found to be correlated with better clinical outcome in patients with brain metastases(the median PFS of CM2＜12 ng/mL and CM2≥12 ng/mL were 17.0 and 27.1 months,respectively,P = 0.038).The plasma concentration of M2≥12 ng/mL was a strong predictor of the PFS of NSCLC patients.In conclusion,for NSCLC patients with EGFR sensitive mutations,the standard dose is suspectable and could be decreased reasonably.M2 plays an important role in efficacy and may be more effective in the treatment of metastatic tumor than gefitinib.
文献关键词：
中图分类号：
作者姓名：
Wei Feng;Xi Chen;Shao-xing Guan;Hong-lian Ruan;Yan Huang;Hui-zhen Zhang;Yun-peng Yang;Wen-feng Fang;Hong-yun Zhao;Wei Zhuang;Shuang Xin;You-hao Chen;Fei Wang;Yue Gao;Min Huang;Xue-ding Wang;Li Zhang
作者机构：
Institute of Clinical Pharmacology,School of Pharmaceutical Sciences,Sun Yat-Sen University,Guangzhou 510006,China;Department of Medical Oncology,Sun Yat-Sen University Cancer Center,State Key Laboratory of Oncology in South China,Guangzhou 510060,China;School of Public Health,Guangzhou Medical University,Guangzhou 510000,China;Ersha Department of Pharmacy,The Second Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510120,China
文献出处：
引用格式：
[1]Wei Feng;Xi Chen;Shao-xing Guan;Hong-lian Ruan;Yan Huang;Hui-zhen Zhang;Yun-peng Yang;Wen-feng Fang;Hong-yun Zhao;Wei Zhuang;Shuang Xin;You-hao Chen;Fei Wang;Yue Gao;Min Huang;Xue-ding Wang;Li Zhang-.Rational application of gefitinib in NSCLC patients with sensitive EGFR mutations based on pharmacokinetics and metabolomics)[J].中国药理学报（英文版）,2022(07):1857-1864
A类：
Conc,attractively,suspectable
B类：
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AB值：
0.456664
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