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Interaction pharmacokinetics of pegylated liposomal doxorubicin (Caelyx) on coadministration with paclitaxel or docetaxel

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Abstract

Purpose

To investigate the pharmacokinetics of polyethylene glycol-coated liposomal doxorubicin (PLD, Caelyx) when given as a single agent and in combination with the taxanes paclitaxel or docetaxel in humans.

Methods

The plasma kinetics of PLD were studied in 19 cancer patients treated with PLD every 4 weeks combined with either paclitaxel (on a weekly basis in seven and as a single infusion in three patients) or docetaxel (weekly in seven and as a single infusion in two). Plasma concentrations of PLD were quantified in two sets of samples per patient to compare the same pharmacokinetic parameters in each subject when treated with single-agent PLD and again with the combination. Total doxorubicin concentrations in plasma were quantified by HPLC. Pharmacokinetics were evaluated by noncompartmental analysis and the data obtained were compared for differences by a matched-pairs nonparametric test.

Results

Coadministration of paclitaxel produced a median/mean 54/80% increase in PLD AUCinf (95% confidence interval 23% to 136%, P=0.002). The observed increase was consistent among all subjects. PLD clearance was also decelerated in the presence of paclitaxel (P=0.013) while other pharmacokinetic parameters were affected modestly. A small increase in the AUC of PLD was observed in the docetaxel/PLD arm (mean increase 12%, P=0.039) while PLD clearance decreased marginally and other pharmacokinetic parameters remained unaffected. AUC extrapolated to infinity was below 8% in both arms.

Conclusions

This study showed the presence of a pharmacokinetic interaction that led to higher plasma concentrations of PLD when combined with paclitaxel and to a minor extent when combined with docetaxel. This pharmacokinetic information may be of value when planning combination therapies of PLD with taxanes.

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References

  1. Nabholtz JM, Falkson C, Campos D, Szanto J, Martin M, Chan S, Pienkowski T, Zaluski J, Pinter T, Krzakowski M, Vorobiof D, Leonard R, Kennedy I, Azli N, Murawsky M, Riva A, Pouillart P (2003) Docetaxel and doxorubicin compared with doxorubicin and cyclophosphamide as first-line chemotherapy for metastatic breast cancer: results of a randomized, multicenter, phase III trial. J Clin Oncol 21:968–975

    Article  PubMed  Google Scholar 

  2. Sonpavde G, Ansari R, Walker P, Sciortino DF, Gabrys GT, Murdock A, Gonin R, Einhorn LH (2000) Phase II study of doxorubicin and paclitaxel as second-line chemotherapy of small-cell lung cancer: a Hoosier Oncology Group Trial. Am J Clin Oncol 23:68–70

    Article  CAS  PubMed  Google Scholar 

  3. Trope C, Kristensen G, Kisic J, Kaern J (2001) Long-term results from a phase II study of paclitaxel combined with doxorubicin in recurrent platinum refractory ovarian cancer. Eur J Gynaecol Oncol 22:223–227

    CAS  PubMed  Google Scholar 

  4. Gehl J, Boesgaard M, Paaske T, Vittrup JB, Dombernowsky P (1996) Combined doxorubicin and paclitaxel in advanced breast cancer: effective and cardiotoxic. Ann Oncol 7:687–693

    CAS  PubMed  Google Scholar 

  5. Perez EA (2001) Doxorubicin and paclitaxel in the treatment of advanced breast cancer: efficacy and cardiac considerations. Cancer Invest 19:155–164

    Article  CAS  PubMed  Google Scholar 

  6. Minotti G, Saponiero A, Licata S, Menna P, Calafiore AM, Teodori G, Gianni L (2001) Paclitaxel and docetaxel enhance the metabolism of doxorubicin to toxic species in human myocardium. Clin Cancer Res 7:1511–1515

    CAS  PubMed  Google Scholar 

  7. Gianni L, Munzone E, Capri G, Fulfaro F, Tarenzi E, Villani F, Spreafico C, Laffranchi A, Caraceni A, Martini C (1995) Paclitaxel by 3-hour infusion in combination with bolus doxorubicin in women with untreated metastatic breast cancer: high antitumor efficacy and cardiac effects in a dose-finding and sequence-finding study. J Clin Oncol 13:2688–2699

    CAS  PubMed  Google Scholar 

  8. Gianni L, Vigano L, Locatelli A, Capri G, Giani A, Tarenzi E, Bonadonna G (1997) Human pharmacokinetic characterization and in vitro study of the interaction between doxorubicin and paclitaxel in patients with breast cancer. J Clin Oncol 15:1906–1915

