The pharmacokinetics of a 1-h paclitaxel infusion

被引:50
作者
Mross K. [1 ]
Holländer N. [2 ]
Hauns B. [1 ]
Schumacher M. [2 ]
Maier-Lenz H. [1 ]
机构
[1] Department of Medical Oncology and Clinical Pharmacology, Tumor Biology Center at the Albert-Ludwigs-University Freiburg, 79106 Freiburg
[2] Institute of Medical Biometry and Medical Informatics, Albert-Ludwigs-University
关键词
Paclitaxel; Pharmacokinetics; Toxicity;
D O I
10.1007/s002800051020
中图分类号
学科分类号
摘要
Purpose: To characterize the disposition of paclitaxel (PAC) after a 1-h infusion in humans and define if possible a pharmacodynamic relationship between PAC disposition and the observed toxicity. Patients and methods: PAC pharmacokinetics were studied in 43 courses of therapy in 30 patients (30 first course, 13 PK third course). PAC was administered at 150, 175, 200, 225 and 250 mg/m2 by a 1-h infusion to patients with advanced cancer (lung, breast, ovarian, cervix, and head and neck). PAC was quantified by high- performance liquid chromatography (HPLC). Pharmacokinetic parameters were calculated by noncompartmental and model-dependent methods. Results: Increases in the area under the curve and the peak plasma concentration were not proportional to increases in the dose. However, the deviation from linearity is rather moderate. The dose-limiting toxicity was central neuropathy which was not associated with pharmacokinetic deviations. Owing to the absence of grade 3 or 4 myelotoxicity, no clear correlation between this toxicity and pharmacokinetic parameters could be established. Conclusion: Within the evaluated dose range of the 1-h infusion there was only a moderate nonlinear disposition of PAC in humans and therefore a dose of 225 mg/m2 is recommended as safe. The observation of central neuropathy could not be directly related to a pharmacokinetic parameter. The complexity of the formulation which included Cremophor EL and ethanol may offer an explanation for the observed central neurotoxicity.
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页码:463 / 470
页数:7
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