Human clearance prediction for small- and macro-molecule drugs was evaluated and compared using various scaling methods and statistical analysis.Human clearance is generally well predicted using single or multiple species simple allometry for macro- and small-molecule drugs excreted renally.The prediction error is higher for hepatically eliminated small-molecules using single or multiple species simple allometry scaling, and it appears that the prediction error is mainly associated with drugs with low hepatic extraction ratio (Eh). The error in human clearance prediction for hepatically eliminated small-molecules was reduced using scaling methods with a correction of maximum life span (MLP) or brain weight (BRW).Human clearance of both small- and macro-molecule drugs is well predicted using the monkey liver blood flow method. Predictions using liver blood flow from other species did not work as well, especially for the small-molecule drugs.
Ixazomib has no clinically meaningful effects on QTc or HR. Integrating preclinical data and concentration-QTc modeling of phase 1 data may obviate the need for a dedicated QTc study in oncology. A framework for QT assessment in oncology drug development is proposed.
Parametric models used in time to event analyses are evaluated typically by survival-based visual predictive checks (VPC). Kaplan-Meier survival curves for the observed data are compared with those estimated using model-simulated data. Because the derivative of the log of the survival curve is related to the hazard--the typical quantity modeled in parametric analysis--isolation, interpretation and correction of deficiencies in the hazard model determined by inspection of survival-based VPC's is indirect and thus more difficult. The purpose of this study is to assess the performance of nonparametric hazard estimators of hazard functions to evaluate their viability as VPC diagnostics. Histogram-based and kernel-smoothing estimators were evaluated in terms of bias of estimating the hazard for Weibull and bathtub-shape hazard scenarios. After the evaluation of bias, these nonparametric estimators were assessed as a method for VPC evaluation of the hazard model. The results showed that nonparametric hazard estimators performed reasonably at the sample sizes studied with greater bias near the boundaries (time equal to 0 and last observation) as expected. Flexible bandwidth and boundary correction methods reduced these biases. All the nonparametric estimators indicated a misfit of the Weibull model when the true hazard was a bathtub shape. Overall, hazard-based VPC plots enabled more direct interpretation of the VPC results compared to survival-based VPC plots.
In concentration-QTc modeling, oscillatory functions have been used to characterize biological rhythms in QTc profiles. Fitting such functions is not always feasible because it requires sufficient electrocardiograph sampling. In this study, drug concentration and QTc data were simulated using a published biological QTc model (oscillatory functions). Then, linear mixed-effect models and the biological model were fitted and evaluated in terms of biases, precisions, and qualities of inferences. The simpler linear mixed-effect model with day and time as a factor variables provided similar accuracy of the concentration-QTc slope estimates to the complex biological model and was able to accurately predict the drug-induced QTc prolongation with less than 1 ms bias, despite its empirical nature to account for biological rhythm. The current study may guide a concentration-QTc modeling strategy that can be easily prespecified, does not suffer from poor convergence, and achieves little bias in drug-induced QTc estimates.
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