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Pharmacokinetics and pharmacodynamics of doxorubicin in patients with small cell lung cancer
Author(s) -
Piscitelli Stephen C,
Rodvold Keith A,
Rushing Daniel A,
Tewksbury Duane A
Publication year - 1993
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.1993.69
Subject(s) - pharmacokinetics , pharmacodynamics , medicine , doxorubicin , pharmacology , lung cancer , concomitant , volume of distribution , dosing , chemotherapy
The pharmacokinetics and pharmacodynamics of doxorubicin and its metabolite, doxorubicinol, were studied in 35 adult (mean age, 66½ years) patients with small cell lung cancer after a 1‐hour intravenous infusion at a dose ranging from 45 to 72 mg/m 2 . All patients also received concomitant therapy with cyclophosphamide and vincristine. Serum concentrations were sampled to 48 hours after dosing. Wide interpatient variability was observed for all pharmacokinetic parameters with coefficients of variation for apparent volume of distribution, clearance, and area under the curve (AUC) of 62%, 65%, and 65%, respectively. Four patients with impaired liver function showed a significant (p < 0.05) decrease in clearance (239 versus 666 ml/min/m 2 ) and increases in AUC (4610 versus 1834 ng · hr/ml) and elimination half‐life (49.3 versus 25.6 hours) compared with patients with normal hepatic function. A significant relationship was found between systemic exposure of doxorubicin (defined by AUC) and surviving factor of white blood cells (r = 0.57, p = 0.0025). No relationships were noted between doxorubicinol exposure and surviving factor of white blood cells or platelets. These findings show the important relationship between systemic exposure of doxorubicin and the degree of myelosuppression in patients with small cell lung cancer. Clinical Pharmacology and Therapeutics (1993) 53, 555–561; doi: 10.1038/clpt.1993.69