背景:Mitotane(o,p'-DDD)是肾上腺皮质癌(ACC)的首选药物,其在血浆中的测量对于控制药物给药至关重要。
目的:开发和验证一种简单的,可靠和直接的方法测定血浆样品中的米托坦。
方法:将无药血浆样品收集在乙二胺四乙酸钾(K-EDTA)管中,并掺入1.0、2.5、10.0、25.0和50.0µg/mL的米托坦(DDD)。P,p'-DDD用作内标(IS),并以25.0μg/mL的浓度添加到所有样品中,标准和控制。样品用乙腈进行蛋白质沉淀,然后离心。将50uL上清液注射到与二极管阵列检测器(DAD)偶联的HPLC系统中。DDD和IS在230nm以12分钟等度模式检测,其中60%乙腈和40%甲酸在水中的溶剂混合物与0.1%泵混合,在0.6毫升/分钟的流速,在保持在28°C的反相(C18)色谱柱中。敏感性,选择性,精度,结转的存在,回收和基质效应,线性度并对方法的准确性进行了评价。
结果:本研究的方法导致了DDD(米托坦)和4,4'-DDD(内标)的对称峰形和良好的基线分辨率,保留时间为6.0分钟,6.4mim,分别,分辨率高于1.0。当比较空白血浆和具有标准的加标血浆时,内源性血浆化合物不会干扰评估的峰。对于米托坦,在1.00-50.00μg/mL的范围内评估线性度(R2>0.9987和97.80%-105.50%的提取效率)。分析灵敏度为0.98μg/mL。功能灵敏度(LOQ)为1.00µg/L,测定内和测定间变异系数小于9.98%,并且该方法未观察到结转。恢复范围从98.00%到117.00%,线性范围为95.00%至119.00%,对于米托坦测量,没有观察到基体效应或干扰的高精度为89.40%至105.90%。通过GC-MS方法将患者样本结果与以前的测量结果进行比较,具有高度相关性(r=0.88,偏倚=-10.20%)。
结论:通过开发和验证的方法测定血浆样品中的DDD是简单的,健壮,高效,并且对治疗药物监测和剂量管理敏感,以达到肾上腺皮质癌患者米托坦的治疗指数。
Mitotane (o,p\'-DDD) is the drug of choice for Adrenocortical Carcinomas (ACC) and its measurement in plasma is essential to control drug administration.
To develop and validate a simple, reliable and straightforward method for mitotane determination in plasma samples.
Drug-free plasma samples were collected in potassium-ethylenediamine tetraacetate (K-EDTA) tubes and spiked with 1.0, 2.5, 10.0, 25.0 and 50.0 µg/mL of mitotane (DDD). The p,p\'-DDD was used as an Internal Standard (IS) and was added at 25.0 µg/mL concentration to all samples, standards and controls. Samples were submitted to protein precipitation with acetonitrile and then centrifuged. 50 uL of the supernatant was injected into an HPLC system coupled to a Diode Array Detector (DAD). DDD and IS were detected at 230 nm in a 12 min isocratic mode with a solvent mixture of 60 % acetonitrile and 40 % formic acid in water with 0.1 % pump mixed, at 0.6 mL/min flow rate, in a reversed-phase (C18) chromatographic column kept at 28°C. The sensitivity, selectivity, precision, presence of carry-over, recovery and matrix-effect, linearity, and method accuracy were evaluated.
The present study\'s method resulted in a symmetrical peak shape and good baseline resolution for DDD (mitotane) and 4,4\'-DDD (internal standard) with retention times of 6.0 min, 6.4 mim, respectively, with resolutions higher than 1.0. Endogenous plasma compounds did not interfere with the evaluated peaks when blank plasma and spiked plasma with standards were compared. Linearity was assessed over the range of 1.00-50.00 µg/mL for mitotane (R2 > 0.9987 and a 97.80 %‒105.50 % of extraction efficiency). Analytical sensitivity was 0.98 µg/mL. Functional sensitivity (LOQ) was 1.00 µg/L, intra-assay and inter-assay coefficient of variations were less than 9.98 %, and carry-over was not observed for this method. Recovery ranged from 98.00 % to 117.00 %, linearity ranged from 95.00 % to 119.00 %, and high accuracy of 89.40 % to 105.90 % with no matrix effects or interference was observed for mitotane measurements. Patients\' sample results were compared with previous measurements by the GC-MS method with a high correlation (r = 0.88 and bias = -10.20 %).
DDD determination in plasma samples by the developed and validated method is simple, robust, efficient, and sensitive for therapeutic drug monitoring and dose management to achieve a therapeutic index of mitotane in patients with adrenocortical cancer.