Abstract | PURPOSE: The purpose of this study was to determine the pharmacokinetic parameters of pentostatin in renally impaired patients in order to establish dosing guidelines for this population. METHODS:
Pentostatin doses were administered as 15-min intravenous infusions to patients based on their measured creatinine clearance (CLcr) as follows. Patients with normal renal function (NRF), defined as CLcr >60 ml/min, received 4 mg/m(2) repeated every14 days. Patients with impaired renal function (IRF) included those with CLcr 41-60 ml/min who received 3 mg/m(2) and those with CLcr 21-40 ml/min who received 2 mg/m(2), also repeated every 14 days. Heparinized plasma samples were collected during drug infusion and out through 96 h after dosing, except in two patients in whom sampling was extended to 144 h after dosing. Urine sampling extended to 96 h after dosing, and all samples were analyzed by a validated enzyme immunoassay for pentostatin concentrations. RESULTS: Enrolled in the study were 13 patients (7 IRF and 6 NRF), of whom 12 contributed samples for pharmacokinetic analysis. Median baseline CLcr values were 71.5 ml/min for NRF patients and 44 ml/min for IRF patients. Following the end of intravenous infusion, pentostatin plasma concentrations declined biexponentially with time. In some patients there was a transient increase in pentostatin equivalents 2 to 4 h after dosing. There was a good correlation between measured CLcr and pentostatin total plasma clearance. The AUC(0- infinity ) values seen in IRF patients, at lower doses, were within the range of the AUC(0- infinity ) values seen in patients with normal CLcr. Toxicities observed in the two groups of patients were similar. CONCLUSIONS: The pentostatin doses used in the study appear to be appropriate for administration to cancer patients with varying degrees of renal impairment.
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Authors | Chetan Lathia, Gini F Fleming, Mark Meyer, Mark J Ratain, Lloyd Whitfield |
Journal | Cancer chemotherapy and pharmacology
(Cancer Chemother Pharmacol)
Vol. 50
Issue 2
Pg. 121-6
(Aug 2002)
ISSN: 0344-5704 [Print] Germany |
PMID | 12172976
(Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Antimetabolites, Antineoplastic
- Enzyme Inhibitors
- Pentostatin
- Creatinine
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Topics |
- Aged
- Aged, 80 and over
- Antimetabolites, Antineoplastic
(administration & dosage, blood, pharmacokinetics, urine)
- Area Under Curve
- Creatinine
(blood)
- Enzyme Inhibitors
(administration & dosage, blood, pharmacokinetics, urine)
- Female
- Humans
- Kidney Diseases
(metabolism)
- Male
- Metabolic Clearance Rate
- Middle Aged
- Neoplasms
(complications, drug therapy, metabolism)
- Pentostatin
(administration & dosage, blood, pharmacokinetics, urine)
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