Digital Features for this article can be found at https://doi.org/10.6084/m9.figshare.16674397. |
Darolutamide is an oral androgen receptor inhibitor approved for men with nonmetastatic castration-resistant prostate cancer. Optimal use of darolutamide depends on the understanding of its pharmacokinetics; the present article therefore provides information on the absorption, distribution, and elimination of the compound. |
Darolutamide is a mixture of two stereoisomers (diastereomers), which exhibit similar properties and contribute equally and interchangeably to the efficacy and safety of darolutamide. |
Following oral administration of darolutamide as a tablet to healthy subjects, it is gradually absorbed, well distributed, and eliminated with a relatively short effective half-life. Sustainable steady-state concentrations are achieved within ~ 2 days, indicating that darolutamide will start working quickly and that drug exposure can be easily adjusted if necessary. Darolutamide and its metabolites are processed and eliminated via the liver and kidneys, resulting in recommended dose adjustments in patients with severe renal or moderate hepatic impairment. |
1 Introduction
2 Methods
2.1 Study Populations
Study | Dose | Subjectsa | Baseline characteristics (pharmacokinetic populations) | |
---|---|---|---|---|
Age in years, mean (SD) [range] | BMI in kg/m2, mean (SD) | |||
PK/bioavailability (ARIADME) | Part 1: 1 × 300 mg oral, fasted (tablet) + 1 × 100 µg IV (14C-labeled) Part 2: 1 × 300 mg oral (14C-labeled), fasted (solution) | 12 healthy male individuals (6 in Part 1 and 6 in Part 2) | 55.5 (5.54) [50–65] | 28.0 (2.86) |
Single-dose and multiple-dose PKb (Study 17723) | Day 1: 1 × 600 mg oral, fed (tablet) Days 4–7: 600 mg BID oral, fed (tablet) | 15 healthy male individuals | 52.5 (3.4) [47–58] | 24.8 (2.0) |
Renal and hepatic impairment (Study 17721) | 1 × 600 mg oral, fed (tablet) | 29 male individuals: | 64.4 (8.1) [52–78] | 28.8 (3.46) |
10 healthy subjects | 61.5 (6.5) [55–73] | 29.3 (2.77) | ||
9 patients without cancer with moderate hepatic impairment (Child-Pugh B) | 64.3 (8.8) [52–78] | 28.4 (4.29) | ||
10 patients without cancer with severe renal impairmentc | 67.3 (8.6) [53–76] | 28.7 (3.58) |
2.2 Pharmacokinetic and Analytical Methods
2.3 Study Designs
2.3.1 Pharmacokinetics and Bioavailability Study
2.3.2 Single-Dose and Multiple-Dose Pharmacokinetics
2.3.3 Hepatic and Renal Impairment Study
3 Results
3.1 Participants
3.2 Absolute and Relative Bioavailability
Parameter | Darolutamide 300 mg as oral tablet (n = 6) | Darolutamide 300 mg as oral 14C-solution (n = 6) | Darolutamide 100 μg as IV 14C-microtracer dose (n = 6) |
---|---|---|---|
Cmax, ng/mL | 800 (25.0) | 3824 (19.0) | 4127 (27.4)a |
