Pharmacokinetics and Pharmacodynamics of PARP Inhibitors in Oncology.

Article Details

Citation

Bruin MAC, Sonke GS, Beijnen JH, Huitema ADR

Pharmacokinetics and Pharmacodynamics of PARP Inhibitors in Oncology.

Clin Pharmacokinet. 2022 Dec;61(12):1649-1675. doi: 10.1007/s40262-022-01167-6. Epub 2022 Oct 11.

PubMed ID
36219340 [ View in PubMed
]
Abstract

Olaparib, niraparib, rucaparib, and talazoparib are poly (ADP-ribose) polymerase (PARP) inhibitors approved for the treatment of ovarian, breast, pancreatic, and/or prostate cancer. Poly (ADP-ribose) polymerase inhibitors are potent inhibitors of the PARP enzymes with comparable half-maximal inhibitory concentrations in the nanomolar range. Olaparib and rucaparib are orally dosed twice a day, extensively metabolized by cytochrome P450 enzymes, and inhibitors of several enzymes and drug transporters with a high risk for drug-drug interactions. Niraparib and talazoparib are orally dosed once a day with a lower risk for niraparib and a minimal risk for talazoparib to cause drug-drug interactions. All four PARP inhibitors show moderate-to-high interindividual variability in plasma exposure. Higher exposure is associated with an increase in toxicity, mostly hematological toxicity. For talazoparib, exposure-efficacy relationships have been described, but for olaparib, niraparib, and rucaparib this relationship remains inconclusive. Further studies are required to investigate exposure-response relationships to improve dosing of PARP inhibitors, in which therapeutic drug monitoring could play an important role. In this review, we give an overview of the pharmacokinetic properties of the four PARP inhibitors, including considerations for patients with renal dysfunction or hepatic impairment, the effect of food, and drug-drug interactions. Furthermore, we focus on the pharmacodynamics and summarize the available exposure-efficacy and exposure-toxicity relationships.

DrugBank Data that Cites this Article

Drug Transporters
DrugTransporterKindOrganismPharmacological ActionActions
TalazoparibATP-binding cassette sub-family G member 2ProteinHumans
Unknown
Substrate
Details
TalazoparibP-glycoprotein 1ProteinHumans
Unknown
Substrate
Details
Drug Interactions
DrugsInteraction
Talazoparib
Lumacaftor
The serum concentration of Talazoparib can be increased when it is combined with Lumacaftor.
Talazoparib
Isavuconazole
The serum concentration of Talazoparib can be increased when it is combined with Isavuconazole.
Talazoparib
Vandetanib
The serum concentration of Talazoparib can be increased when it is combined with Vandetanib.
Talazoparib
Palbociclib
The serum concentration of Talazoparib can be increased when it is combined with Palbociclib.
Talazoparib
Dacomitinib
The serum concentration of Talazoparib can be increased when it is combined with Dacomitinib.