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The interactions of lenalidomide with human uptake and efflux transporters and UDP-glucuronosyltransferase 1A1: lack of potential for drug–drug interactions

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Abstract

Purpose

Lenalidomide is an immunomodulatory agent used for the treatment of myelodysplastic syndromes and multiple myeloma. Renal clearance of lenalidomide is the predominant elimination route and is approximately twofold greater than the glomerular filtration rate (GFR), suggesting the potential contribution of an active secretory mechanism. In vitro studies were conducted to examine whether lenalidomide is a substrate of drug transporters, namely P-glycoprotein (P-gp), human breast cancer resistance protein (BCRP), multidrug resistance proteins (MRP1, MRP2, MRP3), organic anion transporters (OAT1, OAT3), organic cation transporters (OCT1 and OCT2), human organic cation transporter novel 1 and 2 (OCTN1 and OCTN2), multidrug and toxin extrusion (MATE1) and organic anion transporting polypeptide (OATP1B1). Lenalidomide was also evaluated as an inhibitor of P-gp, BCRP, MRP2, OCT2, OAT1, OAT3, OATP1B1, OATP1B3 and bile salt export pump (BSEP). In addition, inhibition of UDP-glucuronosyltransferase 1A1 (UGT1A1) variants by lenalidomide was also assessed.

Method

Cells or vesicles expressing each of the human transporters were used for uptake and inhibition studies, with appropriate probe substrates and known inhibitors.

Results

Results of these studies indicate that the lenalidomide is not a substrate for the transporters examined, except that it is weak substrate of P-gp. None of the transporters studied were inhibited by lenalidomide. Lenalidomide is not an inhibitor of UGT1A1*1/*1 or its polymorphic variants UGT1A1*1/*28 and UGT1A1*28/*28.

Conclusions

Drug interactions are unlikely to occur when lenalidomide is co-administered with substrates or inhibitors of these transporters. In addition, lenalidomide is unlikely to cause interactions when co-administered with substrates of UGT1A1.

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References

  1. Zhu YX, Kortuem KM, Stewark AK (2013) Molecular mechanism of action of immune-modulatory drugs thalidomide, lenalidomide and pomalidomide in multiple myeloma. Leuk Lymphoma 54(4):683–687

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  2. Chen N, Wen L, Lau H, Surapaneni S, Kumar G (2012) Pharmacokinetics, metabolism and excretion of [14C]-lenalidomide following oral administration in healthy male subjects. Cancer Chemother Pharmacol 69:789–797

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  3. Kumar G, Lau H, Laskin OL (2009) Lenalidomide: in vitro evaluation of the metabolism and assessment of cytochrome P450 inhibition and induction. Cancer Chemother Pharmacol 63:1171–1175

    Article  PubMed  CAS  Google Scholar 

  4. Chen N, Lau H, Kong L, Kumar G, Zeldis JB, Knight R, Laskin OL (2007) Pharmacokinetics of lenalidomide in subjects with various degrees of renal impairment and in subjects on hemodialysis. J Clin Pharmacol 47:1466–1475

    Article  PubMed  CAS  Google Scholar 

  5. Giacomini KM, Huang SM, Tweedie DJ, Benet LZ, Brouwer KL, Chu X, Dahlin A, Evers R, Fischer V, Hillgren KM, Hoffmaster KA, Ishikawa T, Keppler D, Kim RB, Lee CA, Niemi M, JPolli JW, Sugiyama Y, Swaan PW, Ware JA, Wright SH, Yee SW, Zamek-Gliszczynski MJ, Zhang L (2010) Membrane transporters in drug development. Nat Rev Drug Discov 9:215–236

    Article  PubMed  CAS  Google Scholar 

  6. Guidance for Industry (2012) (Draft): Drug interaction studies-study design, data analysis, implications for dosing, and labeling recommendations. http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm064982.htm. Accessed 18 Feb 2012

  7. European Medicines Agency’s Guideline on the Investigation of Drug Interactions (2012) http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2012/07/WC500129606.pdf. Accessed 7 June 2012

  8. Zamek-Gliszczynski MJ, Hoffmaster KA, Tweedie DJ, Giacomini KM, Hillgren KM (2012) Highlights from the International Transporter Consortium second workshop. Clin Pharmacol Ther 92:553–556

