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Drug Dosing: Obese Patients

Drug Dosing: Obese Patients

In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...

Pharmacokinetics in Obese Patients: Drug Absorption and Distribution

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Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...

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Drug metabolism, a critical process in the liver, involves two primary phases: Phase I reactions and Phase II conjugation. Obesity introduces significant alterations in this metabolic process, primarily due to fatty infiltration of the liver, leading to conditions such as nonalcoholic fatty liver disease (NAFLD). This condition can modify the activities of both Phase I and II enzymes, impacting how drugs are metabolized in obese patients.Phase I metabolism sees variable effects across...

Drug Dosage Regimen: Overview

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Treatment Resistant Cancers

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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...

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Related Experiment Video

Updated: Nov 7, 2025

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy

Published on: May 8, 2018

Appropriate Systemic Therapy Dosing for Obese Adult Patients With Cancer: ASCO Guideline Update.

Jennifer J Griggs¹, Kari Bohlke², Edward P Balaban³

¹University of Michigan, Ann Arbor, MI.

Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology

|May 3, 2021

Summary

Obese adults with cancer can safely receive full doses of chemotherapy, immunotherapy, and targeted therapies. Dose modifications for toxicity should be similar for obese and nonobese patients.

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Testing Targeted Therapies in Cancer using Structural DNA Alteration Analysis and Patient-Derived Xenografts

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Published on: July 25, 2020

Area of Science:

Oncology
Clinical Pharmacology

Background:

Obesity is a growing concern in cancer patient populations.
Optimal dosing of systemic antineoplastic agents in obese adults remains a critical clinical question.

Purpose of the Study:

To establish evidence-based recommendations for dosing antineoplastic agents in obese adults with cancer.
To update existing guidelines on cancer treatment for obese patients.

Main Methods:

Systematic literature review of randomized controlled trials, meta-analyses, and cohort studies (2010-2020).
Searched PubMed and Cochrane Library for studies on chemotherapy, immunotherapy, and targeted therapy dosing in obese cancer patients.
ASCO Expert Panel convened to review evidence and formulate recommendations.

Main Results:

Evidence supports full, body-size-based dosing of chemotherapy in obese adults.
Limited data exists for optimal dosing of targeted therapies and immunotherapies in this population.
Sixty studies, mostly retrospective, were included in the review.

Conclusions:

Continue recommending full, weight-based cytotoxic chemotherapy doses for obese adults.
Recommend full, approved doses of immunotherapy and targeted therapies for obese adults.
Dose modifications for toxicity should be consistent between obese and nonobese patients.