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[Dose expression of antineoplastic drugs]
La Revue De Medecine Interne
|January 1, 1996
Summary
Body surface area (BSA) is commonly used for anticancer drug dosing but lacks rigorous validation. This study found no significant correlation between BSA and drug clearance, suggesting BSA adjustment increases variability for cytarabine and adriamycin.
Area of Science:
- Pharmacology
- Oncology
- Biostatistics
Context:
- Anticancer drug dosage adjustments are typically based on body surface area (BSA).
- The scientific basis for using BSA to standardize drug doses has not been rigorously established.
- Objective methods are needed to evaluate the utility of BSA in dose adjustment.
Purpose:
- To propose and apply a method for objectively testing the utility of body surface area in anticancer drug dosage.
- To investigate the statistical correlation between body surface area and plasmatic total clearance for anticancer drugs.
- To assess the impact of BSA-based dosing on drug pharmacokinetic variability and efficacy.
Summary:
- Mathematical equations demonstrate that body surface area and drug clearance should correlate for effective dose adjustment.
- Testing with cytarabine and adriamycin revealed no significant correlation between BSA and plasmatic clearance.
- Adjusting doses based on BSA for these drugs increases pharmacokinetic and efficacy variability.
Impact:
- Findings challenge the conventional use of BSA for anticancer drug dosing.
- Suggests that BSA-based dosing may lead to suboptimal therapeutic outcomes due to increased variability.
- Highlights the potential of dose-intensity and pharmacokinetic/pharmacodynamic studies for personalized cancer therapy.
- Recommends using Area Under the Curve (AUC) for determining maximal tolerable and minimal effective drug exposures.