Comparison of two dose prediction models for cisplatin.
Cisplatin toxicity could be decreased by adjusting its dosage to each patient. For this purpose, a limited sampling method was established and validated based on a Bayesian approach taken using the values of assays during a 5-day continuous infusion of cisplatin. Using this method, a dosing model to achieve a target plasma concentration of total platinum (Pt) was evaluated retrospectively; the calculated dose of cisplatin was 95.0 to 104.8% of the actual dose. This model was then studied prospectively and the actual plasma Pt concentration reached at the end of the infusion was 94.9% of the target concentration. A strong correlation was observed between the clearance of Pt and the calculated clearance of creatinine or Cockroft index (p = 1.7 x 10(-11), and this correlation was used to develop another cisplatin dosing model. With this model the actual concentration reached at the end of the infusion was 85.3% of the theoretical concentration. The Bayesian approach gave reliable results for most clinical uses, whereas the creatinine based model has to be improved.
Desoize
B
B
GIBSA, Faculté de Pharmacie, Reim, France.
Dumont
P
P
Manot
L
L
Urien
S
S
Dufour
R
R
Berthiot
G
G
D001499:Bayes Theorem; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects* / Q000493:pharmacokinetics; D003404:Creatinine / Q000097:blood; D004334:Drug Administration Schedule; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008962:Models, Theoretical; D011446:Prospective Studies; D012189:Retrospective Studies
D003404:Creatinine; D002945:Cisplatin