title: Pharmacokinetics of oxaliplatin in a hemodialytic patient treated with modified FOLFOX-6 plus bevacizumab therapy.
abstract: OBJECTIVE
  To establish an appropriate administration schedule for oxaliplatin in FOLFOX plus bevacizumab therapy for a hemodialytic patient.
  
  
  METHODS
  A 50-year-old man on chronic hemodialysis was treated for colon cancer and synchronous hepatic metastasis with modified FOLFOX-6 plus bevacizumab therapy every 3 weeks. The plasma concentration of free platinum was measured at eight points, before and within the first 50 h after oxaliplatin administration. A dose escalation study of oxaliplatin was performed at doses of 60, 70, and 85 mg/m(2). A 4-h dialysis session was begun at the end of the oxaliplatin treatment.
  
  
  RESULTS
  The pharmacokinetics of free platinum showed a bimodal pattern at each dose: The serum concentration decreased rapidly soon after dialysis, then increased, and remained at a high level for 24 h. The areas under the curves (AUC) for free platinum were 17.6, 23.6, and 32.6 μg h/mL after doses of 60, 70, and 85 mg/m(2) oxaliplatin, respectively. These exceeded the AUC when 90 mg/m(2) was given to a patient with normal renal function (7.9 μg h/mL). Treatment was safely continued for 6 months without severe toxicity.
  
  
  CONCLUSIONS
  FOLFOX plus bevacizumab therapy can be given safely to hemodialytic patients with no reduction in the dose of oxaliplatin if hemodialysis is performed soon after the administration of oxaliplatin and the dosing interval is extended to 3 weeks.
authors.affiliation: Department of Gastroenterology and Hepatology, Kyoto University Graduate School of Medicine, 54 Shogoinkawaharacho, Sakyo-ku, Kyoto 606-8507, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Horimatsu
authors.forename: Shin'ichi
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Shuko
authors.initials: S
authors.lastname: Morita
authors.forename: Yoko
authors.initials: Y
authors.lastname: Mashimo
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Ezoe
authors.forename: Manabu
authors.initials: M
authors.lastname: Muto
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Chiba
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D000068258:Bevacizumab; D015179:Colorectal Neoplasms / Q000188:drug therapy; D005472:Fluorouracil / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D002955:Leucovorin / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D000077150:Oxaliplatin; D006435:Renal Dialysis
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000068258:Bevacizumab; D002955:Leucovorin; D005472:Fluorouracil