Originally published as JCO Early Release 10.1200/JCO.2008.18.3285 on February 2 2009

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Effects of Food on the Relative Bioavailability of Lapatinib in Cancer Patients

From GlaxoSmithKline, Clinical Pharmacology, Research Triangle Park, NC; Section of Clinical Pharmacology, Department of Medicine, Dartmouth Medical School and Dartmouth-Hitchcock Medical Center, Lebanon, NH; and Fox Chase Cancer Center, Philadelphia, PA.

Corresponding author: Lionel D. Lewis, MB.BCh, MD, Section of Clinical Pharmacology and Toxicology, Department of Medicine, Hinman Box 7506, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, One Medical Center Dr, Lebanon, NH 03756; e-mail: Lionel.D.Lewis{at}Dartmouth.edu.

Purpose This study was conducted to characterize the effect of food on the relative bioavailability of lapatinib.

Patients and Methods A single 1,500-mg, oral dose of lapatinib was administered to 27 patients with advanced solid tumors on each of three occasions that were 1 week apart, in random order: after an overnight fast, with a low-fat breakfast, and with a high-fat breakfast.

Results The low-fat breakfast produced mean increases in lapatinib area under the concentration-time curve (AUC) of 167% (2.67-fold) and maximum concentration (C_max) of 142% (2.42-fold). The high-fat breakfast produced mean increases in lapatinib AUC of 325% (4.25-fold) and C_max of 203% (3.03-fold) compared with the fasted state. Increased bioavailability in the fed state did not significantly decrease relative variability. Therefore, absolute variability in systemic exposure was increased.

Conclusion These large increases in lapatinib bioavailability and absolute variability support the recommendation for dosing in the fasted state to achieve consistent therapeutic exposure. Prescribers and patients should consider the potential consequences of toxicity or diminished efficacy that might result from dosing without regard to variations in diet.

Supported by GlaxoSmithKline.

Presented in part at the American Society of Clinical Pharmacology and Therapeutics (ASCPT) Annual Meeting, March 21-24, 2007, Anaheim, CA.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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• Effects of Food on Bioavailability of Lapatinib: Useful Data, Wrong Conclusion
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  JCO 2009 27: 42 [Full Text]

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