tmax, h | 3.50 (2.00–4.10) | 1.58 (1.02–3.00) | 0.25 (0.25–0.25) |
AUC0–tlast, ng⋅h/mL | 12,417 (35.6) | 45,323 (21.2) | 12,659 (38.2)a |
AUC0–inf, ng⋅h/mL | 12,898 (36.2) | 45,573 (21.3) | 13,645 (39.5)a |
t½, h | 15.3 (29.3) | 10.6 (22.6) | 11.8 (31.1) |
CL/F, mL/min | 388 (36.2) | 110 (21.3) | NC |
CL, mL/minb | NC | NC | 116 (39.7) |
CLR, mL/min | 6.52 (10.2) | 7.73 (20.5) | NC |
Vd, mL | NC | NC | 118,930 (28.9) |
Vd/F, mL | 513,569 (38.1) | 100,863 (39.2) | NC |
F | 0.299 (19.4) | 0.989 (21.3) | NC |
3.3 Diastereomer Interconversion
3.4 Distribution
3.5 Single-Dose and Multiple-Dose Pharmacokinetics
Parameter | Geometric mean/geometric CV% (range) | ||||
---|---|---|---|---|---|
Darolutamide (n = 15) | (S,R)-darolutamide (n = 15) | (S,S)-darolutamide (n = 15) | Keto-darolutamide (n = 15) | ||
Day 1 (single dose) | Cmax, ng/mL | 1.77/26.4 (1.14–3.05) | 553/33.5 (340–1010) | 1.33/22.4 (0.910–2.04) | 3.96/32.4 (2.51–8.66) |
tmax, ha | 5.97 (2.50–7.95) | 3.97 (1.02–6.02) | 5.98 (2.50–8.00) | 4.00 (2.50–6.02) | |
AUC0–12, µg⋅h/mL | 13.6/25.7 (8.90–21.1) | 3.15/29.1 (1.85–5.42) | 10.4/25.4 (6.60–15.6) | 29.3/29.9 (19.0–58.2) | |
AUC0–inf, µg⋅h/mL | 26.2/22.4 (16.7–36.0) | 4.26/25.9 (2.53–6.93) | 22.1/22.5 (13.6–29.4) | 53.9/28.5 (32.6–91.3) | |
AUC0–tlast, µg⋅h/mL | 25.8/22.1 (16.5–35.0) | 4.11/26.2 (2.46–6.63) | 21.6/22.0 (13.4–28.9) | 52.8/28.4 (32.4–88.7) | |
Terminal t½, h | 11.6/32.7 (6.63–18.9) | 14.5/70.0 (4.03–31.3) | 12.4/37.0 (6.63–20.8) | 12.9/54.4 (5.69–34.6) | |
Day 7 (multiple doses) | Cmax, ng/mL | 3.33/20.8 (2.28–4.31) | 684/31.5 (417–1050) | 2.71/18.8 (1.93–3.58) | 7.98/33.4 (3.66–12.3) |
tmax, ha | 3.98 (2.00–5.98) | 3.00 (0.967–4.00) | 3.98 (0.00–6.02) | 3.00 (1.48–5.97) | |
AUC0–12, µg⋅h/mL | 28.8/22.1 (20.2–37.1) | 3.91/30.1 (2.07–5.85) | 24.8/21.7 (17.6–31.8) | 65.9/33.6 (29.1–110) | |
Effective t½b | 13.0 | 5.08 | 15.3 | 14.1 | |
RAAUC | 2.1 | 1.2 | 2.3 | 2.2 | |
RACmax | 1.9 | 1.2 | 2.0 | 2.0 | |
RLIN | 1.1 | 0.9 | 1.1 | 1.2 |
3.6 Effects of Hepatic and Renal Impairment on the Pharmacokinetics of Darolutamide
Parameter | Geometric mean/geometric CV% (range) | ||
---|---|---|---|
Healthy subjects (n = 10) | Moderate hepatic impairment (n = 9) | Severe renal impairment (n = 10) | |
Cmax, µg/mL | 1.56/37.3 (0.68–2.37) | 2.27/38.7 (1.30–4.72) | 2.47/30.7 (1.44–3.33) |
tmax, ha | 4.00 (3.02–12.0) | 4.00 (4.00–8.00) | 4.00 (3.00–12.0) |
AUC0–48, µg⋅h/mL | 21.3/41.9 (8.25–37.8) | 39.4/36.5 (23.2–67.0) | 52.5/38.9 (28.3–82.3) |
AUC0–inf, µg⋅h/mL | 23.3/43.4 (8.93–42.6) | 45.9/44.6 (24.0–72.9)b | 67.6/41.9 (31.2–107)b |
t½, h | 13.6/18.2 (10.8–20.7) | 13.7/35.4 (9.63–24.6)b | 17.7/16.1 (13.8–22.8)b |
Fraction unbound, % | 7.79/8.78 (6.49–8.81) | 8.79/11.1 (7.29–10.6) | 8.06/11.8 (6.36–8.95) |