生理藥代動力學模型在EGFR-TKI精準治療中的應用進展

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中圖分類號R969.1;R969.3 文獻標志碼A 文章編號1001-0408(2025)08-1013-06
DOI 10.6039/j.issn.1001-0408.2025.08.22
Advances in the application of physiologically-based pharmacokinetic model in EGFR-TKI precision therapy
YANG Yingying',SHAO Jiaqi'2,XIANG Qiulin',LI Guoxing',YU Xian'(1. Phase I Clinical Trial Center, the Second Ailiated Hospital of Chongqing Medical University, Chongqing 400o60,China; 2.College of Pharmacy,Chongqing Medical University, Chongqing 400016,China)
ABSTRACTEpidermalgrowthfactorreceptor-tyrosinekinase inhibitor(EGFR-TKI)representaclassof small-molecule targeted therapeuticsforoncologytreatmentandserveafrst-linetherapyforadvancednonsmallcellungcancer(NSCLC)withEGFRsensitivemutations,withrepresentativeagentsincludinggefitinib,dacomitinib,andosimertinibInclinicalpractice,dose adjustmentofEGFR-TKImay be required forcancer patients under specialcircumstances suchas drug combinationsorhepatic/ renalmpairment.Physiologically-basedphamacokinetic(PBPK)model,capableofpredicting pharmacokinetic(PK)procesesin humans,hasemergedasavitaltolforclinicaldoseptimizationThiarticlesortsthemodelingmethodologiesworkflowsand commonly usedsoftwaretoosforPBPKmodelandsummarizesthecurrent applicationsofPBPKmodelinEGFR-KIprecision therapyasofJune 30,2024.Findings demonstratethat PBPK modeling methodscommonlyemploythe“botom-up"approach and themidle-outapproach.The processtypicallinvolvesfoursteps:parametercolectin,ompartment selection,modelalidatio, andmodeaplication.Commonlyusedsoftwarefor modeling includes Simcyp,GastroPlus,andopen-sourcesoftwaresuchasPKSim.PBPKmodelcanbeutilizedfor predictingdrug-drug interactionsof EGFR-TKIco-administered withmetabolic enzyme inducersorinhibitors,acid-suppressivedrugs,ortraditionalChineseandWestermmedicines.Itcanalsoadjustdosagesin conjunctionwithgenomics,predictPKprocesses inspecialpopulations(suchas patientswithliverorkidneydysfunctionpediatric patients),evaluatethe efficacyand safety of drugs,and extrapolate PK predictions fromanimal models to humans.
KEYWODSphysiologicall-based pharmacokinetic model;EGFR-TKI;precision treatment;drug interaction;non-smallcell lung cancer
表皮生長因子受體(epidermal growth factor receptor,EGFR)基因突變是非小細胞肺癌(non-smallcell lungcancer,NSCLC)常見的致癌驅(qū)動突變,EGFR突變會顯著增強腫瘤細胞的生長和分裂能力,加速腫瘤發(fā)展。(剩余13989字)