[A trial of TS-1 administration on the basis of the pharmacokinetic study for an advanced gastric cancer patient with impaired renal function].
TS-1 is an antitumor drug including 5-chloro-2,4 dihydroxypyridine (CDHP), which inhibits dihydriopyrimidine dehydrogenase (DPD) activity selectively in metabolism of 5-FU. However, TS-1 therapy tends to increase adverse events for patients with impaired renal function due to excessively high blood concentration of 5-FU, because CDHP is mainly excreted into the urine. In a 67-year-old male with advanced gastric cancer, renal dysfunction occurred during TS-1 administration as its adverse event. We studied the pharmacokinetics of 5-FU, which were analyzed on the T1/2 value and the AUC (0-infinity) of 5-FU with a single and consecutive TS-1 administration, and estimated an optimal TS-1 administration regimen for this patient. The regimen is 60 mg/body/day given in one divided dose for 28 days consecutively followed by 14 days rest. This regimen enabled a continuation of TS-1 treatment for the patient. In conclusion, individual dose adjustment using pharmacokinetic study of 5-FU might be beneficial to patients with impaired renal function.
Yamamoto
Kazuyoshi
K
Dept. of Surgery, Sakai Municipal Hospital.
Imamura
Hiroshi
H
Furukawa
Hiroshi
H
Kishimoto
Tomono
T
Tanaka
Junichi
J
Oshiro
Ryota
R
Tatsuta
Masayuki
M
Masutani
Seizo
S
Fukunaga
Mutsumi
M
Nakayama
Takahiro
T
Takemoto
Hiroyoshi
H
Kondo
Motoi
M
Kamigaki
Shunji
S
Kawasaki
Takatoshi
T
D000230:Adenocarcinoma / Q000188:drug therapy*; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D004338:Drug Combinations; D006801:Humans; D007674:Kidney Diseases / Q000150:complications* / Q000378:metabolism; D008297:Male; D010094:Oxonic Acid / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D011725:Pyridines / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D013274:Stomach Neoplasms / Q000188:drug therapy*; D005641:Tegafur / Q000008:administration & dosage* / Q000493:pharmacokinetics*
D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; D011725:Pyridines; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid