title: Experience with trabectedin in an advanced sarcoma patient on peritoneal dialysis for end-stage renal failure.
abstract: BACKGROUND
  We wanted to evaluate the impact of peritoneal dialysis on trabectedin therapy in terms of side effects, response and levels in the blood and dialysate of a patient on peritoneal dialysis for end-stage renal failure caused by previous ifosfamide therapy. This has not yet been reported in the medical literature.
  
  
  METHODS
  We measured the levels of trabectedin in the blood and peritoneal dialysate at different time points before and after the administration of a 3rd cycle of trabectedin (1.5 mg/m(2) over 24 h). Toxicity from the treatment was recorded and the response status was evaluated on a CT scan after the 3rd and 6th cycles.
  
  
  RESULTS
  Serum creatinine clearance (Cockcroft-Gault formula) was 8.31 ml/min. The patient had a World Health Organization performance status score of '0' and did not suffer any significant side effects except for grade 2 anaemia. There was no difference in the plasma level of trabectedin just before and after a 3-hour session of peritoneal dialysis. The amount of trabectedin in the peritoneal dialysates was undetectable (limit of quantification: 25.9 pg/ml). The patient achieved stable disease after 3 cycles, and progressive disease was observed after 6 cycles on CT scan.
  
  
  CONCLUSIONS
  Our patient did not suffer undue side effects from trabectedin, and peritoneal dialysis did not appear to have an impact on the clearance of the drug.
authors.affiliation: Oncology Department, Singleton Hospital, Swansea, UK.
authors.forename: Maung Maung Myat
authors.initials: MM
authors.lastname: Moe
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernandez Teruel
authors.forename: Arturo
authors.initials: A
authors.lastname: Soto-Matos
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000097:blood / Q000627:therapeutic use*; D003404:Creatinine / Q000097:blood; D004149:Dioxoles / Q000097:blood / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010530:Peritoneal Dialysis; D012509:Sarcoma / Q000150:complications / Q000188:drug therapy*; D044005:Tetrahydroisoquinolines / Q000097:blood / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed; D000077606:Trabectedin
chemical_list: D018906:Antineoplastic Agents, Alkylating; D004149:Dioxoles; D044005:Tetrahydroisoquinolines; D003404:Creatinine; D000077606:Trabectedin