Clinical pharmacology of paclitaxel in relation of patient age: CALGB 9762

Li Liu, MD

University of Pennsylvania Cancer
Ultima Vez Modificado: 13 de mayo del 2001

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Presenter: S.M. Lichtman
Affiliation: CALGB, Chicago, IL

Background:

    The taxanes are one of the most important new classes of anticancer agents to emerge in the last decade. Paclitaxel, one of the two taxanes, has been widely used in patients with various malignancies, especially in the elderly population. However, its pharmacokinetics and pharmacodynamics among elderly population have not been established.

Materials and Methods:

  • A total of 148 patients, age 55 years or older, with various non
  • hematologic malignancies were included in this prospective study
  • Total body Clearance (TBC) and toxicity of paclitaxel were evaluated
  • None of the patients received paclitaxel previously
  • There were 3 patient cohorts: 55
  • 64 years, 65
  • 74 years, and 75 years and older

Results:

  • Age is a significant factor in total body clearance, AUC, and decline in WBC nadir
  • The decline in absolute neutrophil count was not statistically significantly associated with age
  • Age is significantly associated with grade 3 ANC toxicity

Authors' Conclusions

  • There is decreased paclitaxel clearance with age
  • There is increased myelosuppression with age

Clinical/Scientific Implications:

  • There is significant interpatient variability in paclitaxel clearance and age related changes account for only of modest proportion
  • Clinical trials evaluating the effects of aging on pharmacology of anticancer in cooperative trials are feasible

ASCO Abstract 265

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Related study shows that survival decreases with age in multiple myeloma patients

Mar 9, 2010 - The presence and number of focal lesions detected by whole-body magnetic resonance imaging strongly predicts the conversion of asymptomatic multiple myeloma to symptomatic disease, according to a study published online Feb. 22 in the Journal of Clinical Oncology. In a related study in the same issue, researchers report that survival after treatment for multiple myeloma decreases with age.



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