Pharmacokinetics and toxicity of weekly docetaxel in older patients Journal Article
| Authors: | Hurria, A.; Fleming, M. T.; Baker, S. D.; Kelly, Wm K.; Cutchall, K.; Panageas, K.; Caravelli, J.; Yeung, H.; Kris, M. G.; Gomez, J.; Miller, V. A.; D'Andrea, G.; Scher, H. I.; Norton, L.; Hudis, C. |
| Article Title: | Pharmacokinetics and toxicity of weekly docetaxel in older patients |
| Abstract: | Purpose: To evaluate the pharmacokinetics of weekly docetaxel in a cohort of older patients with metastatic cancer and to explore the relationship of pharmacokinetic variables, Erythromycin Breath Test results, age, geriatric assessment variables, and toxicity to therapy. Experimental Design: Twenty patients ages ≥65 years with metastatic breast, prostate, or lung cancer entered an Institutional Review Board - approved protocol to evaluate the pharmacokinetics of weekly docetaxel administered at 35 mg/m2 i.v. for 3 weeks followed by a 1-week break. The Erythromycin Breath Test and geriatric assessment were done before the first dose. Blood samples were collected for pharmacokinetic analysis with the first dose of docetaxel. Results: Of the 20 patients who entered the study, 19 were evaluable. There were no age-related differences in the pharmacokinetics of weekly docetaxel. Fifty-eight percent (11 of 19) experienced grade ≥3 toxicity: 16% (3 of 19) grade ≥3 hematologic toxicity, and 53% (10 of 19) grade ≥3 nonhematologic toxicity. There was an association between the Erythromycin Breath Test results and docetaxel pharmacokinetic variables; however, there was no association between Erythromycin Breath Test results or docetaxel pharmacokinetics with frequency of grade ≥3 toxicity. Conclusions: Despite no statistically significant age-related differences in weekly docetaxel pharmacokinetics, over half of these older patients experienced a grade ≥3 toxicity at the 35 mg/m2 starting dose. We advocate a starting dose of 26 mg/m2 on this weekly schedule and dose escalating if no toxicity. © 2006 American Association for Cancer Research. |
| Keywords: | cancer chemotherapy; clinical article; controlled study; treatment outcome; aged; disease course; fatigue; neutropenia; diarrhea; protein function; infection; neuropathy; lung neoplasms; antineoplastic agents, phytogenic; dexamethasone; breast neoplasms; docetaxel; dyspnea; prostate cancer; prostatic neoplasms; confusion; hypokalemia; lung metastasis; disease severity; drug distribution; blood analysis; neoplasm metastasis; drug clearance; aging; daily life activity; taxoids; drug metabolism; liver function test; drug half life; heart arrhythmia; aphasia; breast metastasis; drug dose regimen; hallucination; hematologic disease; geriatric assessment; hypocalcemia; erythromycin; cytochrome p450 3a4; breath analysis |
| Journal Title: | Clinical Cancer Research |
| Volume: | 12 |
| Issue: | 20 |
| ISSN: | 1078-0432 |
| Publisher: | American Association for Cancer Research |
| Date Published: | 2006-10-15 |
| Start Page: | 6100 |
| End Page: | 6105 |
| Language: | English |
| DOI: | 10.1158/1078-0432.ccr-06-0200 |
| PUBMED: | 17062686 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 28" - "Export Date: 4 June 2012" - "CODEN: CCREF" - "Source: Scopus" |
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