Purpose

Dasatinib is a prototypic short half-life BCR-ABL1 tyrosine kinase inhibitor. The recommended dose of dasatinib for chronic myeloid leukemia in chronic phase was changed from 70 mg twice daily to 100 mg once daily following a Phase III dose-optimization study. To better understand the superior benefit-risk profile of dasatinib 100 mg once daily, exposure-response was characterized for efficacy (major cytogenetic response) and safety (pleural effusion).

Patients and methods

Dasatinib exposure in patients with chronic myeloid leukemia in chronic phase was determined by population pharmacokinetic analysis of data from seven dasatinib clinical studies (N = 981), including the Phase III dose-optimization study (n = 567). Data from the Phase III study were then used to characterize exposure-response relationships for the four dasatinib treatment regimens investigated (100 mg once daily, 50 mg twice daily, 140 mg once daily, and 70 mg twice daily).

Results

Major cytogenetic response was significantly (P < 0.01) associated with weighted average steady-state dasatinib plasma concentrations, and pleural effusion was significantly associated with trough concentration. Major cytogenetic response was also significantly associated with maintenance of uninterrupted dosing. The 100 mg once daily arm had the lowest steady-state trough concentration of the four dose arms investigated in the Phase III study, and although this arm also had the lowest weighted average steady-state dasatinib plasma concentration, it had the highest dose maintenance.

Conclusion

Dasatinib dose optimization to 100 mg once daily from 70 mg twice daily significantly minimizes adverse events while maintaining efficacy by exploiting differences in the measures of exposure associated with efficacy and safety.

Three triphenylamine (TPA) substituted cyclometalated Ir(iii) complexes IrA1, IrA2, and IrA3 based on Ir(ppy)₃ were synthesized and applied as phosphorescent probes for the monitoring of molecular oxygen. The phosphorescence intensity of all the Ir(iii) complexes in tetrahydrofuran (THF) was gradually quenched with an increase of oxygen concentration. The increase of TPA substituents on the meta-position of 2-phenylpyridine (IrA1-IrA3) gradually improved the oxygen sensitivity of cyclometalated Ir(iii) complexes. IrA3 showed the highest oxygen sensitivity in THF with a K ^app _SV of 204.8 bar^-1 and a limit of detection (LOD) of 0.27 mbar. The relationship between molecular structure and the collision radiuses (σ) of all the Ir(iii) complexes has been investigated on the basis of the Demas model and the fundamental expression of luminescence quenching systems by oxygen. The ratio of collision radiuses are σ _IrA1/σ _Ir(ppy)3 = 1.27 ± 0.05, σ _IrA2/σ _Ir(ppy)3 = 1.72 ± 0.10, and σ _IrA3/σ _Ir(ppy)3 = 2.13 ± 0.07, respectively. The introduction and increase of TPA substituents can obviously increase the collision radiuses of cyclometalated Ir(iii) complexes which leading to potential oxygen sensitivity. And the incremental effect of collision radiuses caused by the introduction of TPA substituents resulted in outstanding oxygen sensitivity of IrA3. The results demonstrate for the first time evidence between molecular structure and oxygen sensitivity of the emitters for optical sensing.