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中国临床药理学与治疗学 ›› 2020, Vol. 25 ›› Issue (4): 408-412.doi: 10.12092/j.issn.1009-2501.2020.04.009

• 定量药理学 • 上一篇    下一篇

从纳武利尤单抗用法用量变更看模型引导的药物开发方法在剂量优化中的应用

李 健,闫 方,杨进波,王玉珠   

  1. 国家药品监督管理局 药品审评中心,北京 100022
  • 收稿日期:2020-03-16 修回日期:2020-03-08 出版日期:2020-04-26 发布日期:2020-05-12
  • 通讯作者: 王玉珠,博士,研究员,主要从事临床药理技术审评工作。 Tel:010-85243204 E-mail: wangyzh@cde.org.cn
  • 作者简介:李健,博士,助理研究员,主要从事临床药理技术审评工作。 Tel:010-85243199 E-mail: lijian@cde.org.cn

Application of model-informed drug development approach in dose optimization: Insights from the modification of nivolumab dosage regimen

LI Jian, YAN Fang, YANG Jinbo, WANG Yuzhu   

  1. Center of Drug Evaluation, National Medical Products Administration, Beijing 100022, China
  • Received:2020-03-16 Revised:2020-03-08 Online:2020-04-26 Published:2020-05-12

摘要: 纳武利尤单抗是一种针对细胞程序化死亡-1(PD-1)受体的人源化单克隆抗体,2014年美国食品药品管理局(FDA)初始批准的用法用量为3 mg/kg每2周一次(Q2W),2016年变更为固定剂量240 mg Q2W,后于2018年获得批准使用480 mg Q4W。基于已有临床研究数据,采用模型引导的药物开发(MIDD)方法对药物暴露量、安全性和有效性进行分析的结果,是支持监管部门批准纳武利尤单抗新用法用量的关键证据。本文分析了纳武利尤单抗最初上市以及后续2次剂量变更过程中的相关研究内容和评价考虑,讨论了MIDD方法在剂量优化中的应用。

关键词: 纳武利尤单抗, 模型引导的药物开发, 量效关系, 剂量优化

Abstract: Nivolumab is a humanized monoclonal antibody that blocks the programmed death 1 (PD-1) receptor. The initially recommended dose was 3 mg/kg every 2 weeks (Q2W) when nivolumab was firstly approved by the US FDA in 2014. A flat dose of 240 mg Q2W was approved in 2016, and subsequently 480 mg Q4W in 2018. Model-informed drug development (MIDD) approach was applied for the analyses of drug exposure, safety and efficacy based on the data from existed clinical studies, and the model-informed analyses became the key evidences supporting approval of new dosage regimens. Relevant studies and regulatory considerations related to the nivolumab dose selection and subsequent modification were reviewed in this paper. The application of MIDD approach in dose optimization is additionally discussed.

Key words: nivolumab, model-informed drug development, exposure-response relationship, dose optimization

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