Desoize B, Maréchal F, Cattan A
Departement de biologie, GIBSA, Reims, France.
Ann Biol Clin (Paris). 1993;51(2):125-8.
Currently, the dose of anticancer drugs is adjusted according to patient body surface area, although the best criterion for dose adjustment seems to be the plasma concentration of the drug, since a correlation has been established between plasma concentration and efficacy for several drugs. We report here similar results with etoposide and cisplatinum. The plasma concentration and the area under the curve (AUC) of etoposide and platinum (Pt) were higher in responders compared to non-responders, and etoposide clearance was higher in responders. The etoposide toxicity (assessed by the polymorphonuclear blood count) was higher in responders. There was a good correlation between the Pt concentration and creatininaemia. The AUC for Pt was significantly higher in patients with nausea and vomiting. There was no correlation between the infected dose of either drug and efficacy or toxicity. It is not possible to assign efficacy to either compound since they were injected simultaneously. We conclude that when the plasma etoposide or platinum concentrations are low, tumour response is unlikely.
目前,抗癌药物的剂量是根据患者体表面积来调整的,尽管最佳的剂量调整标准似乎是药物的血浆浓度,因为已经在几种药物的血浆浓度和疗效之间建立了相关性。我们在此报告依托泊苷和顺铂的类似结果。与无反应者相比,反应者的依托泊苷和铂(Pt)的血浆浓度及曲线下面积(AUC)更高,且反应者的依托泊苷清除率更高。反应者的依托泊苷毒性(通过多形核血细胞计数评估)更高。Pt浓度与肌酐血症之间存在良好的相关性。有恶心和呕吐症状的患者中Pt的AUC显著更高。两种药物的感染剂量与疗效或毒性之间均无相关性。由于两种化合物是同时注射的,因此无法确定任一化合物的疗效。我们得出结论,当血浆依托泊苷或铂浓度较低时,肿瘤反应不太可能发生。