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 epithelial ovarian cancer, fallopian tube cancer, primary peritoneal cancer, HER2-negative breast cancer, metastatic pancreatic cancer, or castration-resistant prostate cancer with olaparib in a patient in need thereof, wherein the patient is treated with a strong CYP3A4 inhibitor, comprising:
providing to the patient olaparib and a drug label for olaparib, wherein the drug label for olaparib comprises the following instructions:
(a) stop treatment with a strong CYP3A4 inhibitor;
(b) delay administering, for about 3 to about 5 half-lives of the strong CYP3A4 inhibitor after stopping the strong CYP3A4 inhibitor treatment, a dose of olaparib that the patient would have received based on the age and condition of the patient if the patient had not been treated with the strong CYP3A4 inhibitor; and then
(c) administer the dose of olaparib that the patient would have received based on the age and condition of the patient if the patient had not been treated with the strong CYP3A4 inhibitor; and
performing, by the patient, steps (a)-(c),
wherein the strong CYP3A4 inhibitor is posaconazole.
2. The method of claim 1 , wherein the epithelial ovarian, fallopian tube, or primary peritoneal cancer is germline BRCA-mutated (gBRCAm) advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer.
3. The method of claim 2 , wherein the patient is in a complete or partial response to platinum-based chemotherapy.
4. The method of claim 1 , wherein the epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer is recurrent epithelial ovarian cancer, fallopian tube cancer, or primary peritoneal cancer.
5. The method of claim 4 , wherein the patient is in a complete or partial response to platinum-based chemotherapy.
6. The method of claim 1 , wherein the HER2-negative breast cancer is germline BRCA-mutated (gBRCAm) HER2-negative breast cancer.
7. The method of claim 6 , wherein the germline BRCA-mutated (gBRCAm) HER2-negative breast cancer is deleterious or suspected deleterious gBRCAm HER2-negative breast cancer that has been treated with chemotherapy in the neoadjuvant, adjuvant or metastatic setting.
8. The method of claim 1 , wherein the patient has epithelial ovarian cancer, fallopian tube cancer, primary peritoneal cancer, or HER2-negative breast cancer.
9. The method of claim 1 , wherein the patient has metastatic pancreatic cancer.
10. The method of claim 1 , wherein the patient has castration-resistant prostate cancer.
11. The method of claim 10 , wherein the castration-resistant prostate cancer is metastatic castration-resistant prostate cancer.
12. The method of claim 1 , wherein the patient is not obese.
13. The method of claim 1 , wherein the patient has at least one characteristic selected from the group consisting of the following:
i) BMI of at least about 35;
ii) waist size greater than about 42 inches;
iii) % body fat greater than about 40%;
iv) total body fat greater than about 40 kg; and
v) medically diagnosed as obese.
14. The method of claim 1 , wherein the patient is an adult.
15. The method of claim 1 , wherein the patient delays administering the dose of olaparib for 3 half-lives of the strong CYP3A4 inhibitor after stopping the strong CYP3A4 inhibitor in step (a).
16. The method of claim 1 , wherein the patient delays administering the dose of olaparib for 4 half-lives of the strong CYP3A4 inhibitor after stopping the strong CYP3A4 inhibitor in step (a).
17. The method of claim 1 , wherein the patient delays administering the dose of olaparib for 5 half-lives of the strong CYP3A4 inhibitor after stopping the strong CYP3A4 inhibitor in step (a).
18. The method of claim 1 , wherein the dose of olaparib administered by performing step (c) is a total daily dose of 600 mg.
19. The method of claim 1 , wherein the dose of olaparib by performing step (c) is 300 mg, administered twice daily.
20. The method of claim 1 , wherein the drug label for olaparib comprises instructions for administering, and the patient administers, a total daily dose of olaparib of 200 mg concurrently with posaconazole prior to stopping posaconazole treatment in step (a).
21. The method of claim 1 , wherein the drug label for olaparib comprises instructions for administering, and the patient administers, 100 mg of olaparib concurrently with posaconazole prior to stopping posaconazole treatment in step (a).
22. The method of claim 21 , wherein the drug label for olaparib comprises instructions for administering, and the patient administers, 100 mg of olaparib twice daily.
23. The method of claim 1 , wherein the drug label for olaparib comprises instructions for administering, and the patient administers, a total daily dose of olaparib of 200 mg in step (b) prior to administering the dose of olaparib that the patient would have received based on the age and condition of the patient if the patient had not been treated with the strong CYP3A4 inhibitor in step (c).
24. The method of claim 1 , wherein the drug label comprises instructions for administering, and the patient administers, 100 mg of olaparib in step (b) prior to administering the dose of olaparib that the patient would have received based on the age and condition of the patient if the patient had not been treated with the strong CYP3A4 inhibitor in step (c).
25. The method of claim 24 , the drug label comprises instructions for administering, and the patient administers, 100 mg of olaparib twice daily.