J Clin Pharmacol
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First published on September 24, 2009
The Journal of Clinical Pharmacology 2009, doi:10.1177/0091270009347868
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©© 2009 American College of Clinical Pharmacology, Inc.
The Journal of Clinical Pharmacology, 10.1177/0091270009347868


Article

Pharmacokinetics and Safety of Sunitinib Malate in Subjects With Impaired Renal Function

Reza Khosravan 1*, Melvin Toh 1, May Garrett 1, JoAnn La Fargue 1, Grace Ni 1, Thomas C. Marbury 2, Suzanne K. Swan 3, Norman M. Lunde 4, and Carlo L. Bello 1

1 Pfizer
2 Orlando Clinical Research Center
3 DaVita Clinical Research and Hennepin County Medical Center
4 Twin Cities Clinical Research

* To whom correspondence should be addressed. E-mail: Reza.Khosravan{at}Pfizer.com.


   Abstract
This phase I, open-label, single-dose study evaluates the effects of severe renal impairment and end-stage renal disease (ESRD) requiring hemodialysis on the pharmacokinetics, safety, and tolerability of sunitinib and its primary active metabolite, SU12662. Subjects with normal renal function (creatinine clearance > 80 mL/min), severe renal impairment (creatinine clearance < 30 mL/min), and ESRD requiring hemodialysis receive a single dose of sunitinib 50 mg. Serial blood samples are collected for quantification of plasma concentrations using a validated liquid chromatography with tandem mass spectrometry assay. Safety is monitored. Twenty-four subjects complete the study. Pharmacokinetics in subjects with severe renal impairment appear similar to those with normal renal function. Plasma exposure to sunitinib and SU12662 appears lower in subjects with ESRD compared with subjects with normal renal function or severe renal impairment. Single-dose sunitinib 50 mg is well tolerated regardless of renal function. The currently approved starting dose of sunitinib 50 mg on Schedule 4/2 is expected to be appropriate for patients with renal impairment; any subsequent dose modifications should be based on patients’ ability to tolerate treatment.
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