Prospective evaluation of pharmacokinetically guided dosing of carboplatin in Japanese patients with cancer
Prospective evaluation of pharmacokinetically guided dosing of carboplatin in Japanese patients with cancer
复制标题
DOI：
10.1111/j.1349-7006.2010.01729.x
复制
发表时间：
2010-12-01
期刊：
影响因子：
5.7
通讯作者：
Hasegawa, Yoshinori
中科院分区：
文献类型：
--
作者：
Shimokata, Tomoya;Ando, Yuichi;Hasegawa, Yoshinori
Calvert公式，即卡铂剂量(Mg)=浓度-时间曲线(AUC)x(肾小球滤过率[GFR]+25)下的靶区，尚未在准确测量GFR的日本受试者中得到验证。这项研究的目的是评估该公式对日本癌症患者的有效性，并对其进行修改以适用于这一人群。GFR是根据菊粉清除率来测量的，这被认为是准确反映GFR的基础。本文测定了28例癌症患者的菊糖清除率。调整后的24小时肌酐清除量(24小时Ccr)对于GFR评估是无偏见的(平均预测误差[MPE]+/-SE=-2.3+/-4.5%)和可接受的精确度(均方根误差=23.7%)。对21例GFR为17.2~91.4毫升/分的患者进行了卡铂的药代动力学分析。最初的卡尔弗特公式高估了卡铂的清除量，导致MPE为14.3%。当我们修改了日本患者的卡尔弗特公式，用非肾脏清除量15代替25，即剂量=靶AUCx(GfR+15)时，最大摄入量降至-0.1%(P<；0.001)。我们的结论是，调整后的24小时Ccr对于GFR的评估是可以接受的准确的，建议日本癌症患者的卡铂非肾脏清除量低于西方同行。(《癌症科学》2010；101：2601-2605)。
The Calvert formula, that is, carboplatin dose (mg) = target area under the concentration versus time curve (AUC) x (glomerular filtration rate [GFR] + 25), has not been validated in Japanese subjects in whom the GFR was accurately measured. The purpose of this study is to evaluate the validity of this formula for Japanese patients with cancer and modify it for this population. The GFR was measured on the basis of inulin clearance, which is considered to reflect the accurate GFR. Inulin clearance was measured in 28 patients with cancer. The adjusted 24-h creatinine clearance (24-h Ccr) was unbiased (mean prediction error [MPE] +/- SE = -2.3 +/- 4.5%) and acceptably precise (root mean squared error = 23.7%) for GFR assessment. The pharmacokinetics of carboplatin were analyzed in 21 patients with a GFR of 17.2-91.4 mL/min. The original Calvert formula overestimated carboplatin clearance, resulting in an MPE of 14.3%. When we revised the Calvert formula for Japanese patients by substituting a non-renal clearance of 15 for 25, that is, dose = target AUC x (GFR + 15), the MPE decreased to -0.1% (P < 0.001). We conclude that the adjusted 24-h Ccr is acceptably precise for GFR assessment, and the non-renal clearance of carboplatin is suggested to be lower in Japanese patients with cancer than in their Western counterparts. (Cancer Sci 2010; 101: 2601-2605).