TC > 0.05 as a Pharmacokinetic Parameter of Paclitaxel for Therapeutic Efficacy and Toxicity in Cancer Patients.

Autor: Xin DS; Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Raoping Rd, Shantou 515041, Guangdong, China., Zhou L; Department of Gynecologic Oncology, Cancer Hospital of Shantou University Medical College, Raoping Rd, Shantou 515041, Guangdong, China., Li CZ; Department of Gynecologic Oncology, Cancer Hospital of Shantou University Medical College, Raoping Rd, Shantou 515041, Guangdong, China., Zhang SQ; Medical Oncology, Cancer Hospital of Shantou University Medical College, Raoping Rd, Shantou, Guangdong, 515041, China., Huang HQ; Department of Ultrasound, Cancer Hospital of Shantou University Medical College, Raoping Rd, Shantou 515041, Guangdong, China., Qiu GD; Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Raoping Rd, Shantou 515041, Guangdong, China.; Clinical Pharmacy Research Center, Shantou University Medical College, Raoping Rd, Shantou 515041, Guangdong, China., Lin LF; Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Raoping Rd, Shantou 515041, Guangdong, China., She YQ; Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Raoping Rd, Shantou 515041, Guangdong, China.; Clinical Pharmacy Research Center, Shantou University Medical College, Raoping Rd, Shantou 515041, Guangdong, China., Zheng JT; Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Raoping Rd, Shantou 515041, Guangdong, China., Chen C; Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Raoping Rd, Shantou 515041, Guangdong, China., Fang L; Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Raoping Rd, Shantou 515041, Guangdong, China., Chen ZS; Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, St. John`s University, 8000 Utopia Parkway, Queens, NY 11439, United States., Zhang SY; Department of Pharmacy, Cancer Hospital of Shantou University Medical College, Raoping Rd, Shantou 515041, Guangdong, China.; Clinical Pharmacy Research Center, Shantou University Medical College, Raoping Rd, Shantou 515041, Guangdong, China.
Jazyk: angličtina
Zdroj: Recent patents on anti-cancer drug discovery [Recent Pat Anticancer Drug Discov] 2018; Vol. 13 (3), pp. 341-347.
DOI: 10.2174/1574892813666180305170439
Abstrakt: Background: Paclitaxel (PTX) has remarkable anti-tumor activity, but it causes severe toxicities. There is an urgent need to seek an appropriate pharmacokinetic parameter of PTX to improve treatment efficacy and reduce adverse effects.
Objective: To evaluate the association of pharmacokinetic parameter TC > 0.05 of paclitaxel (PTX) and its therapeutic efficacy and toxicity in patients with solid tumors.
Methods: A total of 295 patients with ovarian cancer, esophageal cancer, breast cancer, and non-small cell lung cancer (NSCLC), who were admitted to the Tumor Hospital of Shantou University Medical College, China, were recruited for this study. Patients received 3 weeks of PTX chemotherapy. The plasma concentrations of PTX were examined using the MyPaclitaxel™ kit. The patients' PTX TC > 0.05 (the time during which PTX plasma concentration exceed 0.05µmol/L) were calculated based on pharmacokinetic analysis.
Results: The results showed that: (1) the concentrations of PTX in these 295 patients ranged from 0.0358-0.127 µmol/L; (2) the PTX TC > 0.05 ranged from 14 to 38h with a median time of 27h; (3) among all treatment cycles, there was a statistically significant difference in the PTX TC > 0.05 between CR+PR and SD+PD; (4) with the increasing value of TC > 0.05, level of leukopenia and leukopenic fever increased; (5) high PTX TC > 0.05 led to the occurrence of neutropenia, neutropenic fever, severe anemia, and severe peripheral neurotoxicity. Taken together, our results indicated that the pharmacokinetic parameter PTX TC > 0.05 was an effective measure of treatment efficacy and toxicity in patients with solid tumors. Maintaining PTX TC > 0.05 at 26 to 30h could improve its efficacy and reduce the incidence of leukopenia, neutropenia, anemia, and peripheral neurotoxicity in these patients.
Conclusion: PTX TC > 0.05 is a key pharmacokinetic parameter of PTX which should be monitored to optimize individual treatment in patients with solid tumors.
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Databáze: MEDLINE