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Cisplatin pharmacokinetics in children with cancer

Lookup NU author(s): Professor Alan Boddy, Professor Andrew Pearson, Dr Michael Tilby, Professor Herbie Newell

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Abstract

Cisplatin is an important drug in the treatment of a number of paediatric cancers yet, despite widespread use, there are only very limited data on the pharmacokinetics of the drug in children. Cisplatin pharmacokinetics were studied in 21 patients following a 24 h infusion of 50-120 mg/m(2) cisplatin. Total and free platinum (Pt) levels in plasma and Pt in urine, were measured by atomic absorption spectrophotometry. Pharmacokinetic parameters were determined by non-compartmental and compartmental analyses. There was 3-fold interpatient variability in free drug exposure (area under the plasma concentration versus time curve - AUC) for a given surface area-based dose of cisplatin. The mean (+/- SD) pharmacokinetic parameters for free Pt were: AUC 0.47 +/- 0.13 mg/ml.min/100 mg/m(2), V-dss 12.5 +/- 2.7 l/m(2), t(1/2) 39 +/- 9 min, Ke 0.019 +/- 0.006 min(-1), Cl-renal 62 ml/min/m(2), Cl-total 233 +/- 455 ml/min/m(2), Cp-ss 0.31 +/- 0.09 mu g/ml. The total free Pt clearance was 1.5-5.8-fold higher (3.4 +/- 1.0) than the glomerular filtration rate (GFR). The renal clearance of cisplatin was not related to GFR and cisplatin was subject to only limited urinary excretion (27% administered dose 0-48 h), indicating that there are other important pathways of clearance beside renal elimination. Patient and treatment heterogeneity pre eluded the investigation of pharmacokinetic-pharmacodynamic relationships; however, the degree of interpatient pharmacokinetic variability observed suggests that body surface area-based dosing of cisplatin in children is not satisfactory. (C) 1997 Elsevier Science Ltd.


Publication metadata

Author(s): Peng, B., English, M. W., Boddy, A. V., Price, L, Wyllie, R., Pearson, A. D. J. , Tilby, M. J., Newell, D. R.

Publication type: Article

Publication status: Published

Journal: European Journal of Cancer

Year: 1997

Volume: 33

Issue: 11

Pages: 1823-1828

Print publication date: 01/10/1997

ISSN (print): 0959-8049

ISSN (electronic): 1879-0852

URL: http://dx.doi.org/10.1016/S0959-8049(97)00341-9

DOI: 10.1016/S0959-8049(97)00341-9


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