Abstract

BackgroundImatinib, a tyrosine kinase inhibitor currently approved for treatment of several malignancies, has been shown to be a substrate for multiple efflux-transporter proteins, including ABCB1 (P-glycoprotein) and ABCG2 (BCRP). The effect of inhibiting these transporters on tissue exposure to imatinib remains unclear.ObjectiveTo assess the role of these transporters on drug disposition, 50 mg/kg imatinib was administered to Balb/C mice, 30 minutes after receiving tariquidar (10 mg/kg), an inhibitor of both ABCB1 and ABCG2, or vehicle, via oral gavage.MethodsQuantitative determination of imatinib in mouse plasma, liver and brain was performed using a newly-developed and validated liquid-chromatography-mass spectrometric method. Results: Exposure to imatinib was 2.2-fold higher in plasma, liver and brain in mice that received tariquidar, as compared to those that received the vehicle (P = 0.001). The peak plasma concentration did not increase substantially, suggesting that tariquidar is affecting the distribution, metabolism and/or excretion of imatinib, rather than absorption. Though tariquidar increased the absolute exposure of imatinib, the brain-to-plasma ratio of imatinib was unaffected.ConclusionThis study suggests that intentional inhibition of ABCB1 and ABCG2 function at the blood-brain barrier is unlikely to significantly improve clinical outcome of imatinib with currently used dosing regimens.

Highlights

  • Imatinib, a tyrosine kinase inhibitor currently approved for treatment of several malignancies, has been shown to be a substrate for multiple efflux-transporter proteins, including ABCB1 (P-glycoprotein) and ABCG2 (BCRP)

  • The AUC0–24 for imatinib was 2.2-fold higher in mice pretreated with tariquidar compared to the vehicle (26,725 vs 12,168 hr*ng/mL, P = 0.001)

  • The maximal corrected concentration of imatinib achieved in brain tissue was 114% higher in the imatinib plus tariquidar group (417 vs 195 ng/g), and the AUC0–4 was 2.2-fold higher (417 vs 195 hr*ng/mL, P = 0.00002)

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Summary

Introduction

A tyrosine kinase inhibitor currently approved for treatment of several malignancies, has been shown to be a substrate for multiple efflux-transporter proteins, including ABCB1 (P-glycoprotein) and ABCG2 (BCRP). Imatinib mesylate is an orally administered tyrosine kinase inhibitor, currently FDA approved for the treatment of Philadelphia chromosome-positive chronic myeloid leukemia (targeting Brc-Abl) and unresectable and/or metastatic malignant gastrointestinal stromal tumors (targeting c-KIT) [1]. This agent is currently under intensive investigation in other tumor types, most notably as a single agent or in combination with hydroxyurea for the treatment of gliomas. Experiments comparing the plasma and brain pharmacokinetics of imatinib following i.v. administration of radiolabeled drug to wild-type, Abcb knockout and Abcg knockout mice have confirmed a role of these transporter proteins in limiting brain exposure [9]

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