title: Pharmacokinetics of trabectedin on hemodialysis: an application for the management of cancer patients with end-stage renal disease.
abstract: OBJECTIVE
  The pharmacokinetics of trabectedin has never been reported in patients with impaired renal function or in patients on hemodialysis.
  
  
  METHODS
  We examined trabectedin PK in a patient on hemodialysis, starting trabectedin therapy at a standard dose for recurrence of a retroperitoneal myxoid liposarcoma that had occurred under immunosuppressive drugs for kidney transplant.
  
  
  RESULTS
  As compared with a population with normal renal function, the study patient presented a higher C                            (max) and AUC, with lower clearance, terminal half-life, and volume of distribution. The low dialysis clearance, accounting for a minor part of the total body clearance and the absence of detectable trabectedin in the dialysate samples, suggests that hemodialysis does not efficiently clear trabectedin. Trabectedin tolerance was good.
  
  
  CONCLUSIONS
  This case reports for the first time the feasibility of trabectedin therapy in a hemodialyzed patient. Given the rising incidence of cancer in patients with end-stage renal disease, it is crucial to provide data that improve the management of anticancer drugs in dialyzed patients.
authors.affiliation: Department of Radiation Oncology/IBDC CNRS 6543, Centre Antoine Lacassagne, 33 Av. de Valombrose, 06189 Nice Cedex 2, France. jthariat@hotmail.com
authors.forename: Juliette
authors.initials: J
authors.lastname: Thariat
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Etienne-Grimaldi
authors.forename: Vincent
authors.initials: V
authors.lastname: Launay-Vacher
authors.forename: Arturo
authors.initials: A
authors.lastname: Soto-Matos
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernandez-Teruel
authors.forename: Thomas
authors.initials: T
authors.lastname: Ghafari
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Marcy
authors.forename: Gérard
authors.initials: G
authors.lastname: Milano
authors.forename: Nicole
authors.initials: N
authors.lastname: Renée
authors.forename: Lauris
authors.initials: L
authors.lastname: Gastaud
authors.forename: Antoine
authors.initials: A
authors.lastname: Thyss
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000493:pharmacokinetics* / Q000627:therapeutic use; D019540:Area Under Curve; D004149:Dioxoles / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005260:Female; D006207:Half-Life; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology; D008080:Liposarcoma / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008875:Middle Aged; D006435:Renal Dialysis; D044005:Tetrahydroisoquinolines / Q000493:pharmacokinetics* / Q000627:therapeutic use; D000077606:Trabectedin
chemical_list: D018906:Antineoplastic Agents, Alkylating; D004149:Dioxoles; D044005:Tetrahydroisoquinolines; D000077606:Trabectedin