    CAS  PubMed  Google Scholar 

  9. Moreira A, Lobato R, Morais J, Silva S, Ribeiro J, Figueira A, Vale D, Sousa C, Araujo F, Fernandes A, Oliveira J, Passos-Coelho JL (2001) Influence of the interval between the administration of doxorubicin and paclitaxel on the pharmacokinetics of these drugs in patients with locally advanced breast cancer. Cancer Chemother Pharmacol 48:333–337

    Article  CAS  PubMed  Google Scholar 

  10. Rischin D, Ackland SP, Smith J, Garg MB, Clarke S, Millward MJ, Toner GC, Zalcberg J (2002) Phase I and pharmacokinetic study of docetaxel in combination with epirubicin and cyclophosphamide in advanced cancer: dose escalation possible with granulocyte colony-stimulating factor, but not with prophylactic antibiotics. Ann Oncol 13:1810–1818

    Article  CAS  PubMed  Google Scholar 

  11. Judson I, Radford JA, Harris M, Blay JY, van Hoesel Q, le Cesne A, van Oosterom AT, Clemons MJ, Kamby C, Hermans C, Whittaker J, Donato DP, Verweij J, Nielsen S (2001) Randomised phase II trial of pegylated liposomal doxorubicin (DOXIL/CAELYX) versus doxorubicin in the treatment of advanced or metastatic soft tissue sarcoma: a study by the EORTC Soft Tissue and Bone Sarcoma Group. Eur J Cancer 37:870–877

    Article  CAS  PubMed  Google Scholar 

  12. Hamilton A, Biganzoli L, Coleman R, Mauriac L, Hennebert P, Awada A, Nooij M, Beex L, Piccart M, Van Hoorebeeck I, Bruning P, de Valeriola D (2002) EORTC 10968: a phase I clinical and pharmacokinetic study of polyethylene glycol liposomal doxorubicin (Caelyx, Doxil) at a 6-week interval in patients with metastatic breast cancer. European Organization for Research and Treatment of Cancer. Ann Oncol 13:910–918

    Article  CAS  PubMed  Google Scholar 

  13. Gabizon AA (2001) Pegylated liposomal doxorubicin: metamorphosis of an old drug into a new form of chemotherapy. Cancer Invest 19:424–436

    Article  CAS  PubMed  Google Scholar 

  14. Safra T, Muggia F, Jeffers S, Tsao-Wei DD, Groshen S, Lyass O, Henderson R, Berry G, Gabizon A (2000) Pegylated liposomal doxorubicin (Doxil): reduced clinical cardiotoxicity in patients reaching or exceeding cumulative doses of 500 mg/m2. Ann Oncol 11:1029–1033

    Article  CAS  PubMed  Google Scholar 

  15. Mavroudis D, Kouroussis C, Kakolyris S, Agelaki S, Kalbakis K, Androulakis N, Souglakos J, Samonis G, Georgoulias V (2002) Phase I study of paclitaxel (Taxol) and pegylated liposomal doxorubicin (Caelyx) administered every 2 weeks in patients with advanced solid tumors. Oncology 62:216–222

    Article  CAS  PubMed  Google Scholar 

  16. Tolis C, Briasoulis E, Tzamakou E, Rammou D, Karavasilis V, Piperidou CH, Soulti K, Pavlidis N (2000) Phase I trial and interaction pharmacokinetics of pegylated-liposomal doxorubicin (Caelyx; Doxil) and weekly Taxol (abstract 803). Proceedings Annual Meeting of the American Society of Clinical Oncology

  17. Briasoulis E, Rammou D, Tzamakou E, Karavasilis V, Ioannidou A, Soulti K, Pavlidis N (2000) Pegylated-liposomal doxorubicin (Caelyx) plus weekly docetaxel (Taxotere): a phase I and pharmacokinetic study. Ann Oncol 11:134

    Article  Google Scholar 

  18. Gabizon AA, Barenholz Y, Bialer M (1993) Prolongation of the circulation time of doxorubicin encapsulated in liposomes containing a polyethylene glycol-derivatized phospholipid: pharmacokinetic studies in rodents and dogs. Pharm Res 10:703–708

    Article  CAS  PubMed  Google Scholar 

  19. Gabizon A, Catane R, Uziely B, Kaufman B, Safra T, Cohen R, Martin F, Huang A, Barenholz Y (1994) Prolonged circulation time and enhanced accumulation in malignant exudates of doxorubicin encapsulated in polyethylene-glycol coated liposomes. Cancer Res 54:987–992

    CAS  PubMed  Google Scholar 

  20. Symon Z, Peyser A, Tzemach D, Lyass O, Sucher E, Shezen E, Gabizon A (1999) Selective delivery of doxorubicin to patients with breast carcinoma metastases by stealth liposomes. Cancer 86:72–78