    Article  PubMed  CAS  Google Scholar 

  9. Hillgren KM, Keppler D, Zur A, Giacomini KM, Stieger B, Cass CE, Zhang L (2013) Emerging transporters of clinical importance: an update from the international transporter consortium. Clin Pharmacol Ther 94(1):52–63

    Article  PubMed  CAS  Google Scholar 

  10. Simmondsen KA, Kolesar JM (2012) Lenalidomide-induced elavated bilirubin. J Oncol Pharm Pract 18(4):402–405

    Article  Google Scholar 

  11. Zhang D, Cui D, Gambardella J, Ma L, Barros A, Wang L, Fu Y, Rahematpura S, Nielsen J, Donegan M, Zhang H, Humphreys WG (2007) Characterization of the UDP glucuronosyltransferase activity of human liver microsomes genotyped for the UGT1A1*28 polymorphism. Drug Metab Dispos 35(12):2270–2280

    Article  PubMed  CAS  Google Scholar 

  12. Riedmaier AE, Nies AT, Schaeffeler E, Schwab M (2012) Organic anion transporters and their implications in pharmacotherapy. Pharmacol Rev 64:421–449

    Article  CAS  Google Scholar 

  13. Koepsell H (2013) The SLC22 family with transporters of organic cations, anions and zwitterions. Mol Aspects Med 34:413–435

    Article  PubMed  CAS  Google Scholar 

  14. Hofmeister CC, Yang X, Pichiorri F, Chen P, Rozewski DM, Johnson AJ, Lee S, Liu Z, Garr CL, Hade EM, Ji J, Schaaf LJ, Benson DM Jr, Kraut EH, Hicks WJ, Chan KK, Chen CS, Farag SS, Grever MR, Byrd JC, Phelps MA (2011) Phase I Trial of lenalidomide and CCI-779 in patients with relapsed multiple myeloma: evidence for lenalidomide-CCI-779 Interaction via P-glycoprotein. J Clin Oncol 29(25):3427–3434

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  15. Takahashi N, Miura M, Kameoka Y, Abumiya M, Sawada K (2012) Drug interaction between lenalidomide and itraconazole. Am J Hematol 87(3):338–339

    Article  PubMed  Google Scholar 

  16. Chen N, Kasserra C, Kumar G, Palmisano M (2012) Evidence does not support clinically significant lenalidomide-CCI-779 interaction via P-glycoprotein. J Clin Oncol 30(3):340–341

    Article  PubMed  CAS  Google Scholar 

  17. Fenner KS, Troutman MD, Kempshall S, Cook JA, Ware JA, Smith DA, Lee CA (2009) Drug–drug interactions mediated through P-glycoprotein: clinical relevance and in vitro-in vivo correlation using digoxin as a probe drug. Clin Pharmacol Ther 85(2):173–181

    Article  PubMed  CAS  Google Scholar 

  18. Lankisch TO, Moebius U, Wehmeier M, Behrens G, Manns MP, Schmidt RE, Strassburg CP (2006) Gilbert’s disease and atazanavir: from phenotype to UDP-glucuronosyltransferase haplotype. Hepatology 44(5):1324–1332

    Article  PubMed  CAS  Google Scholar 

  19. Meza-Junco J, Chu QS, Christensen O, Rajagopalan P, Das S, Stefanyschyn R, Sawyer MB (2009) UGT1A1 polymorphism and hyperbilirubinemia in a patient who received sorafenib. Cancer Chemother Pharmacol 65(1):1–4

    Article  PubMed  Google Scholar 

  20. Culley CL, Kiang TK, Gilchrist SE, Ensom MH (2013) Effect of the UGT1A1*28 allele on unconjugated hyperbilirubinemia in HIV-positive patients receiving atazanavir: a systematic review. Ann Pharmacother 47(4):561–572

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Zeen Tong.

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Tong, Z., Yerramilli, U., Surapaneni, S. et al. The interactions of lenalidomide with human uptake and efflux transporters and UDP-glucuronosyltransferase 1A1: lack of potential for drug–drug interactions. Cancer Chemother Pharmacol 73, 869–874 (2014). https://doi.org/10.1007/s00280-014-2415-y

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  • DOI: https://doi.org/10.1007/s00280-014-2415-y

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