Kearns C M, Egorin M J
Division of Developmental Therapeutics, University of Maryland Cancer Center, Baltimore 21201, USA.
Semin Oncol. 1997 Feb;24(1 Suppl 2):S2-91-S2-96.
Whenever drugs are given in combination for the treatment of a disease, the potential for synergistic, additive, or antagonistic effects exists. Evaluation of the effects of drugs in combination requires that the effect of each drug as a single agent be well described. Recently, combination chemotherapy with carboplatin and paclitaxel (Taxol; Bristol-Myers Squibb Company, Princeton, NJ) has met with much clinical interest. Toxicity expectations of the combination were based on the established pharmacokinetic/pharmacodynamic relationships of each drug as a single agent. In several independent studies, investigators have noted that carboplatin-associated thrombocytopenia was less than expected in patients treated with combination carboplatin/paclitaxel. Although the mechanism underlying this observation has not been identified, carboplatin underdosing, variation in analytic or computational techniques, and pharmacokinetic interactions can be ruled out as contributing factors.
每当联合使用药物治疗疾病时，就存在协同、相加或拮抗作用的可能性。评估联合用药的效果需要充分描述每种药物作为单一药剂的效果。最近，卡铂与紫杉醇（泰素；百时美施贵宝公司，新泽西州普林斯顿）的联合化疗引起了临床的广泛关注。联合用药的毒性预期是基于每种药物作为单一药剂已确立的药代动力学/药效学关系。在几项独立研究中，研究人员注意到，在接受卡铂/紫杉醇联合治疗的患者中，卡铂相关的血小板减少症比预期的要少。尽管尚未确定这一观察结果的潜在机制，但卡铂剂量不足、分析或计算技术的差异以及药代动力学相互作用可被排除为促成因素。
