Dobbs, N.A., Twelves, C.J., Gregory, W., Cruickshanka, C., Richards, M.A. and Rubens, R.D. (2003) Epirubicin in patients with liver dysfunction: development and evaluation of a novel dose modification scheme. European Journal of Cancer, 39, pp. 580-586.
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Abstract
This study aimed to develop an epirubicin dose modification scheme in women with breast cancer and liver dysfunction. We first identified target areas under the concentration-time curve (AUCs) of 2400 and 1600 ng/ml.h from pharmacokinetic studies in 15 women with normal liver tests. In a second group of 16 women with abnormal liver biochemistry, the relationship between raised asparate aminotransferase (AST) and epirubicin clearance was: dose=AUC (97.5-34.2xlog AST). Adaptive dosing was evaluated prospectively in a third group of 41 women with serum AST > or =2xnormal+/-raised bilirubin. The median AUCs were 2444 and 1608 ng/ml.h, close to the high and low target AUCs, respectively. Variability in AUC was lower with adaptive dosing than in a fourth group given an unadjusted dose of epirubicin (coefficient of variation=25.8, 30.0 and 46.5%, respectively; P=0.06). Epirubicin dosing based on AST is safe and may reduce pharmacokinetic variability.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | UNSPECIFIED |
| Authors: | Dobbs, N.A., Twelves, C.J., Gregory, W., Cruickshanka, C., Richards, M.A., and Rubens, R.D. |
| College/School: | College of Medical Veterinary and Life Sciences |
| Journal Name: | European Journal of Cancer |
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