Intravenously administered chemotherapeutic
cabazitaxel is used
for palliative treatment of prostate cancer. An oral formulation would
be more patient-friendly and reduce the need for hospitalization.
We therefore study determinants of the oral pharmacokinetics of cabazitaxel
in a ritonavir-boosted setting, which reduces the CYP3A-mediated first-pass
metabolism of cabazitaxel. We here assessed the role of organic anion-transporting
polypeptides (OATPs) in the disposition of orally boosted cabazitaxel
and its active metabolites, using the Oatp1a/b-knockout and the OATP1B1/1B3-transgenic
mice. These transporters may substantially affect plasma clearance
and hepatic and intestinal drug disposition. The pharmacokinetics
of cabazitaxel and DM2 were not significantly affected by Oatp1a/b
and OATP1B1/1B3 activity. In contrast, the plasma AUC0–120 min of DM1 in Oatp1a/b
–/–
was 1.9-fold (p < 0.05) higher than that
in wild-type mice, and that of docetaxel was 2.4-fold (p < 0.05) higher. We further observed impaired hepatic uptake and
intestinal disposition for DM1 and docetaxel in the Oatp-ablated strains.
None of these parameters showed rescue by the OATP1B1 or -1B3 transporters
in the humanized mouse strains, suggesting a minimal role of OATP1B1/1B3.
Ritonavir itself was also a potent substrate for mOatp1a/b, showing
a 2.9-fold (p < 0.0001) increased plasma AUC0–120 min and 3.5-fold (p <
0.0001) decreased liver-to-plasma ratio in Oatp1a/b
–/–
compared to those in
wild-type mice. Furthermore, we observed the tight binding of cabazitaxel
and its active metabolites, including docetaxel, to plasma carboxylesterase
(Ces1c) in mice, which may complicate the interpretation of pharmacokinetic
and pharmacodynamic mouse studies. Collectively, these results will
help to further optimize (pre)clinical research into the safety and
efficacy of orally applied cabazitaxel.