Bioequivalence and Pharmacokinetic Evaluation of Regorafenib Tablets in Healthy Chinese Volunteers.

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  • Author(s): Wang Z;Wang Z; Zhang Y; Zhang Y; Liu J; Liu J; Chen X; Chen X
  • Source:
    Clinical pharmacology in drug development [Clin Pharmacol Drug Dev] 2024 Dec; Vol. 13 (12), pp. 1317-1323. Date of Electronic Publication: 2024 Oct 23.
  • Publication Type:
    Journal Article; Randomized Controlled Trial
  • Language:
    English
  • Additional Information
    • Source:
      Publisher: Wiley Country of Publication: United States NLM ID: 101572899 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2160-7648 (Electronic) Linking ISSN: 2160763X NLM ISO Abbreviation: Clin Pharmacol Drug Dev Subsets: MEDLINE
    • Publication Information:
      Publication: 2013- : Hoboken, NJ : Wiley
      Original Publication: Thousand Oaks, Calif. : Sage Publications, c2012-
    • Subject Terms:
    • Abstract:
      This was a single-center, randomized, open-label, 2-formulation, and 2-cycle crossover trial conducted in 48 healthy Chinese volunteers, under fasting and fed conditions. The participants received oral doses of the test formulation (regorafenib) and reference formulation (40 mg) during each study period. Blood samples were collected before and up to 144 hours after the formulations were administered to determine changes in the pharmacokinetic parameters and adverse reactions, which were then used to evaluate bioequivalence and safety. The geometric mean ratios of maximum blood concentration, area under the plasma concentration-time curve from time 0 to the last quantifiable concentration , and area under the plasma concentration-time curve from time 0 to infinity for regorafenib were as follows: 94.7%, 91.4%, and 91.7%, respectively, under fasting conditions; and 94.6%, 97.7%, and 98.8%, respectively, under fed conditions. The 90% confidence intervals for the geometric mean ratios were within the 80%-125% equivalence interval for both the fasting and fed tests. Ingesting high-fat and high-calorie foods increases exposure to regorafenib, leading to slower rates of absorption. The safety profiles of the 2 preparations were similar.
      (© 2024, The American College of Clinical Pharmacology.)
    • References:
      Arai H, Battaglin F, Wang J, et al. Molecular insight of regorafenib treatment for colorectal cancer. Cancer Treat Rev. 2019;81:101912.
      Regorafenib approved for liver cancer. Cancer Discov. 2017;7(7):660.
      Kelly CM, Gutierrez Sainz L, Chi P. The management of metastatic GIST: current standard and investigational therapeutics. J Hematol Oncol. 2021;14(1):2.
      Ou DL, Chen CW, Hsu CL, et al. Regorafenib enhances antitumor immunity via inhibition of p38 kinase/Creb1/Klf4 axis in tumor‐associated macrophages. J Immunother Cancer. 2021;9(3):e001657.
      Grothey A, Blay JY, Pavlakis N, Yoshino T, Bruix J. Evolving role of regorafenib for the treatment of advanced cancers. Cancer Treat Rev. 2020;86:101993.
      Fondevila F, Méndez‐Blanco C, Fernández‐Palanca P, González‐Gallego J, Mauriz JL. Anti‐tumoral activity of single and combined regorafenib treatments in preclinical models of liver and gastrointestinal cancers. Exp Mol Med. 2019;51(9):1‐15.
      Keunecke A, Hoefman S, Drenth HJ, Zisowsky J, Cleton A, Ploeger BA. Population pharmacokinetics of regorafenib in solid tumours: exposure in clinical practice considering enterohepatic circulation and food intake. Br J Clin Pharmacol. 2020;86(12):2362‐2376.
      Sunakawa Y, Furuse J, Okusaka T, et al. Regorafenib in Japanese patients with solid tumors: phase I study of safety, efficacy, and pharmacokinetics. Invest New Drugs. 2014;32(1):104‐112.
      Rousseau B, Boukerma AK, Henriques J, et al. Impact of trough concentrations of regorafenib and its major metabolites M‐2 and M‐5 on overall survival of chemorefractory metastatic colorectal cancer patients: results from a multicentre GERCOR TEXCAN phase II study. Eur J Cancer. 2022;168:99‐107.
      Fukudo M, Asai K, Tani C, Miyamoto M, Ando K, Ueno N. Pharmacokinetics of the oral multikinase inhibitor regorafenib and its association with real‐world treatment outcomes. Invest New Drugs. 2021;39(5):1422‐1431.
      Gerisch M, Hafner FT, Lang D, et al. Mass balance, metabolic disposition, and pharmacokinetics of a single oral dose of regorafenib in healthy human subjects. Cancer Chemother Pharmacol. 2018;81(1):195‐206.
      Geoerger B, Morland B, Jiménez I, et al. Phase 1 dose‐escalation and pharmacokinetic study of regorafenib in paediatric patients with recurrent or refractory solid malignancies. Eur J Cancer. 2021;153:142‐152.
