Impact of doxorubicin dose capping on the outcome of DLBCL patients with elevated body surface area

Gay, Caroline; Milpied, Noël; Obéric, Lucie; Boussetta, Sami; Haı̈oun, Corinne; Tilly, Hervé; Salles, Gilles; Lamy, Thierry; Lester, Marie-Antoinette; Houot, Roch

doi:10.1182/blood-2017-02-766147

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…This study did not show any impact of doxorubicin dose capping on PFS nor OS in DLBCL patients. The data of this study suggest that both therapeutic options (capping and uncapping) seem acceptable in DLBCL patients with elevated BSA [40]. Chemotherapy dose capping in obese patient (BSA 2.15 m 2 ) with acute myeloid leukemia was associated with worse overall survival at 5 years and displayed a worse adverse outcome.…”

Section: Other Types Of Malignanciesmentioning

confidence: 72%

Obesity and chemotherapy administration: between empiric and mathematic method review

et al. 2019

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Introduction: Obesity is a major risk factor for chronic disease and cancer development. Therapeutic management of obese patients with cancer is a real challenge for physician because of the alteration of antineoplastic pharmacokinetics parameters in this population. In routine clinical practices, chemotherapy doses in obese patients are arbitrarily capped or adjusted to an ideal weight to minimize excessive toxicities. Material and methods: The main goal of this review is to describe the current state of knowledge concerning the correlation between the adjustment of BSA (capping or ideal weight) and the rates of global toxicities and survival outcomes in obese patients under chemotherapy in different types of cancer. We searched in the Medline database (via PubMed) in order to identify all publications of literature reviews whose subject chemotherapy dosing in obese population. Results: Only a single study was pointing toward increased of global toxicities of full weight dosing. Furthermore, some studies suggests that the practice of limiting doses in overweight and obese patients may negatively influence the quality of care and outcomes in a constantly increasing population. Conclusion: This review highlights the lack of prospective studies focusing on chemotherapy methods of administration in obese patients. At this time, there is no prospective study comparing capping and full weight dose chemotherapy administration in obese patient population.

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Section: Other Types Of Malignanciesmentioning

confidence: 72%

Obesity and chemotherapy administration: between empiric and mathematic method review

et al. 2019

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“…39 Additionally, doxorubicin, another drug extensively metabolized by CYP3A4, showed a 1.85fold lower clearance and area under the plasma drug concentration-time curve (AUC), 40 and it was shown that dose-capping in individuals with higher BMIs did not result in inferior efficacy. 41 Cytochrome P450 2E1 Chlorzoxazone. Cytochrome P450 2E1 (CYP2E1) is another enzyme that has shown altered expression/activity in people with obesity in some studies.…”

Section: What Is the Role Of The Therapeutic Window Of A Drug For Inf...mentioning

confidence: 99%

“…Overall, dosing guidelines were proposed with a decrease of up to 40% in Tac starting doses for different BMI groups 39 . Additionally, doxorubicin, another drug extensively metabolized by CYP3A4, showed a 1.85‐fold lower clearance and area under the plasma drug concentration–time curve (AUC), 40 and it was shown that dose‐capping in individuals with higher BMIs did not result in inferior efficacy 41 …”

Section: Decision Tree Framework To Inform On Drugs That Are Expected...mentioning

confidence: 99%

Is There a Need for a Dedicated Pharmacokinetic Trial for a Drug in Obese Populations? A Drug Prioritization Decision Tree Framework

Langevin,

Gobburu,

Gopalakrishnan

2023

The Journal of Clinical Pharma

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Obesity is a growing global health concern associated with high comorbidity rates, leading to an increasing number of patients who are obese requiring medication. However, clinical trials often exclude or under‐represent individuals who are obese, creating the need for a methodology to adjust labeling to ensure safe and effective dosing for all patients. To address this, we developed a 2‐part decision tree framework to prioritize drugs for dedicated pharmacokinetic studies in obese subjects. Leveraging current drug knowledge and modeling techniques, the decision tree system predicts expected exposure changes and recommends labeling strategies, allowing stakeholders to prioritize resources toward the drugs most in need. In a case study evaluating 30 drugs from literature across different therapeutic areas, our first decision tree predicted the expected direction of exposure change accurately in 73% of cases. We conclude that this decision tree system offers a valuable tool to advance research in obesity pharmacology and personalize drug development for patients who are obese, ensuring safe and effective medication.

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Body mass index and survival of patients with lymphoma

Chihara

Larson

Robinson

et al. 2021

Leukemia & Lymphoma

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Impact of doxorubicin dose capping on the outcome of DLBCL patients with elevated body surface area

Cited by 4 publications

References 14 publications

Obesity and chemotherapy administration: between empiric and mathematic method review

Obesity and chemotherapy administration: between empiric and mathematic method review

Is There a Need for a Dedicated Pharmacokinetic Trial for a Drug in Obese Populations? A Drug Prioritization Decision Tree Framework

Body mass index and survival of patients with lymphoma

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