Kavitha Ranganathan1, Eric Simon2, Jeremy Lynn1, Alicia Snider1, Yu Zhang1, Noah Nelson1, Alexis Donneys1, Jose Rodriguez3, Lauren Buchman1, Dawn Reyna2, Elke Lipka2, Steven R Buchman4. 1. Department of Plastic Surgery, University of Michigan, 1540 E. Hospital Dr., Floor 4, Suite 4-730, Ann Arbor, Michigan, 48105, USA. 2. Therapeutic Systems Research Laboratories, Inc., Ann Arbor, Michigan, USA. 3. Department of Plastic Surgery, Carilion Clinic, Roanoke, Virginia,, USA. 4. Department of Plastic Surgery, University of Michigan, 1540 E. Hospital Dr., Floor 4, Suite 4-730, Ann Arbor, Michigan, 48105, USA. sbuchman@med.umich.edu.
Abstract
PURPOSE: Amifostine (AMF), a radioprotectant, is FDA-approved for intravenous administration in cancer patients receiving radiation therapy (XRT). Unfortunately, it remains clinically underutilized due to adverse side effects. The purpose of this study is to define the pharmacokinetic profile of an oral AMF formulation potentially capable of reducing side effects and increasing clinical feasibility. METHODS: Calvarial osteoblasts were radiated under three conditions: no drug, AMF, and WR-1065 (active metabolite). Osteogenic potential of cells was measured using alkaline phosphatase staining. Next, rats were given AMF intravenously or directly into the jejunum, and pharmacokinetic profiles were evaluated. Finally, rats were given AMF orally or subcutaneously, and blood samples were analyzed for pharmacokinetics. RESULTS: WR-1065 preserved osteogenic potential of calvarial osteoblasts after XRT to a greater degree than AMF. Direct jejunal AMF administration incurred a systemic bioavailability of 61.5%. Subcutaneously administrated AMF yielded higher systemic levels, a more rapid peak exposure (0.438 vs. 0.875 h), and greater total systemic exposure of WR-1065 (116,756 vs. 16,874 ng*hr/ml) compared to orally administered AMF. CONCLUSIONS: Orally administered AMF achieves a similar systemic bioavailability and decreased peak plasma level of WR-1065 compared to intravenously administered AMF, suggesting oral AMF formulations maintain radioprotective efficacy without causing onerous side effects, and are clinically feasible.
PURPOSE:Amifostine (AMF), a radioprotectant, is FDA-approved for intravenous administration in cancerpatients receiving radiation therapy (XRT). Unfortunately, it remains clinically underutilized due to adverse side effects. The purpose of this study is to define the pharmacokinetic profile of an oral AMF formulation potentially capable of reducing side effects and increasing clinical feasibility. METHODS: Calvarial osteoblasts were radiated under three conditions: no drug, AMF, and WR-1065 (active metabolite). Osteogenic potential of cells was measured using alkaline phosphatase staining. Next, rats were given AMF intravenously or directly into the jejunum, and pharmacokinetic profiles were evaluated. Finally, rats were given AMF orally or subcutaneously, and blood samples were analyzed for pharmacokinetics. RESULTS: WR-1065 preserved osteogenic potential of calvarial osteoblasts after XRT to a greater degree than AMF. Direct jejunal AMF administration incurred a systemic bioavailability of 61.5%. Subcutaneously administrated AMF yielded higher systemic levels, a more rapid peak exposure (0.438 vs. 0.875 h), and greater total systemic exposure of WR-1065 (116,756 vs. 16,874 ng*hr/ml) compared to orally administered AMF. CONCLUSIONS: Orally administered AMF achieves a similar systemic bioavailability and decreased peak plasma level of WR-1065 compared to intravenously administered AMF, suggesting oral AMF formulations maintain radioprotective efficacy without causing onerous side effects, and are clinically feasible.
Entities:
Keywords:
amifostine; head and neck cancer; hypotension; radiation
Authors: Erin E Page; Sagar S Deshpande; Noah S Nelson; Peter A Felice; Alexis Donneys; Jose J Rodriguez; Samir S Deshpande; Steven R Buchman Journal: J Plast Reconstr Aesthet Surg Date: 2014-08-30 Impact factor: 2.740
Authors: Y Polyatskaya; N S Nelson; J J Rodriguez; A R Zheutlin; S S Deshpande; P A Felice; A Donneys; S R Buchman Journal: J Plast Reconstr Aesthet Surg Date: 2015-10-24 Impact factor: 2.740
Authors: Alexandra O Luby; Chitra Subramanian; Lauren K Buchman; Jeremy V Lynn; Kevin M Urlaub; Noah S Nelson; Alexis Donneys; Mark S Cohen; Steven R Buchman Journal: Ann Plast Surg Date: 2020-10 Impact factor: 1.763