Effects of Food, Gastric Acid Reduction, and Strong CYP3A Induction on the Pharmacokinetics of Tasurgratinib, a Novel Selective Fibroblast Growth Factor Receptor Inhibitor

J Clin Pharmacol. 2024 Dec;64(12):1541-1551. doi: 10.1002/jcph.6104. Epub 2024 Aug 1.

Abstract

We conducted this three-part study in healthy subjects to investigate the pharmacokinetics of tasurgratinib (orally available selective inhibitor of fibroblast growth factor receptor 1-3) and M2 (its major metabolite) under different conditions. In Part A, subjects received tasurgratinib 35 mg either fed with a high-fat meal or fasted. In Parts B and C, subjects received tasurgratinib 35 mg alone or with either rabeprazole (acid-reducing agent) 20 mg (Part B) or rifampin (strong CYP3A inducer) 600 mg (Part C). Primary endpoints were maximum concentration (Cmax), and areas under the plasma concentration-time curve to time of last quantifiable concentration (AUC(0-t)) and extrapolated to infinite time (AUC(0-inf)). Forty-two subjects were enrolled, 14 each into Parts A, B, and C. In Part A, administration of tasurgratinib with a high-fat meal resulted in 33% reduction in Cmax and ∼23% reduction in AUC(0-t) and AUC(0-inf) of tasurgratinib, and 47% reduction in Cmax with ∼30% reduction in AUC(0-t) and AUC(0-inf) of M2. In Part B, co-administration of rabeprazole at steady state resulted in no/weak interaction with tasurgratinib (∼8% increase in AUC(0-t) and AUC(0-inf) without an effect on Cmax) and M2 (∼18% increase in AUC(0-t) and AUC(0-inf) without an effect on Cmax). In Part C, co-administration of rifampin at steady state resulted in a weak interaction with tasurgratinib (∼16% reduction in AUC(0-t) and AUC(0-inf)) and M2 (∼12% reduction in AUC(0-t) and AUC(0-inf)). Administration of tasurgratinib with a high-fat meal appeared to reduce systemic exposure of tasurgratinib, however co-administration with an acid-reducing agent or a CYP3A inducer had a minimal impact on pharmacokinetics.

Keywords: FGFR; drug‐drug interactions; food effect; pharmacokinetics; tasurgratinib.

Publication types

  • Randomized Controlled Trial
  • Clinical Trial, Phase I

MeSH terms

  • Adult
  • Area Under Curve
  • Cross-Over Studies
  • Cytochrome P-450 CYP3A / metabolism
  • Cytochrome P-450 CYP3A Inducers* / pharmacology
  • Drug Interactions
  • Fasting / metabolism
  • Female
  • Food-Drug Interactions*
  • Gastric Acid / metabolism
  • Humans
  • Male
  • Middle Aged
  • Pyrroles
  • Rabeprazole* / administration & dosage
  • Rabeprazole* / pharmacokinetics
  • Rabeprazole* / pharmacology
  • Receptors, Fibroblast Growth Factor / antagonists & inhibitors
  • Rifampin / pharmacokinetics
  • Rifampin / pharmacology
  • Sulfonamides / administration & dosage
  • Sulfonamides / pharmacokinetics
  • Young Adult

Substances

  • Cytochrome P-450 CYP3A Inducers
  • Rabeprazole
  • Receptors, Fibroblast Growth Factor
  • Rifampin
  • Cytochrome P-450 CYP3A
  • Sulfonamides
  • 1-(5-(2-fluorophenyl)-1-(pyridin-3-ylsulfonyl)-1H-pyrrol-3-yl)-N-methylmethanamine
  • Pyrroles