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Related Experiment Videos

Cisplatin pharmacokinetics in elderly patients

A Bonetti1, T Franceschi, P Apostoli

  • 1Department of Medical Oncology, University of Verona, Italy.

Therapeutic Drug Monitoring
|October 1, 1994
PubMed
Summary

Therapeutic drug monitoring of cisplatin chemotherapy in elderly cancer patients showed a reduced ability to clear platinum, leading to increased drug exposure. This suggests careful monitoring is crucial for optimizing treatment in this population.

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Area of Science:

  • Oncology
  • Pharmacology
  • Geriatrics

Background:

  • Elderly cancer patients present unique treatment challenges due to organ function decline, comorbidities, and narrow therapeutic indices of chemotherapy drugs.
  • Therapeutic drug monitoring (TDM) can be a valuable tool for optimizing chemotherapy efficacy and safety in older adults.

Purpose of the Study:

  • To evaluate the pharmacokinetic profile of cisplatin-based chemotherapy in elderly patients (over 70 years) with solid tumors.
  • To assess the safety and tolerability of cisplatin chemotherapy in this specific patient cohort.

Main Methods:

  • Six elderly patients with solid tumors received cisplatin (DDP) chemotherapy (50-65 mg/m2).
  • Plasma and urine platinum (Pt) levels were measured using atomic absorption spectroscopy during the first cycle.

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  • Pharmacokinetic analysis was performed using a two-compartment open model.

    • Main Results:

    • Cisplatin treatment was generally well-tolerated, with minor impacts on hemoglobin levels.
    • A notable increase in serum creatinine and a decrease in creatinine clearance were observed post-treatment.
    • Pharmacokinetic parameters for total platinum aligned with data from other adult populations, but a reduced clearance of ultrafilterable platinum was evident, leading to increased drug exposure (AUC).

    Conclusions:

    • Elderly patients may exhibit impaired clearance of ultrafilterable platinum, necessitating careful therapeutic drug monitoring.
    • While generally tolerated, cisplatin chemotherapy in the elderly requires vigilant monitoring of renal function and drug levels to optimize outcomes.
    • Further studies with larger cohorts are needed to confirm these findings due to the limited sample size and concomitant therapies used.