Sparse-data set analysis for irinotecan and SN-38 pharmacokinetics in cancer patients co-treated with cisplatin

Anticancer Drugs. 1999 Jan;10(1):9-16. doi: 10.1097/00001813-199901000-00002.

Abstract

The clinical pharmacokinetics of the antineoplastic agent irinotecan (CPT-11) are associated with substantial interpatient variability. The degree to which this variability in CPT-11 exposure impacts upon the response and toxicity of the drug has not yet been properly determined. In general, the area under the plasma concentration-time curve (AUC) is an appropriate indicator of exposure, but requires collection of up to 17 timed blood samples. This presents difficulties if large-scale population samplings are required. The present study involved the development and validation of a strategy to estimate the AUCs of the lactone and total (i.e. lactone plus carboxylate) forms of CPT-11 and its active metabolite SN-38 from a limited number of blood samples in patients co-treated with cisplatin. Using data from 24 patients, univariate and multivariate regression analyses were employed to generate the models. The best predictive models for simultaneous estimation of CPT-11 and SN-38 AUCs were obtained with three time points at 0.5, 1.67 and 5.50 h after start of the 90 min i.v. infusion of CPT-11. The models were tested separately in another group of 24 patients receiving the same combination treatment. This validation set demonstrated that CPT-11 and SN-38 AUCs after standard dose administration could be predicted sufficiently unbiased and precisely with three timed samples to warrant clinical application.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase I
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / pharmacokinetics
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Agents, Phytogenic / administration & dosage
  • Antineoplastic Agents, Phytogenic / pharmacokinetics*
  • Antineoplastic Combined Chemotherapy Protocols / pharmacokinetics
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Area Under Curve
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives*
  • Camptothecin / pharmacokinetics
  • Cisplatin / administration & dosage
  • Female
  • Humans
  • Irinotecan
  • Linear Models
  • Male
  • Middle Aged
  • Models, Biological
  • Neoplasms / drug therapy*
  • Predictive Value of Tests
  • Reproducibility of Results

Substances

  • Antineoplastic Agents
  • Antineoplastic Agents, Phytogenic
  • Irinotecan
  • Cisplatin
  • Camptothecin