      Zopf D, Fichtner I, Bhargava A, et al. Pharmacologic activity and pharmacokinetics of metabolites of regorafenib in preclinical models. Cancer Med. 2016;5(11):3176‐3185.
      Kubota Y, Fujita KI, Takahashi T, et al. Higher systemic exposure to unbound active metabolites of regorafenib is associated with short progression‐free survival in colorectal cancer patients. Clin Pharmacol Ther. 2020;108(3):586‐595.
      Miners JO, Chau N, Rowland A, et al. Inhibition of human UDP‐glucuronosyltransferase enzymes by lapatinib, pazopanib, regorafenib and sorafenib: implications for hyperbilirubinemia. Biochem Pharmacol. 2017;129:85‐95.
      Schmulenson E, Bovet C, Theurillat R, et al. Population pharmacokinetic analyses of regorafenib and capecitabine in patients with locally advanced rectal cancer (SAKK 41/16 RECAP). Br J Clin Pharmacol. 2022;88(12):5336‐5347.
      Weekes C, Lockhart AC, Lee JJ, et al. A phase 1b study evaluating the safety and pharmacokinetics of regorafenib in combination with cetuximab in patients with advanced solid tumors. Int J Cancer. 2019;145(9):2450‐2458.
      de Man FM, Hussaarts KGAM, de With M, et al. Influence of the proton pump inhibitor esomeprazole on the bioavailability of regorafenib: a randomized crossover pharmacokinetic study. Clin Pharmacol Ther. 2019;105(6):1456‐1461.
      Dong C, Zhang X, Zhang Y, et al. Pharmacokinetics, bioequivalence and safety of two formulations of ticagrelor in healthy Chinese subjects: effects of food. Basic Clin Pharmacol Toxicol. 2023;132(4):313‐320.
      Deng J, Zhu X, Chen Z, et al. A review of food‐drug interactions on oral drug absorption. Drugs. 2017;77(17):1833‐1855.
      Dueck AC, Mendoza TR, Mitchell SA, et al. Validity and reliability of the US national cancer institute's patient‐reported outcomes version of the common terminology criteria for adverse events (PRO‐CTCAE). JAMA Oncol. 2015;1(8):1051‐1059.
      Zhang Q, Wang Z, Wu J, Zhou Z, Zhou R, Hu W. Bioequivalence and pharmacokinetic evaluation of two oral formulations of regorafenib: an open‐label, randomised, single‐dose, two‐period, two‐way crossover clinical trial in healthy Chinese volunteers under fasting and fed conditions. Drug Des Devel Ther. 2021;15:3277‐3288.
      Herbrink M, Nuijen B, Schellens JH, Beijnen JH. Variability in bioavailability of small molecular tyrosine kinase inhibitors. Cancer Treat Rev. 2015;41(5):412‐422.
      Veerman GDM, Hussaarts KGAM, Jansman FGA, Koolen SWL, van Leeuwen RWF, Mathijssen RHJ. Clinical implications of food‐drug interactions with small‐molecule kinase inhibitors. Lancet Oncol. 2020;21(5):e265‐e279.
      Kort A, Durmus S, Sparidans RW, Wagenaar E, Beijnen JH, Schinkel AH. Brain and testis accumulation of regorafenib is restricted by breast cancer resistance protein (BCRP/ABCG2) and P‐glycoprotein (P‐GP/ABCB1). Pharm Res. 2015;32(7):2205‐2216.
      Fujita KI, Masuo Y, Yamazaki E, et al. Involvement of the transporters p‐glycoprotein and breast cancer resistance protein in dermal distribution of the multikinase inhibitor regorafenib and its active metabolites. J Pharm Sci. 2017;106(9):2632‐2641.
      Li J, Qin S, Xu R, et al. Regorafenib plus best supportive care versus placebo plus best supportive care in Asian patients with previously treated metastatic colorectal cancer (CONCUR): a randomised, double‐blind, placebo‐controlled, phase 3 trial. Lancet Oncol. 2015;16(6):619‐629.
      Ishiyama S, Yamada T, Nakamura M, et al. Efficacy and safety of regorafenib dose‐escalation therapy for Japanese patients with refractory metastatic colorectal cancer (RECC study). Int J Clin Oncol. 2022;27(8):1300‐1308.
    • Contributed Indexing:
      Keywords: bioequivalence; healthy Chinese volunteers; pharmacokinetic; regorafenib
    • Accession Number:
      24T2A1DOYB (regorafenib)
      0 (Pyridines)
      0 (Phenylurea Compounds)
      0 (Tablets)
    • Publication Date:
      Date Created: 20241023 Date Completed: 20241202 Latest Revision: 20241202
    • Publication Date:
      20241204
    • Accession Number:
      10.1002/cpdd.1474
    • Accession Number:
      39439380