Taking Tykerb with Food Boosts Bioavailability, Could Cut Cost

Commentary offers modest proposal based on lapatinib's increased bioavailability with food

TUESDAY, July 24 (HealthDay News) -- Although the package insert for lapatinib (Tykerb) indicates that this oral targeted therapy for breast cancer should be taken at least an hour before or after food, taking it with food boosts bioavailability and could allow a smaller, less-expensive dose and reduced side effects, according to a commentary in the Aug. 10 issue of the Journal of Clinical Oncology.

Mark J. Ratain, M.D., and Ezra E. Cohen, M.D., of the University of Chicago, cite a study that found that "peak concentration and area under the concentration-time curve were increased markedly when a single 1,500-mg dose of lapatinib was taken with food as opposed to when fasting, and was increased further by a high-fat meal." These findings were presented at the 2007 meeting of the American Society for Clinical Pharmacology and Therapeutics.

Based on this data, if the drug were taken with food and the dosage were decreased accordingly, the current monthly cost would drop from $2,900 to $1,740. In addition, a lower dose might reduce the severity and frequency of diarrhea, a major side effect of lapatinib that might be due to the amount of the drug that is unabsorbed.

"As we enter an era of targeted anti-cancer agents with a monthly cost measured in thousands of dollars, we should view drug-drug or drug-food interactions as opportunities to lower costs. This is particularly true for marketed drugs that have already been priced, such as lapatinib," the authors write. "It is important, however, to emphasize that we strongly recommend study of a lower dose with food, rather than routine prescribing without a formal pharmacokinetic study."

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