Evaluation of oral versus intravenous dose of vinorelbine to achieve equivalent blood exposures in patients with solid tumours.

Details

Serval ID
serval:BIB_14FDC8EE9C12
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Evaluation of oral versus intravenous dose of vinorelbine to achieve equivalent blood exposures in patients with solid tumours.
Journal
Cancer chemotherapy and pharmacology
Author(s)
Bourgeois H., Vermorken J., Dark G., Jones A., Fumoleau P., Stupp R., Tourani J., Brain E., Nguyen L., Lefresne F., Puozzo C.
ISSN
0344-5704
Publication state
Published
Issued date
2007
Peer-reviewed
Oui
Volume
60
Number
3
Pages
407-13
Language
english
Notes
Publication types: Clinical Trial, Phase I ; Journal Article ; Multicenter Study ; Randomized Controlled Trial - Publication Status: ppublish
Abstract
Patient's preference is for oral chemotherapy when both oral and i.v. are available, provided that efficacy is equivalent. Reliable switch from oral to i.v. is possible if correspondence between respective doses has been established. Vinorelbine oral was developed as a line extension of VRL i.v. on the basis that similar AUCs result in similar activities. From a first crossover study on 24 patients receiving VRL 25 mg/m2 i.v. and 80 mg/m2 oral data extrapolation concluded on AUCs bioequivalence between Vinorelbine 30 mg/m2 i.v. and 80 mg/m2 oral. A new trial was performed to support this calculation. In a crossover design study on patients (PS 0-1) with advanced solid tumours (44% breast carcinoma), VRL was administered (30 mg/m2 i.v., 80 mg/m2 oral) with a standard meal and 5-HT3 antagonists, at 2 weeks interval. Pharmacokinetics was performed over 168 h and VRL was measured by LC-MS/MS. Statistics included bioequivalence tests. Forty-eight patients were evaluable for PK: median age 58 years (25-71), PS0/PS1: 20/28, M/F: 11/37. Mean AUCs were 1,230 +/- 290 and 1,216 +/- 521 ng/ml for i.v. and oral, respectively. The confidence interval of the AUC ratio (0.83-1.03) was within the required regulatory range (0.8-1.25) and proved the bioequivalence between the two doses. The absolute bioavailability was 37.8 +/- 16.0%, and close to the value from the first study (40%). Patient tolerability was globally comparable between both forms with no significant difference on either haematological or non-haematological toxicities (grade 3-4). This new study, conducted on a larger population, confirmed the reliable dose correspondence previously established between vinorelbine 80 mg/m2 oral and 30 mg/m2 i.v.
Keywords
Administration, Oral, Adolescent, Adult, Aged, Antineoplastic Agents, Phytogenic, Area Under Curve, Cross-Over Studies, Female, Humans, Infusions, Intravenous, Lymphoma, Male, Middle Aged, Neoplasms, Patient Selection, Vinblastine
Pubmed
Web of science
Create date
28/01/2008 9:39
Last modification date
20/08/2019 13:43
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