Pharmacokinetic analysis of carboplatin in patients with cancer who are undergoing hemodialysis

Oguri, Tomoyo; Shimokata, Tomoya; Inada, Megumi; Ito, Isao; Ando, Yumiko; Sasaki, Yasutsuna; Hasegawa, Yoshinori

doi:10.1007/s00280-010-1366-1

Cited by 24 publications

(28 citation statements)

References 17 publications

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“…Therefore, various options on the timing of hemodialysis in patients receiving carboplatin have been conceived. In a case in which 125 mg of carboplatin was administered to produce a target AUC of 5.0 mg/ml min, the actual AUCs were reported at 2.21, 4.43, and 6.1 mg/ml min when hemodialysis was started after 1.5-, 16-, and 24-h administration of carboplatin, respectively [18,19]. Grade 3 neutropenia was observed when conditions for the start of hemodialysis were modified at 16-h (but not at 1.5-h) after carboplatin administration [19].…”

Section: Discussionmentioning

confidence: 99%

“…For the present case, a combination of carboplatin and weekly paclitaxel was selected instead of some single-agent regimens for the following reasons: the combination of carboplatin and paclitaxel is currently one of the standard regimens for first line chemotherapy in patients with NSCLC and ovarian cancer, and the use of this regimen in cancer patients receiving hemodialysis for ESRD has previously been reported [18,[24][25][26]. Not only chronologic age but comorbidity has also been reported to be associated with more severe toxicity and lower chemotherapy dose intensity for NSCLC patients [27].…”

Section: Discussionmentioning

confidence: 99%

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Carboplatin and weekly paclitaxel chemotherapy in hemodialysis patient with advanced lung cancer and severe comorbidity: effect of the drugs and their chemical intermediates

Tanaka

2014

Res Chem Intermed

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In advanced non-small-cell lung cancer (NSCLC) patients with severe comorbidity or who are elderly, significant differences exist at the induction of chemotherapy. A 68-year-old man with a history of severe aortic stenosis and cerebral infarction had been receiving hemodialysis for end-stage renal disease. On admission due to loss of consciousness caused by aortic stenosis, a mass in the upper lobe of the right lung with a small amount of pleural effusion was detected. The patient was diagnosed with adenocarcinoma of lung (cT2bN1M1a, stage IV). A weekly regimen of paclitaxel in combination with carboplatin is less toxic than the standard regimen of administering both simultaneously. Therefore, this regimen is preferable for patients with severe comorbidity or who are elderly. For the present case, combination chemotherapy of carboplatin and weekly paclitaxel was selected and administered for four cycles. Tumor response was evaluated as stable disease and adverse events were tolerable. This combination was found to be a candidate regimen for advanced NSCLC patients receiving hemodialysis with severe comorbidity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Carboplatin and weekly paclitaxel chemotherapy in hemodialysis patient with advanced lung cancer and severe comorbidity: effect of the drugs and their chemical intermediates

Tanaka

2014

Res Chem Intermed

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“…The dose of carboplatin is calculated based on the Calvert formula [i.e. dose (mg) = area under the concentration-time curve (AUC) ×(glomerular filtration rate +25)], with the glomerular filtration rate considered to be zero in most of case reports of anuric hemodialysis patients (12). However, this method may be inadequate, as the Calvert formula was originally validated only in patients with a glomerular filtration rate of 33-136 mL/min (13).…”

Section: Discussionmentioning

confidence: 99%

Advanced Thymic Cancer Treated with Carboplatin and Paclitaxel in a Patient Undergoing Hemodialysis

et al. 2015

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A 53-year-old man with an asymptomatic anterior mediastinal tumor undergoing hemodialysis was referred to our institution. He was diagnosed with thymic basaloid carcinoma based on the findings of a chest tomography-guided biopsy and successfully treated with carboplatin (300 mg/m 2 /day) and paclitaxel (200 mg/ m 2 /day) on day 1 for six three-week cycles. To our knowledge, this is the first report regarding the efficiency of a carboplatin dose-definition method based on the body surface area with paclitaxel in a hemodialysis patient. This report may therefore be useful for treating hemodialysis patients who are candidates for carboplatin and paclitaxel therapy.

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“…In our patient, TLCcausedAKIanddelayedclearanceofcarboplatin.Asa result,carboplatinAUCwashigherthantargeted,leadingto extended exposure to this drug and severe hematological toxicity. Carboplatinhasgoodmembranepermeabilityinhemodialysis [12,13].Thereisanincreasingnumberofreportsindicating the safe use of carboplatin and etoposide in chronic hemodialysis patients [13,14]. We suggest that in a case of TLC-induced AKI, rescue hemodialysis can eliminate the highplasmalevelsofcarboplatin,therebydecreasingtherisk of severe hematologic sequelae.…”

Section: Case Reportmentioning

confidence: 99%

Tumor Lysis Syndrome in a Patient with Merkel Cell Carcinoma and Provoked Pathologic Sequence of Acute Kidney Injury, Reduced Clearance of Carboplatin and Fatal Pancytopenia

Grenader¹,

Shavit

2011

Onkologie

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Background: Merkel cell carcinoma (MCC) is a rare, highly malignant cancer of the skin primarily affecting the elderly, with a tendency for local recurrence and regional lymph node metastasis. It is very unusual for this kind of tumor to induce clinically apparent tumor lysis syndrome (TLS) which is a consequence of spontaneous cytolysis or massive tumor cell lysis, beginning a few hours after the initiation of treatment. Case Report: We report here on a patient with metastatic MCC, who developed TLS following combination chemotherapy with carboplatin and etoposide. Conclusion: The evolving acute kidney injury (AKI) provoked a pathologic sequence of reduced renal clearance leading to protracted clearance of carboplatin and subsequent fatal pancytopenia. When AKI occurs in close association with the administration of carboplatin, the institution of rescue hemodialysis is recommended to decrease plasma carboplatin levels and avoid this lethal complication.

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Pharmacokinetic analysis of carboplatin in patients with cancer who are undergoing hemodialysis

Cited by 24 publications

References 17 publications

Carboplatin and weekly paclitaxel chemotherapy in hemodialysis patient with advanced lung cancer and severe comorbidity: effect of the drugs and their chemical intermediates

Carboplatin and weekly paclitaxel chemotherapy in hemodialysis patient with advanced lung cancer and severe comorbidity: effect of the drugs and their chemical intermediates

Advanced Thymic Cancer Treated with Carboplatin and Paclitaxel in a Patient Undergoing Hemodialysis

Tumor Lysis Syndrome in a Patient with Merkel Cell Carcinoma and Provoked Pathologic Sequence of Acute Kidney Injury, Reduced Clearance of Carboplatin and Fatal Pancytopenia

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