title: [Dose expression of antineoplastic drugs].
abstract: Anticancer drugs dosage are currently adjusted to body surface area. This measure is supposed to be the best morphometric parameter to adjust anticancer drug doses. However, dose adjustment to body surface area has not historically been rigorously demonstrated. We propose a method to objectively test this parameter utility. The statistical justification of drug adjustment to body surface area can use mathematical equations to be expressed. We can demonstrate that body surface area and plasmatic total clearance of a drug should be correlated to adjust dose anticancer drug to body surface area. When we test the hypothesis of body surface area and plasmatic clearance correlation for cytarabine and adriamycin we did not find any significant correlation. For these anticancer drugs, dose adjustment to body surface area increase their pharmacokinetic and efficiency variabilities. The concept of dose-intensity is probably the best justification of individual dose adjustment from plasmatic drug samples, and from pharmacokinetic and pharmacodynamic studies. The determination of the "maximal tolerable exposition" and of the "minimal effective exposition" should reduce the overexpression of toxic risks and avoid the ineffective underexpositions. However, it is difficult to precisely define these two expositions and to research the most relevant pharmacokinetic parameters to their measure. Area under curve appears to be their most appropriate expression.
authors.affiliation: Service d'oncologie médicale, CHU Timone-Adulte, Marseille, France.
authors.forename: R
authors.initials: R
authors.lastname: Favre
authors.forename: F
authors.initials: F
authors.lastname: Duffaud
authors.forename: G
authors.initials: G
authors.lastname: Erard
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000493:pharmacokinetics; D001830:Body Surface Area; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008433:Mathematics
chemical_list: D000970:Antineoplastic Agents