Journal
CANCER CHEMOTHERAPY AND PHARMACOLOGY
Volume 68, Issue 5, Pages 1363-1367Publisher
SPRINGER
DOI: 10.1007/s00280-011-1718-5
Keywords
Trabectedin; Ecteinascidin; Pharmacokinetics; Hemodialysis; End-stage renal disease; Dialysis
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The pharmacokinetics of trabectedin has never been reported in patients with impaired renal function or in patients on hemodialysis. We examined trabectedin PK in a patient on hemodialysis, starting trabectedin therapy at a standard dose for recurrence of a retroperitoneal myxoid liposarcoma that had occurred under immunosuppressive drugs for kidney transplant. As compared with a population with normal renal function, the study patient presented a higher C (max) and AUC, with lower clearance, terminal half-life, and volume of distribution. The low dialysis clearance, accounting for a minor part of the total body clearance and the absence of detectable trabectedin in the dialysate samples, suggests that hemodialysis does not efficiently clear trabectedin. Trabectedin tolerance was good. This case reports for the first time the feasibility of trabectedin therapy in a hemodialyzed patient. Given the rising incidence of cancer in patients with end-stage renal disease, it is crucial to provide data that improve the management of anticancer drugs in dialyzed patients.
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