Medline ® Abstract for Reference 226
of 'Chemotherapy hepatotoxicity and dose modification in patients with liver disease'
An open-label study to describe pharmacokinetic parameters of erlotinib in patients with advanced solid tumors with adequate and moderately impaired hepatic function.
O'Bryant CL, Haluska P, Rosen L, Ramanathan RK, Venugopal B, Leong S, Boinpally R, Franke A, Witt K, Evans J, Belani C, Gail Eckhardt S, Ramalingam S
Cancer Chemother Pharmacol. 2012 Mar;69(3):605-12. Epub 2011 Sep 22.
PURPOSE: To compare the pharmacokinetic (PK) parameters of a single dose of erlotinib in cancer patients with moderate hepatic impairment (MHI) to those of cancer patients with adequate hepatic function (AHF).
METHODS: Cancer patients with either AHF or MHI were treated with a single 150 mg dose of erlotinib on day 1 only followed by 96 h of plasma sampling for PK assessment. From day 5, patients were allowed to continue daily erlotinib in a maintenance phase. Non-smoking patients were stratified into an AHF cohort (total bilirubin ≤ upper limit of normal [ULN]and ALT/AST ≤ 1.5 X ULN) or a MHI cohort (Child-Pugh score of 7-9). The frequency of adverse events and laboratory changes were assessed.
RESULTS: Thirty-six patients, 21 with AHF and 15 with MHI, received at least onedose of erlotinib. The PK of erlotinib was similar between the two cohorts with a median C (max) of 1.09 versus 0.828 μg/mL and corresponding median AUC(0-t ) 29.3 versus 30.5 μg h/mL for the AHF and MHI cohorts, respectively. Adverse events from erlotinib in cancer patients with MHI were consistent with the known safety profile.
CONCLUSIONS: The PK and safety profiles of erlotinib in patients with MHI were similar to those with AHF. As a result, a reduced starting dose of erlotinib in patients with MHI is not required and treatment should be guided by patients' tolerability.
Department of Clinical Pharmacy, School of Pharmacy, University of Colorado Cancer Center, Mail Stop C238, 12850 East Montview Blvd., V20-1223, Aurora, CO, 80045, USA. Cindy.OBryant@ucdenver.edu