METHOD DEVELOPMENT ON ANALYSIS CYCLOPHOSPHAMIDE AND 4-HYDROXYCYCLOPHOPHAMIDE IN DRIED BLOOD SPOT AND ITS APPLICATION IN BREAST CANCER PATIENTS
DOI:
https://doi.org/10.22159/ijap.2020v12i4.36092Keywords:
Cyclophosphamide, 4-OHCP, UPLC-MSMS, DBS, CancerAbstract
Objective: To develop the method for the simultaneous analysis of cyclophosphamide and 4-hydroxycyclophosphamide (4-OHCP) in Dried Blood Spot (DBS) using Ultra-High-Performance Liquid Chromatography-Tandem Mass Spectrometry (UPLC-MS/MS) and its application in breast cancer patients for therapeutic drug monitoring.
Methods: Sample preparation used protein precipitation with methanol and acetonitrile (2:1 v/v). The separation was conducted using 1.7μm (2.1 x 100 mm) Waters AcquityTM UPLC C18 column; mobile phase consists of 0.01% formic acid and methanol (50:50 v/v) with isocratic elution, column temperature 30 °C, flow rate 0.3 ml/min and hexamethylphosphoramide (HMP) used as an internal standard. Analysis was performed by a triple quadrupole mass spectrometry with a positive ion mode of Electrospray Ionization. Cyclophosphamide was detected at m/z 260.968>139.978, 4-OHCP at m/z 338.011>224.979, and HMP at m/z 180.17>92.08. The method was applied to quantify cyclophosphamide and 4-OHCP in DBS of breast cancer patients. Blood samples were collected at 2 and 4 h after cyclophosphamide administration for therapeutic drug monitoring.
Results: The method was linear in the range of 50–30.000 ng/ml for cyclophosphamide and 10–1000 ng/ml for 4-OHCP. Lower Limit of Quantification (LLOQ) concentration of cyclophosphamide was 50 ng/ml and 4-OHCP was 10 ng/ml. Accuracy and precision within-run and between-run met the requirements with % diff and CV, not exceeding ±15% and not more than ±20% for LLOQ concentration. The results from DBS samples of cancer patients showed that the level of cyclophosphamide was in the range of 6045.980 ng/ml to 37024.403 ng/ml and 4-OHCP was in the range 33.155 ng/ml to 246.362 ng/ml.
Conclusion: The developed method met the requirements of all validation parameters under the Guideline on Bioanalytical Method Validation by the European Medicines Agency in 2011. Method can be applied on DBS of cancer patients and the results showed that cyclophosphamide and 4-OHCP was detected on 17 samples of breast cancer patients. This can be one of the parameters for therapeutic drug monitoring.
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References
LaPlant K, Louzon P. Anticancer drug. In: K Whalen, R Finkel, T Panavelil. editors. Lippincott Ilustrated Reviews: Pharmacology. 6th ed. China: Wolters Kluwer; 2015. p. 587-617.
Chabner BA. Cytotoxic agent. In: L Brunton, B Knollmann, B Chabner. editors. Goodman and gilman's the pharmacological basis of therapeutics. 12th ed. New York: McGraw Hill; 2011. p. 1677-730.
Veal GJ, Cole M, Chinnaswamy G, Sludden J, Jamieson D, Errington J, et al. Cyclophosphamide pharmacokinetics and pharmacogenetics in children with B-cell non-hodgkin’s lymphoma. Eur J Cancer 2016;55:56-64.
Kalhorn TF, Howald WN, Cole S, Phillips B, Wang J, Slattery JT, et al. Rapid quantitation of cyclophosphamide metabolites in plasma by liquid chromatography–mass spectrometry. J Chromatogr B 2006;835:105-13.
Harahap Y, Samuel C, Andalusia R, Syafhan NF. Analysis of 4-hydroxycyclophosphamide in cancer patients plasma fortherapeutic drug monitoring of cyclophosphamide. Int J Pharm Pharm Sci 2016;8:194-200.
Ekhart C, Gebretensae A, Rosing H, Rodenhuis S, Beijnen JH, Huitema ADR. Simultaneous quantification of cyclophosphamide and its active metabolite 4-hydroxycyclophosphamide in human plasma by high-performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry (LC–SM/SM). J Chromatogr B 2007;854:345-9.
Sadagopan N, Cohen L, Roberts B, Collard W, Omer C. Liquid chromatography–tandem mass spectrometric quantitation of cyclophosphamide and its hydroxy metabolite in plasma and tissue for determination of tissue distribution. J Chromatogr B 2001;759:277-84.
Hussain S, Shaikh T. Ultra high performance liquid chromatography (UPLC): a new trend in analysis. World J Pharm Res 2016;5:387–94.
Bai F, Fraga CH, Tagen M, Schaiquevich P, Hagedorn N, Stewart CF. Simulaneous Determination of cyclophosphamide and carboxyethylphosphoramide mustard in human plasma using online extraction and electrospray tandem mass spectrometry (HTLC-ESI-MS/MS). J Chromatogr B 2009;877:1709-15.
Baumann F, Lorenz C, Jaehde U, Preiss R. Determination of cyclophosphamide and its metabolites in human plasma by high-performance liquid chromatography–mass spectrometry. J Chromatogr B 1999;729:297-305.
Ministry of Health Indonesia. Infodatin: Pusat Data danInformasi Kementerian Kesehatan Republik Indonesia. Jakarta; 2015. p. 3.
European Medicines Agency. Guideline on Bioanalytical Method Validation, Sciences Medicines Health. London: European Medicines Agency; 2011.
Almeida AM, Castel Branco M, Falcao A. Linear regression for calibration lines revisited: weighting schemes for bioanalytical methods. J Chromatogr B 2002;774:215-22.
Moldoveanu S, David V. The role of derivatization in chromatography. Modern Sample Preparation for Chromatography; 2015. p. 307–31.
Mess J, Taillon M, Cote C. Dried blood spot on-card derivatization : an alternative form of sample handling to overcome the instability of thiorphan in biological matrix. Biomed Chromatogr 2012;26:1617-24.
Torres LM, Espinova LR, Pacheco JLC, Navas CF, Demetrio JA, Medina RA, et al. A new method to quantify ifosfamide blood levels using dried blood spots and UPLC-MS/MS in paediatric patients with embryonic solid tumours. Plos One 2015;10:1-13.
Joy MS, La M, Wang J, Bridges AS, Hu Y, Hogan SL, et al. Cyclophosphamide and 4-hydroxycyclophosphamide pharmacokinetics in patients with glomerulonephritis secondary to lupus and small vessel vasculitis. Br J Clin Pharmacol 2012;74:445–55.
Anderson L, Ludeman S, Colvin O, Grochow L, Strong J. Quantitation of 4-hydroxycyclophosphamide/aldophosphamide in whole blood. J Chromatogr B 1995;667:247-57.