Adjustment of creatinine clearance for carboplatin dosing in Calvert's formula and clinical efficacy for lung cancer.

Autor: Hatta T; Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan., Hase T; Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan., Hara T; Department of Respiratory Medicine, Anjo Kosei Hospital, Anjo, Japan., Kimura T; Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Japan., Kojima E; Department of Respiratory Medicine, Komaki City Hospital, Komaki, Japan., Abe T; Department of Respiratory Medicine, Ogaki Municipal Hospital, Ogaki, Japan., Horio Y; Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan., Goto Y; Department of Respiratory Medicine, Fujita Health University School of Medicine, Toyoake, Japan., Ozawa N; Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan., Yogo N; Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan., Shibata H; Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan., Shimokata T; Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan., Oguri T; Department of Education and Research Center for Community Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan., Yamamoto M; Department of Respiratory Medicine, Nagoya Ekisaikai Hospital, Nagoya, Japan., Yanagisawa K; Division of Molecular and Cancer Medicine, Faculty of Pharmacy, Meijo University, Nagoya, Japan., Ando M; Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan., Ando Y; Department of Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan., Kondo M; Department of Respiratory Medicine, Fujita Health University School of Medicine, Toyoake, Japan., Ishii M; Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan., Hasegawa Y; Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.; National Hospital Organization, Nagoya Medical Center, Nagoya, Japan.
Jazyk: angličtina
Zdroj: Cancer medicine [Cancer Med] 2023 Aug; Vol. 12 (15), pp. 15955-15969. Date of Electronic Publication: 2023 Jun 23.
DOI: 10.1002/cam4.6235
Abstrakt: Background: The Cockcroft-Gault formula is commonly used as a substitute for glomerular filtration rate (GFR) in Calvert's formula for carboplatin dosing, where adjusting serum creatinine measured using the enzymatic method with 0.2 mg/dL has been suggested in Japan. However, the effects of these adjustments on efficacy in patients with non-small-cell lung cancer remain unknown.
Methods: We conducted a post hoc analysis of the PREDICT1 study (CJLSG1201), a multicenter prospective observational trial of carboplatin-pemetrexed. Glomerular filtration rate values in Calvert's formula were back-calculated from the administered dosages of carboplatin and the reported value of the target area under the curve. We estimated the serum creatinine adjustments and divided the patients into crude and adjusted groups.
Results: Patients in the crude group (N = 169) demonstrated similar efficacy to those in the adjusted group (N = 104) in progression-free survival (PFS) and overall survival (OS) (hazard ratio [HR], 1.02; 95% confidence interval [CI], 0.76-1.35; p = 0.916 vs. HR, 0.87; 95% CI, 0.65-1.17; p = 0.363), with higher grade 3-4 hematologic toxicity. Among patients aged ≥75 years, the crude group (N = 47) showed superior efficacy compared with the adjusted group (N = 17) in PFS and OS (HR, 0.37; 95% CI, 0.20-0.69; p = 0.002 vs. HR, 0.43; 95% CI, 0.23-0.82; p = 0.010).
Conclusions: Serum creatinine adjustment may be associated with similar efficacy compared to the crude serum creatinine value. In older patients, the adjustment should be cautiously applied owing to the potential for reduced efficacy.
(© 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje