Stochastic Pharmacokinetic/Pharmacodynamic Modeling for Assessing the Systemic Health Risk of Perfluorooctanoate (PFOA)

Convertino Convertino, Timothy Church, Geary Olsen, Yang Liu, Eddie Doyle, Clifford Elcombe, Anna Barnett, Leslie Samuel, Iain MacPherson, Thomas Evans

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)
9 Downloads (Pure)


A phase 1 dose-escalation trial assessed the chemotherapeutic potential of ammonium perfluorooctanoate (APFO). Forty-nine primarily solid-tumor cancer patients who failed standard therapy received weekly APFO doses (50–1200 mg) for 6 weeks. Clinical chemistries and plasma PFOA (anionic APFO) were measured predose and weekly thereafter. Several clinical measures including total cholesterol, high-density lipoproteins (HDLs), thyroid stimulating hormone (TSH), and free thyroxine (fT4), relative to PFOA concentrations were examined by: Standard statistical analyses using generalized estimating equations (GEE) and a probabilistic analysis using probability distribution functions (pdf) at various PFOA concentrations; and a 2-compartment pharmacokinetic/pharmacodynamic (PK/PD) model to directly estimate mean changes. Based on the GEE, the average rates of change in total cholesterol and fT4 associated with increasing PFOA were approximately ﰀ1.2ﰁ10ﰀ3 mmol/l/lM and
2.8ﰁ10ﰀ3 pmol/l/lM, respectively. The PK/PD model predicted more closely the trends observed in the data as well as the pdfs of biomarkers. A decline in total cholesterol was observed, with a clear transition in shape and range of the pdfs, manifested by the maximum value of the Kullback-Leibler (KL) divergence, that occurred at plasma PFOA between 420 and 565 lM (175 000–
230 000 ng/ml). High-density lipoprotein was unchanged. An increase in fT4 was observed at a higher PFOA transition point, albeit TSH was unchanged. Our findings are consistent with some animal models and may motivate re-examination of the epidemiologic studies to PFOA at levels several orders of magnitude lower than this study. These observational studies have reported contrary associations, but currently understood biology does not support the existence of such conflicting effects.
Original languageEnglish
Pages (from-to)293-306
Number of pages14
JournalToxicological Sciences
Issue number1
Early online date16 Feb 2018
Publication statusPublished - 1 May 2018

Bibliographical note

This work was supported by the sponsor of this phase 1 clinical trial, CXR Biosciences (Dundee, UK). 3 M Company (St Paul, Minnesota) licensed a part of the database from CXR Biosciences for the purpose of the analyses presented herein.


  • APFO
  • phase 1 trial
  • PK/PD modeling
  • cholesterol
  • PFOA
  • thyroid


Dive into the research topics of 'Stochastic Pharmacokinetic/Pharmacodynamic Modeling for Assessing the Systemic Health Risk of Perfluorooctanoate (PFOA)'. Together they form a unique fingerprint.

Cite this