Improvement in intraperitoneal intraoperative cisplatin exposure based on pharmacokinetic analysis in patients with ovarian cancer
| Autor: | Jean-Pierre Kantelip, Xavier Pivot, Bruno Chauffert, Emmanuel Guardiola, Delphine Delroeux, Marielle Combe, Bernard Royer, Guillaume Hoizey, Bruno Heyd, Damien Montange |
|---|---|
| Přispěvatelé: | Laboratoire de Pharmacologie Clinique et Toxicologie [Besancon], Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz-Université de Franche-Comté ( UFC ), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC ( HOTE GREFFON ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Etablissement français du sang [Bourgogne-France-Comté] ( EFS [Bourgogne-France-Comté] ) -Université de Franche-Comté ( UFC ), Service de chirurgie viscérale et digestive - Unité de transplantation hépatique, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Jean Minjoz, Service d'oncologie Médicale, Département d'Anesthésie, Université de Reims Champagne-Ardenne ( URCA ), Mort cellulaire et cancer, Université de Bourgogne ( UB ) -IFR100 - Structure fédérative de recherche Santé-STIC-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Saas, Philippe, Laboratoire de Pharmacologie Clinique et Toxicologie [CHRU Besancon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service d'Oncologie Médicale [CHRU Besançon], Université de Reims Champagne-Ardenne (URCA), Université de Bourgogne (UB)-IFR100 - Structure fédérative de recherche Santé-STIC-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Jazyk: | angličtina |
| Rok vydání: | 2008 |
| Předmět: |
Cancer Research
medicine.medical_treatment FIGO Stage IIIC MESH : Aged Toxicology MESH : Antineoplastic Agents Phytogenic Carboplatin Intraoperative Period 0302 clinical medicine MESH: Carboplatin Medicine [ SDV.IMM ] Life Sciences [q-bio]/Immunology Pharmacology (medical) Infusions Parenteral MESH : Neoplasm Staging MESH : Female 030212 general & internal medicine Ovarian Neoplasms MESH: Aged MESH: Middle Aged Area under the curve MESH : Protein Binding MESH: Neoplasm Staging Middle Aged MESH : Adult Debulking 3. Good health MESH: Ovarian Neoplasms MESH : Antineoplastic Agents MESH : Infusions Parenteral Oncology 030220 oncology & carcinogenesis Area Under Curve MESH : Paclitaxel MESH : Carboplatin [SDV.IMM]Life Sciences [q-bio]/Immunology Female MESH : Intraoperative Period medicine.drug Protein Binding Adult medicine.medical_specialty Paclitaxel [SDV.IMM] Life Sciences [q-bio]/Immunology MESH: Antineoplastic Agents Phytogenic Urology Antineoplastic Agents MESH : Cisplatin 03 medical and health sciences Pharmacokinetics Humans MESH: Protein Binding MESH : Middle Aged MESH: Paclitaxel Aged Neoplasm Staging Pharmacology Cisplatin MESH: Intraoperative Period Chemotherapy MESH: Humans business.industry MESH : Ovarian Neoplasms MESH : Humans Cancer MESH: Adult medicine.disease Antineoplastic Agents Phytogenic Surgery MESH: Infusions Parenteral MESH: Cisplatin MESH: Antineoplastic Agents MESH: Area Under Curve MESH : Area Under Curve business Ovarian cancer MESH: Female |
| Zdroj: | Cancer Chemotherapy and Pharmacology Cancer Chemotherapy and Pharmacology, Springer Verlag, 2008, 61 (3), pp.415-21. 〈10.1007/s00280-007-0484-x〉 Cancer Chemotherapy and Pharmacology, Springer Verlag, 2008, 61 (3), pp.415-21. ⟨10.1007/s00280-007-0484-x⟩ |
| ISSN: | 0344-5704 1432-0843 |
| DOI: | 10.1007/s00280-007-0484-x〉 |
| Popis: | International audience; Ovarian cancer is the leading cause of gynecological cancer-related death in Western countries. The present treatment standards for ovarian cancer are based on the association of debulking surgery with platinum-based chemotherapy. Another strategy that could be further investigated is intraperitoneal chemotherapy (IP). We previously described that the 2-h administration of intraoperative IP cisplatin did not reach satisfactory concentrations. In the present study, we present the results of a pharmacokinetic analysis performed after two consecutive 1-h IP 30 mg/l cisplatin administrations. Twenty-seven patients with advanced epithelial cancer classified FIGO stage IIIC were included in the study. Blood and IP samples were taken over a 24-h period, during and after IP treatment. Both total and ultrafiltered (Uf) platinum (Pt) concentration levels were analyzed. Biological and clinical toxicities were also recorded. With this strategy, IP Pt concentrations stayed above the target concentration (10 mg/l) for a satisfactory length of time. The serum Pt concentrations were higher than those observed with the "one-bath" protocol and they induced the occurrence of recoverable renal toxicities (3 grade 1, 7 grade 2 and 4 grade 3). The best predictive parameter for renal failure was the total Pt 24-h Area Under the Curve (AUC) with a threshold value of 25 mg h/l RR = 0.31 (95% CI 0.13 - 0.49, P < 0.01). Administration of an increased amount of cisplatin is feasible and a satisfactory level of IP Pt concentrations is obtained. However, this improvement is associated with an increase in serum Pt levels and resulting renal toxicities. An attractive solution would be to decrease Pt transfer from peritoneum to bloodstream. A phase 1 study using intraoperative IP epinephrine in order to decrease this transfer is presently being carried out. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink