Population Pharmacokinetic Modeling of Adavosertib (AZD1775) in Patients with Solid Tumors

J Clin Pharmacol. 2024 Nov;64(11):1419-1431. doi: 10.1002/jcph.2492. Epub 2024 Jul 19.

Abstract

Adavosertib (AZD1775) is a potent small-molecule inhibitor of Wee1 kinase. This analysis utilized pharmacokinetic data from 8 Phase I/II studies of adavosertib to characterize the population pharmacokinetics of adavosertib in patients (n = 538) with solid tumors and evaluate the impact of covariates on exposure. A nonlinear mixed-effects modeling approach was employed to estimate population and individual parameters from the clinical trial data. The model for time dependency of apparent clearance (CL) was developed in a stepwise manner and the final model validated by visual predictive checks (VPCs). Using an adavosertib dose of 300 mg once daily on a 5 days on/2 days off dosing schedule given 2 weeks out of a 3-week cycle, simulation analyses evaluated the impact of covariates on the following exposure metrics at steady state: maximum concentration during a 21-day cycle, area under the curve (AUC) during a 21-day cycle, AUC during the second week of a treatment cycle, and AUC on day 12 of a treatment cycle. The final model was a linear 2-compartment model with lag time into the dosing compartment and first-order absorption into the central compartment, time-varying CL, and random effects on all model parameters. VPCs and steady-state observations confirmed that the final model satisfied all the requirements for reliable simulation of randomly sampled Phase I and II populations with different covariate characteristics. Simulation-based analyses revealed that body weight, renal impairment status, and race were key factors determining the variability of drug-exposure metrics.

Keywords: Wee1 inhibition; adavosertib; modeling; population pharmacokinetics.

Publication types

  • Clinical Trial, Phase I

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / blood
  • Antineoplastic Agents / pharmacokinetics
  • Area Under Curve
  • Clinical Trials, Phase I as Topic
  • Clinical Trials, Phase II as Topic
  • Computer Simulation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Models, Biological*
  • Neoplasms* / drug therapy
  • Protein Kinase Inhibitors / administration & dosage
  • Protein Kinase Inhibitors / blood
  • Protein Kinase Inhibitors / pharmacokinetics
  • Pyrazoles* / administration & dosage
  • Pyrazoles* / blood
  • Pyrazoles* / pharmacokinetics
  • Pyrimidinones* / administration & dosage
  • Pyrimidinones* / pharmacokinetics
  • Young Adult

Substances

  • Pyrazoles
  • adavosertib
  • Pyrimidinones
  • Antineoplastic Agents
  • Protein Kinase Inhibitors