The pharmacokinetics of 4'-epi-doxorubicin (4'-epi-adriamycin, 4'-epi-DX) in man can be described by a three-compartment model with a rapid distribution phase and a very long elimination phase. Urine excretion amounts to a total of about 11% of the administered dose during 48 h after drug administration, and less than 1% during the following 48 h. In plasma 4'-epi-doxorubicin is rapidly converted to five metabolites (4'-epi-doxorubicinol, aglycones and glucuronides), the concentration of the aglycones sometimes exceeding that of 4'-epi-DX. In urine only three metabolites were found in addition to the parent drug; they were identified as 4'-epi-doxorubicinol (EOH), 4'-epi-doxorubicin-glucuronide (E-Glu) and 4'-epi-doxorubicinol-glucuronide (EOH-Glu). Comparison of the pharmacokinetics and metabolic profiles of 4'-epi-DX and doxorubicin (DX) in man revealed that 4'-epi-DX eliminates faster than DX.
The determination of thioproline in plasma of cancer patients, using high performance liquid chromatography (HPLC) is reported. As column support, a silica-bonded cation exchanger was used. Detection was performed at 205 nm. The detection limit of the method was 5 X 10(-6) M and the linear dynamic range was over 500. No sample clean-up procedure was necessary other than deproteinization of the plasma. The method was applied to the measurement of plasma drug levels in 3 patients, part of a clinical trial testing the effectiveness of thioproline as an anti-cancer agent.
In 9 patients with advanced malignant disease who received carminomycin (CMM) in an i.v. bolus injection (dose 18 mg/m2), curves of plasma concentrations of CMM and carminomycinol (CMMOH), a metabolite, versus time were constructed. For determination of plasma concentrations, high pressure liquid chromatography was used. For CMM and CMMOH the median areas under the curves (AUC's) were 31 (range 4-57) X 10(-8) mol/Ql/hr (measured over 24 hr) and 100 (range 309-158) X 10(-8) mol/l/hr (measured over 48 hr) respectively. From the data an accumulation of CMMOH in patients receiving treatments separated by brief intervals ban be predicted (half-life time of plasma disappearance for CMMOH was 2 days). Clinical toxicity was lowest in those 3 patients showing the lowest AUC for both CMM and CMMOH.
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