Prospective evaluation of the pharmacokinetics and toxicity profile of docetaxel in the elderly.
OBJECTIVE
To prospectively study the pharmacokinetics and toxicity profile of docetaxel in elderly patients with cancer.


METHODS
Docetaxel was administered at a dose 75 mg/m(2) once every 3 weeks to 25 elderly cancer patients aged >/= 65 years and 26 cancer patients aged younger than 65 years. Pharmacokinetic studies and toxicity assessments were performed during the first cycle of therapy.


RESULTS
Of 51 patients treated, 20 aged >/= 65 years (median, 71 years; range, 65 to 80 years) and 20 aged younger than 65 years (median, 53 years; range, 26 to 64 years) were assessable for pharmacokinetic studies, and 39 were assessable for toxicity. Patient characteristics were similar (P >/= .15) between the two cohorts. Mean docetaxel clearance was not altered in the elderly versus younger patients: 30.1 L/h (standard deviation [SD] 18.3 L/h) v 30.0 L/h (SD, 14.8 L/h; P = .98). The percentage of patients with grade 4 and febrile neutropenia was higher in the elderly (63% and 16%, respectively) versus younger (30% and 0%, respectively) cohort, although this observation did not reach a level of statistical significance (P = .056). From logistic regression analysis, the odds ratio for a patient aged 65 years was 1.98 for developing grade 4 neutropenia compared with a patient aged 50 years (P = .091).


CONCLUSIONS
Docetaxel plasma pharmacokinetics are unaltered in elderly patients. Patients aged >/= 65 years appear to be more sensitive to docetaxel-induced neutropenia.
ten Tije
Albert J
AJ
Erasmus University Medical Center, Rotterdam, The Netherlands.
Verweij
Jaap
J
Carducci
Michael A
MA
Graveland
Wilfried
W
Rogers
Theresa
T
Pronk
Tatjana
T
Verbruggen
M P
MP
Dawkins
Fitzroy
F
Baker
Sharyn D
SD
D000328:Adult; D000368:Aged; D000972:Antineoplastic Agents, Phytogenic / Q000009:adverse effects* / Q000493:pharmacokinetics*; D000077143:Docetaxel; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D009503:Neutropenia / Q000139:chemically induced; D043823:Taxoids / Q000009:adverse effects* / Q000493:pharmacokinetics*
D000972:Antineoplastic Agents, Phytogenic; D043823:Taxoids; D000077143:Docetaxel