The AAPS Journal

, Volume 15, Issue 3, pp 662–673 | Cite as

Development of a Preclinical PK/PD Model to Assess Antitumor Response of a Sequential Aflibercept and Doxorubicin-Dosing Strategy in Acute Myeloid Leukemia

  • Gerald J. Fetterly
  • Urvi Aras
  • Deepika Lal
  • Michael Murphy
  • Patricia D. Meholick
  • Eunice S. Wang
Research Article


Timing of the anti-angiogenic agent with respect to the chemotherapeutic agent may be crucial in determining the success of combination therapy in cancer. We investigated the effects of sequential therapy with the potent VEGF inhibitor, aflibercept, and doxorubicin (DOX) in preclinical acute myeloid leukemia (AML) models. Mice were engrafted with human HL-60 and HEL-luciferase leukemia cells via S.C. and/or I.V. injection and treated with two to three doses of aflibercept (5–25 mg/kg) up to 3–7 days prior to doxorubicin (30 mg/kg) administration. Leukemia growth was determined by local tumor measurements (days 0–16) and systemic bioluminescent imaging (days 0–28) in animals receiving DOX (3 mg/kg) with or without aflibercept. A PK/PD model was developed to characterize how prior administration of aflibercept altered intratumoral DOX uptake. DOX concentration–time profiles were described using a four-compartment PK model with linear elimination. We determined that intratumoral DOX concentrations were 6-fold higher in the aflibercept plus DOX treatment group versus DOX alone in association with increased drug uptake rates (from 0.125 to 0.471 ml/h/kg) into tumor without affecting drug efflux. PD modeling demonstrated that the observed growth retardation was mainly due to the combination of DOX plus TRAP group; 0.00794 vs. 0.0043 h−1. This PK/PD modeling approach in leukemia enabled us to predict the effects of dosing frequency and sequence for the combination of anti-VEGF and cytotoxic agents on AML growth in both xenograft and marrow, and may be useful in the design of future rational combinatorial dosing regimens in hematological malignancies.


acute myeloid leukemia aflibercept doxorubicin pharmacokinetics/pharmacodynamics VEGF TRAP 



We would like to acknowledge Ashleigh Lamson M. S. for technical support. This research was supported by an American Cancer Society Mentored Research Scientist Award MRSG-06-044-01-LIB (to E.S.W) and the Szefel Leukemia Research Fund (to E.S.W). Core institute resource support was provided by the NCI Cancer Center Support Grant (CA016156).


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Copyright information

© American Association of Pharmaceutical Scientists 2013

Authors and Affiliations

  • Gerald J. Fetterly
    • 1
  • Urvi Aras
    • 1
  • Deepika Lal
    • 2
  • Michael Murphy
    • 1
  • Patricia D. Meholick
    • 1
  • Eunice S. Wang
    • 2
  1. 1.PK/PD Core Facility, Department of MedicineRoswell Park Cancer InstituteBuffaloUSA
  2. 2.Leukemia Service, Department of MedicineRoswell Park Cancer InstituteBuffaloUSA

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