Methods of treatment
The present disclosure provides for methods of treating a patient with a CYP3A4 substrate drug, wherein the patient is treated with posaconazole. In some embodiments, the patient stops posaconazole treatment, waits for at least 3 days, and then is treated with the CYP3A4 substrate drug as soon as it is safe to do so. In some embodiments, treatment with the CYP3A4 substrate drug is delayed for about 3-42 days after stopping posaconazole. In some embodiments, the patient is treated with a reduced dose of the CYP3A4 substrate drug for about 3-42 days.
1. A method of treating mantle cell lymphoma (MCL), Waldenström's macroglobulinemia (WM), marginal zone lymphoma (MZL), chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), or chronic graft versus host disease (cGVHD) in a patient in need thereof with an anti-neoplastic drug, wherein the patient is treated with a strong CYP3A4 inhibitor, comprising:
a. discontinuing the strong CYP3A4 inhibitor treatment;
b. delaying administering, for at least about 3 days after discontinuing the strong CYP3A4 inhibitor treatment, a dose of the anti-neoplastic drug that the patient would have received based on the patient's age and condition if the patient had not been treated with the strong CYP3A4 inhibitor; and then
c. administering the dose of the anti-neoplastic drug that the patient would have received based on the patient's age and condition if the patient had not been treated with the strong CYP3A4 inhibitor;
wherein the strong CYP3A4 inhibitor is posaconazole.
2. The method of claim 1 , wherein the patient has MCL.
3. The method of claim 2 , wherein the patient with MCL has received at least one prior therapy.
4. The method of claim 1 , wherein the patient has WM.
5. The method of claim 1 , wherein the patient has MZL.
6. The method of claim 5 , wherein the patient with MZL requires systemic therapy.
7. The method of claim 5 , wherein the patient with MZL has received at least one prior anti-CD20-based therapy.
8. The method of claim 7 , wherein the patient has CLL/SLL.
9. The method of claim 8 , wherein the patient has CLL/SLL with 17p deletion.
10. The method of claim 1 , wherein the patient has cGVHD.
11. The method of claim 10 , wherein the patient with cGVHD has failed one or more lines of systemic therapy.
12. The method of claim 1 , wherein the delaying in step (b) is in the range of from 3-11 days.
13. The method of claim 1 , wherein the delaying in step (b) is in the range of from 3-9 days.
14. The method of claim 1 , wherein the delaying in step (b) is in the range of from 3-7 days.
15. The method of claim 2 , wherein the delaying in step (b) is in the range of from 3-7 days.
16. The method of claim 3 , wherein the delaying in step (b) is in the range of from 3-7 days.
17. The method of claim 4 , wherein the delaying in step (b) is in the range of from 3-7 days.
18. The method of claim 5 , wherein the delaying in step (b) is in the range of from 3-7 days.
19. The method of claim 6 , wherein the delaying in step (b) is in the range of from 3-7 days.
20. The method of claim 7 , wherein the delaying in step (b) is in the range of from 3-7 days.
21. The method of claim 8 , wherein the delaying in step (b) is in the range of from 3-7 days.
22. The method of claim 9 , wherein the delaying in step (b) is in the range of from 3-7 days.
23. The method of claim 10 , wherein the delaying in step (b) is in the range of from 3-7 days.
24. The method of claim 11 , wherein the delaying in step (b) is in the range of from 3-7 days.