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Population Pharmacokinetics of Nivolumab in Japanese Patients with Non-Small Cell Lung Cancer.

BACKGROUND
Nivolumab is an anti-programmed death-1 (PD-1) antibody used for immuno-oncological therapy of various cancers, including non-small cell lung cancer (NSCLC). This study aimed to characterize the real-world population pharmacokinetics (PK) of nivolumab in NSCLC patients.


METHODS
PK samples were collected by opportunistic sampling of Japanese NSCLC patients treated with nivolumab monotherapy. Population PK analysis was performed using a two-compartment model in NONMEM. Patient-specific factors such as body weight, age, sex, serum albumin (ALB), estimated glomerular filtration rate (eGFR), performance status, programmed cell death receptor ligand 1 (PD-L1) expression in tumors, and treatment periods were evaluated as potential covariates for clearance.


RESULTS
A total of 223 serum samples collected from 34 patients were available for analysis. The median (min-max) age and weight were 69 years (38-83) and 62.7 kg (36.8-80.5), respectively. The mean (95 % confidence interval) clearance estimate was 0.0064 L/h (0.0058-0.0070). The inclusion of the ALB level, eGFR, and treatment period significantly improved the model fit.


CONCLUSION
A real-world nivolumab population PK model was developed using an opportunistic sampling strategy in Japanese patients with NSCLC. Further studies are warranted to characterize the exposure-response relationship and determine the optimal dosing regimens for these patients.