title: [Safe and effective administration of carboplatin-based chemotherapy in a patient undergoing hemodialysis with cancer of unknown primary by monitoring observed AUC of carboplatin-a case report].
abstract: Here we report a case of successful treatment with combination chemotherapy of carboplatin(CBDCA)and paclitaxel for a patient undergoing hemodialysis(HD)with cancer of unknown primary, conducted by monitoring the observed AUC of ultrafilterable CBDCA. CBDCA was administered at a dose of 125 mg on day 1 in each course, an amount which had been calculated by the Calvert formula(GFR: 0, target AUC: 5). HD was started at a point in time one hour after the completion of each CBDCA administration, and performed for 5 hours in each course. Blood samples were collected during the first 3 courses of chemotherapy to measure the plasma concentration of free-platinum. The observed AUCs(o-AUC)of CBDCA in the first, second and third courses were 3. 03, 3. 44 and 3. 50mg·min/mL, respectively. The o-AUC in the first course was lower than that in the second course. The o-AUC in the second course was nearly equal to that in the third course, while each o-AUC was below the target AUC(t-AUC). Partial response was achieved after two courses of the CBDCA and paclitaxel combination chemotherapy, with adverse events of Grade 3 neutropenia and Grade 3 peripheral neuropathy observed in each course after the second course of chemotherapy. o-AUC of CBDCA administered to HD patients can not only be below t-AUC, as in this case, but also oppositely above t-AUC in cases with different doses of CBDCA or HD settings. Our results suggest that the monitoring of o-AUC of CBDCA is useful when practicing CBDCA-based chemotherapy safely and effectively in cancer patients undergoing HD.
authors.affiliation: Dept. of Pharmacy, Nagoya City University Hospital.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kondo
authors.forename: Junko
authors.initials: J
authors.lastname: Kuroda
authors.forename: Yoshitomo
authors.initials: Y
authors.lastname: Ikai
authors.forename: Rumiko
authors.initials: R
authors.lastname: Hayashi
authors.forename: Shiori
authors.initials: S
authors.lastname: Uegaki
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Yoshida
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Yoshida
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Komatsu
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kimura
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D019540:Area Under Curve; D016190:Carboplatin / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications; D008297:Male; D009382:Neoplasms, Unknown Primary / Q000150:complications / Q000188:drug therapy*; D006435:Renal Dialysis
chemical_list: D000970:Antineoplastic Agents; D016190:Carboplatin