title: Pharmacokinetic and myocardial enzyme profiles of two administration routes of epirubicin in breast cancer patients.
abstract: To evaluate the changes in myocardial enzymes and plasma epirubicin concentration following administration by micro-pump (MP) and intravenous drip (ID) in breast cancer patients.11 self-controlled breast cancer patients were recruited for a trial with epirubicin administration by MP for 48 h and by ID for 1 h during 2 cycles of treatment. Plasma concentration of epirubicin at different time points was determined using LC-MS/MS. The levels of myocardial enzymes before and after chemotherapy were compared. Another group of patients receiving epirubicin by ID (n=4) or MP (n=9) were monitored for 4 months.8 patients completed the self-controlled study. The peak concentration of epirubicin in the MP group and the ID group were 21.84±18.85 ng/mL and 294.80±225.54 ng/mL, respectively. The MP group had a longer duration (54~60 h) of plasma concentration of epirubicin not less than 10 ng/mL than that of the ID group (8~14 h). There was significant difference for the alteration of myocardial enzymes before and after chemotherapy (p<0.05) in the ID group, whereas the MP group showed no significant difference (p>0.05). The increased range of myocardial enzymes after chemotherapy in the ID group was larger than that of the MP group and the difference was significant (p<0.05). There is an increased cardiotoxicity in patients receiving epirubicin by ID during the 4-month trial.Administration of epirubicin by MP maintained an effective drug concentration for a longer period of time than by ID. The higher peak plasma concentration observed following epirubicin administration by ID may lead to cardiac toxicity.
authors.affiliation: Chemotherapy Research Center, Kunming Medical University, Kunming, China.
authors.forename: R-X
authors.initials: RX
authors.lastname: Yang
authors.forename: H-X
authors.initials: HX
authors.lastname: Ren
authors.forename: L
authors.initials: L
authors.lastname: Zhuang
authors.forename: C-L
authors.initials: CL
authors.lastname: Gao
authors.forename: C
authors.initials: C
authors.lastname: Dong
authors.forename: C-X
authors.initials: CX
authors.lastname: Luo
authors.forename: X-N
authors.initials: XN
authors.lastname: Wang
authors.forename: E-F
authors.initials: EF
authors.lastname: Feng
authors.forename: J-C
authors.initials: JC
authors.lastname: He
mesh_terms: D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D019540:Area Under Curve; D001943:Breast Neoplasms / Q000378:metabolism*; D052279:Creatine Kinase, MB Form / Q000378:metabolism; D004562:Electrocardiography / Q000187:drug effects; D015251:Epirubicin / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D005260:Female; D006207:Half-Life; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D008875:Middle Aged; D009206:Myocardium / Q000201:enzymology*; D017239:Paclitaxel / Q000627:therapeutic use
chemical_list: D000903:Antibiotics, Antineoplastic; D000972:Antineoplastic Agents, Phytogenic; D015251:Epirubicin; D007770:L-Lactate Dehydrogenase; D052279:Creatine Kinase, MB Form; D017239:Paclitaxel