Bioequivalence of Liposome-Entrapped Paclitaxel Easy-To-Use (LEP-ETU) Formulation and Paclitaxel in Polyethoxylated Castor Oil: A Randomized, Two-Period Crossover Study in Patients With Advanced Cancer

Background: Preclinical studies comparing paclitaxel formulated with polyethoxylated castor oil with the sonicated formulation of liposome-entrapped paclitaxel (LEP) have demonstrated that LEP was associated with reduced toxicity while maintaining similar efficacy. Preliminary studies on the pharmacokinetics in patients support earlier preclinical data, which suggested that the LEP Easy-to-Use (LEP-ETU) formulation and paclitaxel formulated with castor oil may have comparable pharmacokinetic properties. Objectives: Our objectives were: (1) to determine bioequivalence of paclitaxel pharmaceutically formulated as LEP-ETU (test) and paclitaxel formulated with castor oil (reference); and (2) to assess the tolerability of LEP-ETU following intravenous administration. Methods: Patients with advanced cancer were studied in a randomized, 2-period crossover bioequivalence study. Patients received paclitaxel 175 mg/m(2) administered as an intravenous infusion over 180 minutes, either as a single-treatment cycle of the test formulation followed by a single-treatment cycle of the reference formulation, or vice versa. Results: Thirty-two of 58 patients were evaluable and were included in the analysis for bioequivalence. Mean total paclitaxel C-max values for the test and reference formulations were 4955.0 and 5108.8 ng/mL, respectively. Corresponding AUC(0-infinity), values were 15,853.8 and 18,550.8 ng.h/mL, respectively. Treatment ratios of the geometric means were 97% (90% CI, 91%-103%) for C-max and 84% (90% CI, 80%-90%) for AUC(0-infinity). These results met the required 80% to 125% bioequivalence criteria. The most frequently reported adverse events after LEP-ETU administration were fatigue, alopecia, and myalgia. Conclusion: At the studied dose regimen, LEP-ETU showed bioequivalence with paclitaxel formulated with polyethoxylated castor oil. (C) 2013 Elsevier HS Journals, Inc. All rights reserved.