    Article  CAS  PubMed  Google Scholar 

  21. Gabizon A, Shmeeda H, Barenholz Y (2003) Pharmacokinetics of pegylated liposomal doxorubicin: review of animal and human studies. Clin Pharmacokinet 42:419–436

    CAS  PubMed  Google Scholar 

  22. Gogas H, Papadimitriou C, Kalofonos HP, Bafaloukos D, Fountzilas G, Tsavdaridis D, Anagnostopoulos A, Onyenadum A, Papakostas P, Economopoulos T, Christodoulou C, Kosmidis P, Markopoulos C (2002) Neoadjuvant chemotherapy with a combination of pegylated liposomal doxorubicin (Caelyx) and paclitaxel in locally advanced breast cancer: a phase II study by the Hellenic Cooperative Oncology Group. Ann Oncol 13:1737–1742

    Article  CAS  PubMed  Google Scholar 

  23. Campos SM, Matulonis UA, Penson RT, Lee H, Berkowitz RS, Duska LR, Fuller AF, Wilson KS, Puchalski TA, Supko JG, Seiden MV (2003) Phase II study of liposomal doxorubicin and weekly paclitaxel for recurrent Mullerian tumors. Gynecol Oncol 90:610–618

    Article  CAS  PubMed  Google Scholar 

  24. Holmes FA, Rowinsky EK (2001) Pharmacokinetic profiles of doxorubicin in combination with taxanes. Semin Oncol 28:8–14

    Article  CAS  Google Scholar 

  25. Badary OA, Al Shabanah OA, Al Gharably NM, Elmazar MM (1998) Effect of Cremophor EL on the pharmacokinetics, antitumor activity and toxicity of doxorubicin in mice. Anticancer Drugs 9:809–815

    CAS  PubMed  Google Scholar 

  26. Millward MJ, Webster LK, Rischin D, Stokes KH, Toner GC, Bishop JF, Olver IN, Linahan BM, Linsenmeyer ME, Woodcock DM (1998) Phase I trial of Cremophor EL with bolus doxorubicin. Clin Cancer Res 4:2321–2329

    CAS  PubMed  Google Scholar 

  27. Ozpolat B, Lopez-Berestein G, Adamson P, Fu CJ, Williams AH (2003) Pharmacokinetics of intravenously administered liposomal all-trans-retinoic acid (ATRA) and orally administered ATRA in healthy volunteers. J Pharm Pharm Sci 6:292–301

    CAS  PubMed  Google Scholar 

  28. Keefe DL (2002) Trastuzumab-associated cardiotoxicity. Cancer 95:1592–1600

    Article  CAS  PubMed  Google Scholar 

  29. Jerian S, Keegan P (1999) Cardiotoxicity associated with paclitaxel/trastuzumab combination therapy. J Clin Oncol 17:1647–1648

    CAS  PubMed  Google Scholar 

  30. Horton J (2002) Trastuzumab use in breast cancer: clinical issues. Cancer Control 9:499–507

    PubMed  Google Scholar 

  31. Haq MM, Legha SS, Choksi J, Hortobagyi GN, Benjamin RS, Ewer M, Ali M (1985) Doxorubicin-induced congestive heart failure in adults. Cancer 56:1361–1365

    CAS  PubMed  Google Scholar 

  32. Rahman A, More N, Schein PS (1982) Doxorubicin-induced chronic cardiotoxicity and its protection by liposomal administration. Cancer Res 42:1817–1825

    Google Scholar 

  33. Batist G, Ramakrishnan G, Rao CS, Chandrasekharan A, Gutheil J, Guthrie T, Shah P, Khojasteh A, Nair MK, Hoelzer K, Tkaczuk K, Park YC, Lee LW (2001) Reduced cardiotoxicity and preserved antitumor efficacy of liposome-encapsulated doxorubicin and cyclophosphamide compared with conventional doxorubicin and cyclophosphamide in a randomized, multicenter trial of metastatic breast cancer. J Clin Oncol 19:1444–1454

    CAS  PubMed  Google Scholar 

  34. Sparano JA, Malik U, Rajdev L, Sarta C, Hopkins U, Wolff AC (2001) Phase I trial of pegylated liposomal doxorubicin and docetaxel in advanced breast cancer. J Clin Oncol 19:3117–3125

    CAS  PubMed  Google Scholar 

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Acknowledgement

We thank statistician Afroditi Katsaraki for consultation on statistical analysis of this study.

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Correspondence to Evangelos Briasoulis.

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Briasoulis, E., Karavasilis, V., Tzamakou, E. et al. Interaction pharmacokinetics of pegylated liposomal doxorubicin (Caelyx) on coadministration with paclitaxel or docetaxel. Cancer Chemother Pharmacol 53, 452–457 (2004). https://doi.org/10.1007/s00280-003-0750-5

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  • DOI: https://doi.org/10.1007/s00280-003-0750-5

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