Drug Metab Pharmacokinet. 2026 Feb 16. pii: S1347-4367(26)00014-5. [Epub ahead of print]67
101528
Krisztina Herédi-Szabó,
Sumito Ito,
Xiaomin Liang,
Yeojin Park,
Masud Parvez,
Philip Sandoval,
Hong Shen,
Kelly M Staiger,
Kazuhiro Tetsuka,
Mark S Warren,
Ling Zou,
Yurong Lai.
Drug transporters play essential roles in governing the absorption, distribution, metabolism, and excretion (ADME) of therapeutic drugs. Transporter modulation frequently contributes to clinically significant drug-drug interactions (DDIs). This review provides a comprehensive overview of in vitro transporter assay systems and their applications in mechanistic characterization and prediction of transporter-mediated DDIs. Current global regulatory guidelines, including ICH M12, highlight key transporters requiring evaluation and emphasize the need for mechanistic insight to support risk assessment. A broad range of in vitro platforms-membrane vesicles, transporter-overexpressing cell lines, polarized monolayers, primary human hepatocytes and kidney cells, induced pluripotent stem cell (iPSC)-derived systems, organoids, and organ-on-chip models-are described, with discussion of their advantages, limitations, and translational relevance. These systems enable the determination of kinetic parameters, the evaluation of vectorial transport, and the integration of transporter-enzyme interplay. Challenges in in vitro-to-in vivo extrapolation (IVIVE), including substrate-dependent inhibition, nonspecific binding, and variability in assay conditions, are addressed alongside emerging strategies such as biomarker-informed modeling, quantitative proteomics, and physiologically based pharmacokinetic (PBPK) modeling. Collectively, the review provides guidance on the effective application of transporter assays in drug discovery and development to improve DDI prediction, support regulatory decision-making, and advance precision medicine.
Keywords: Drug transporters; Drug-drug interactions; Endogenous biomarkers; In vitro to in vivo extrapolation. ADME; Microphysiological systems; PBPK; Pharmacokinetics