Abstract

PurposeRecent in vitro studies demonstrated that dasatinib inhibits organic cation transporter 2 (OCT2), multidrug and toxin extrusion proteins (MATEs), and organic anion transporting polypeptide 1B1/1B3 (OATP1B1/1B3). We developed a physiologically based pharmacokinetic (PBPK) model to assess drug–drug interaction (DDI) potential between dasatinib and known substrates for these transporters in a virtual population.MethodsThe dasatinib PBPK model was constructed using Simcyp® Simulator by combining its physicochemical properties, in vitro data, in silico predictions, and pharmacokinetic (PK) results from clinical studies. Model validation against three independent clinical trials not used for model development included dasatinib DDI studies with ketoconazole, rifampin, and simvastatin. The validated model was used to simulate DDIs of dasatinib and known substrates for OCT2 and MATEs (metformin) and OATP1B1/1B3 (pravastatin and rosuvastatin).ResultsSimulations of metformin PK in the presence and absence of dasatinib, using inhibitor constant (Ki) values measured in vitro, produced estimated geometric mean ratios (GMRs) of the maximum observed concentration (Cmax) and area under the concentration–time curve (AUC) of 1.05 and 1.06, respectively. Sensitivity analysis showed metformin exposure increased < 30% in both AUC and Cmax when dasatinib Ki was reduced by tenfold for OCT2 and MATEs simultaneously, and < 40% with a 20-fold Ki reduction. The estimated GMRs of Cmax and AUC for pravastatin and rosuvastatin with co-administration of dasatinib were unity (1.00).ConclusionsThis PBPK model accurately described the observed PK profiles of dasatinib. The validated PBPK model predicts low risk of clinically significant DDIs between dasatinib and metformin, pravastatin, or rosuvastatin.

Highlights

  • Dasatinib is a tyrosine kinase inhibitor (TKI) approved for the treatment of adult patients with Philadelphia-positive (Ph +) chronic myeloid leukemia (CML) or Ph + acute lymphoblastic leukemia (ALL) with resistance or intolerance to prior therapies including imatinib [1]

  • Dasatinib was shown to inhibit organic cation transporter 2 (OCT2), multidrug and toxin extrusion proteins (MATE1/2K), and organic anion transporting polypeptide 1B1/1B3 (OATP1B1/1B3) with half maximal inhibitory concentration ­(IC50) values of 0.034, 0.22, 0.86, 9.2, and 4.4 μM, respectively. Based on these in vitro findings, we investigated whether dasatinib has potential inhibitory effects on OCT2, MATEs (MATE1/2K), and OATP1B1/1B3 transporters in vivo

  • Elimination intrinsic clearances of cytochrome P450 3A4 (CYP3A4) and other enzymes were predicted by the retrograde method (a “top-down” approach to derive clearance from clinical PK) within S­ imcyp® based on both the oral clearance (CLpo) observed following oral administration in human and the fraction of metabolites formed by CYP3A4 enzymes responsible for dasatinib metabolism determined in vitro

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Summary

Introduction

Dasatinib is a tyrosine kinase inhibitor (TKI) approved for the treatment of adult patients with Philadelphia-positive (Ph +) chronic myeloid leukemia (CML) or Ph + acute lymphoblastic leukemia (ALL) with resistance or intolerance to prior therapies including imatinib [1]. Dasatinib pharmacokinetics (PK) are characterized by absorption following oral administration in patients with CML, and exposures are approximately dose proportional over a dose range of 15–240 mg [1]. The overall mean elimination half-life of dasatinib is 3–5 h and is not affected by dosing regimen (QD or twice daily) or by disease status (CML in chronic or acute phase) [1]. In vitro studies indicate that dasatinib is a time-dependent inhibitor of CYP3A4, but has little potential to induce CYP enzymes [5, 6]. In vitro studies have demonstrated that dasatinib is likely a weak substrate and not an inhibitor of P-glycoprotein (P-gp) [7]

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