Continuous ambulatory peritoneal dialysis: Pharmacokinetics and clinical outcome of paclitaxel and carboplatin treatment
Purpose: Administration of chemotherapy in patients with renal failure, treated with hemodialysis or continuous ambulatory peritoneal dialysis (CAPD) is still a challenge and literature data is scarce. Here we present a case study of a patient on CAPD, treated with weekly and three-weekly paclitaxel/ carboplatin for recurrent ovarian cancer. Experimental: During the first, second and ninth cycle of treatment, blood, urine and CAPD samples were collected for pharmacokinetic analysis of paclitaxel and total and unbound carboplatin-derived platinum. Results: Treatment was well tolerated by the patient. No excessive toxicity was observed and at the end of treatment she was in a complete remission. The plasma pharmacokinetics of paclitaxel were unaltered compared to historical data, with neglectable urinary and CAPD clearance. In contrast, the pharmacokinetics of carboplatin were altered, with doubled half-lives compared to patients with normal renal function. Of the administered carboplatin dose, up to 20% was cleared via the dialysate, while only up to 8% was cleared via the urine. Conclusion: Paclitaxel and carboplatin can be safely administered to patients with chronic renal failure on CAPD. For paclitaxel the generally applied dose can be administered, and although for carboplatin dose-adjustment is required due to the diminished renal function, the dose can be calculated using Calvert's formula.
|Keywords||CAPD, Carboplatin, Ovarian cancer, Paclitaxel, Pharmacokinetic|
|Persistent URL||dx.doi.org/10.1007/s00280-007-0671-9, hdl.handle.net/1765/15940|
|Journal||Cancer Chemotherapy and Pharmacology|
Heijns, J.B, van der Burg, M.E.L, van Gelder, T, Fieren, M.W.J.A, de Bruijn, P, van der Gaast, A, & Loos, W.J. (2008). Continuous ambulatory peritoneal dialysis: Pharmacokinetics and clinical outcome of paclitaxel and carboplatin treatment. Cancer Chemotherapy and Pharmacology, 62(5), 841–847. doi:10.1007/s00280-007-0671-9