Cremophor EL pharmacokinetics in a phase I study of paclitaxel (Taxol®) and carboplatin in non-small cell lung cancer patients

The purpose of our study was to investigate the pharmacokinetics of Cremophor EL following administration of escalating doses of Taxol (paclitaxel dissolved in Cremophor EL/ethanol) to non-small cell lung cancer (NSCLC) patients. Patients with NSCLC stage IIIb or IV without prior chemotherapy treatm...

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Bibliographic Details
Published in:	Anti-cancer drugs Vol. 11; no. 9; pp. 687 - 694
Main Authors:	Meerum Terwogt, Jetske M, van Tellingen, Olaf, Nannan Panday, Vinodh R, Huizing, Manon T, Schellens, Jan HM, ten Bokkel Huinink, Wim W, Boschma, Marcel US, Giaccone, Giuseppe, Veenhof, Cees HN, Beijnen, Jos H
Format:	Journal Article
Language:	English
Published:	England Lippincott Williams & Wilkins, Inc 01-10-2000
Subjects:	Adult Aged Antineoplastic Combined Chemotherapy Protocols - pharmacokinetics Area Under Curve Carboplatin - administration & dosage Carcinoma, Non-Small-Cell Lung - drug therapy Carcinoma, Non-Small-Cell Lung - metabolism Dose-Response Relationship, Drug Drug Administration Schedule Female Glycerol - administration & dosage Glycerol - analogs & derivatives Glycerol - pharmacokinetics Humans Lung Neoplasms - drug therapy Lung Neoplasms - metabolism Male Middle Aged Paclitaxel - administration & dosage Pharmaceutical Vehicles - administration & dosage Pharmaceutical Vehicles - pharmacokinetics
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Summary:	The purpose of our study was to investigate the pharmacokinetics of Cremophor EL following administration of escalating doses of Taxol (paclitaxel dissolved in Cremophor EL/ethanol) to non-small cell lung cancer (NSCLC) patients. Patients with NSCLC stage IIIb or IV without prior chemotherapy treatment were eligible for treatment with paclitaxel and carboplatin in a dose-finding phase I study. The starting dose of paclitaxel was 100 mg/m and doses were escalated with steps of 25 mg/m, which is equal to a starting dose of Cremophor EL of 8.3 ml/m with dose increments of 2.1 ml/m. Carboplatin dosages were 300, 350 or 400 mg/m. Pharmacokinetic sampling was performed during the first and the second course, and the samples were analyzed using a validated high-performance liquid chromatographic assay. A total of 39 patients were included in this pharmacokinetic part of the study. The doses of paclitaxel were escalated up to 250 mg/m (20.8 ml/m Cremophor EL). Pharmacokinetic analyses revealed a low elimination-rate of Cremophor EL (Cl=37.8-134 ml/h/m; t½=34.4-61.5 h) and a volume of distribution similar to the volume of the central blood compartment (VSS=4.96-7.85 l). In addition, a dose-independent clearance of Cremophor EL was found indicating linear kinetics. Dose adjustment using the body surface area, however, resulted in a non-linear increase in systemic exposure. The use of body surface area in calculations of Cremophor EL should therefore be re-evaluated.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23
ISSN:	0959-4973 1473-5741
DOI:	10.1097/00001813-200010000-00003