Pharmacodynamic Study of the Saltz Regimen for Metastatic Colorectal Cancer in a Hemodialyzed Patient
Objective: Combination therapy with irinotecan (CPT-11), 5-fluorouracil (5-FU) and leucovorin is widely used for the treatment of metastatic colorectal cancer. However, little is known about the safety of chemotherapy of malignancies in hemodialysis (HD) patients. We encountered a patient with color...
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| Veröffentlicht in: | Chemotherapy (Basel) 2007-01, Vol.53 (6), p.418-421 |
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| creator | Akiyama, Shinichiro Nakayama, Hidetsugu Takami, Hiroya Gotoh, Hiromichi Gotoh, Yoshikazu |
| description | Objective: Combination therapy with irinotecan (CPT-11), 5-fluorouracil (5-FU) and leucovorin is widely used for the treatment of metastatic colorectal cancer. However, little is known about the safety of chemotherapy of malignancies in hemodialysis (HD) patients. We encountered a patient with colorectal carcinoma on HD. We decided to administer combination chemotherapy while monitoring the pharmacodynamics of the patient. Case Report: A 74-year-old male received regular HD 3 times a week because of type 1 diabetes mellitus. He was diagnosed with stage IV colorectal cancer in November 2004. After sigmoidectomy, the patient received chemotherapy: a weekly schedule of CPT-11 (50 mg/m 2 ) was administered followed by l-leucovorin (10 mg/m 2 ) and 5-FU (400 mg/m 2 ) just after HD. During the course, the plasma concentrations of both SN-38, an active metabolite of CPT-11, and 5-FU were not increased compared with those of patients with normal renal function. Our patient presented with grade III hematological toxicity that was easily recovered by granulocyte colony-stimulating factor. Conclusion: These data suggest that the dose-reduced Saltz regimen can be feasible for colorectal cancer patients receiving dialysis as postoperative adjuvant chemotherapy. |
| doi_str_mv | 10.1159/000110006 |
| format | Article |
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However, little is known about the safety of chemotherapy of malignancies in hemodialysis (HD) patients. We encountered a patient with colorectal carcinoma on HD. We decided to administer combination chemotherapy while monitoring the pharmacodynamics of the patient. Case Report: A 74-year-old male received regular HD 3 times a week because of type 1 diabetes mellitus. He was diagnosed with stage IV colorectal cancer in November 2004. After sigmoidectomy, the patient received chemotherapy: a weekly schedule of CPT-11 (50 mg/m 2 ) was administered followed by l-leucovorin (10 mg/m 2 ) and 5-FU (400 mg/m 2 ) just after HD. During the course, the plasma concentrations of both SN-38, an active metabolite of CPT-11, and 5-FU were not increased compared with those of patients with normal renal function. Our patient presented with grade III hematological toxicity that was easily recovered by granulocyte colony-stimulating factor. Conclusion: These data suggest that the dose-reduced Saltz regimen can be feasible for colorectal cancer patients receiving dialysis as postoperative adjuvant chemotherapy.</description><identifier>ISSN: 0009-3157</identifier><identifier>EISSN: 1421-9794</identifier><identifier>DOI: 10.1159/000110006</identifier><identifier>PMID: 17952001</identifier><language>eng</language><publisher>Basel, Switzerland: S. 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pharmacology</topic><topic>Camptothecin - administration & dosage</topic><topic>Camptothecin - analogs & derivatives</topic><topic>Case studies</topic><topic>Chemotherapy</topic><topic>Colorectal cancer</topic><topic>Colorectal Neoplasms - drug therapy</topic><topic>Colorectal Neoplasms - etiology</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 1 - drug therapy</topic><topic>Diabetes Mellitus, Type 1 - surgery</topic><topic>Drug therapy</topic><topic>Fluorouracil - administration & dosage</topic><topic>Hemodialysis</topic><topic>Humans</topic><topic>Kinetics</topic><topic>Leucovorin - administration & dosage</topic><topic>Male</topic><topic>Pharmacology</topic><topic>Renal Dialysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Akiyama, Shinichiro</creatorcontrib><creatorcontrib>Nakayama, Hidetsugu</creatorcontrib><creatorcontrib>Takami, Hiroya</creatorcontrib><creatorcontrib>Gotoh, Hiromichi</creatorcontrib><creatorcontrib>Gotoh, Yoshikazu</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><jtitle>Chemotherapy (Basel)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Akiyama, Shinichiro</au><au>Nakayama, Hidetsugu</au><au>Takami, Hiroya</au><au>Gotoh, Hiromichi</au><au>Gotoh, Yoshikazu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pharmacodynamic Study of the Saltz Regimen for Metastatic Colorectal Cancer in a Hemodialyzed Patient</atitle><jtitle>Chemotherapy (Basel)</jtitle><addtitle>Chemotherapy</addtitle><date>2007-01-01</date><risdate>2007</risdate><volume>53</volume><issue>6</issue><spage>418</spage><epage>421</epage><pages>418-421</pages><issn>0009-3157</issn><eissn>1421-9794</eissn><abstract>Objective: Combination therapy with irinotecan (CPT-11), 5-fluorouracil (5-FU) and leucovorin is widely used for the treatment of metastatic colorectal cancer. However, little is known about the safety of chemotherapy of malignancies in hemodialysis (HD) patients. We encountered a patient with colorectal carcinoma on HD. We decided to administer combination chemotherapy while monitoring the pharmacodynamics of the patient. Case Report: A 74-year-old male received regular HD 3 times a week because of type 1 diabetes mellitus. He was diagnosed with stage IV colorectal cancer in November 2004. After sigmoidectomy, the patient received chemotherapy: a weekly schedule of CPT-11 (50 mg/m 2 ) was administered followed by l-leucovorin (10 mg/m 2 ) and 5-FU (400 mg/m 2 ) just after HD. During the course, the plasma concentrations of both SN-38, an active metabolite of CPT-11, and 5-FU were not increased compared with those of patients with normal renal function. Our patient presented with grade III hematological toxicity that was easily recovered by granulocyte colony-stimulating factor. Conclusion: These data suggest that the dose-reduced Saltz regimen can be feasible for colorectal cancer patients receiving dialysis as postoperative adjuvant chemotherapy.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>17952001</pmid><doi>10.1159/000110006</doi><tpages>4</tpages></addata></record> |
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| ispartof | Chemotherapy (Basel), 2007-01, Vol.53 (6), p.418-421 |
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| source | MEDLINE; Karger Journals Complete |
| subjects | Aged Antineoplastic Combined Chemotherapy Protocols - pharmacology Camptothecin - administration & dosage Camptothecin - analogs & derivatives Case studies Chemotherapy Colorectal cancer Colorectal Neoplasms - drug therapy Colorectal Neoplasms - etiology Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - drug therapy Diabetes Mellitus, Type 1 - surgery Drug therapy Fluorouracil - administration & dosage Hemodialysis Humans Kinetics Leucovorin - administration & dosage Male Pharmacology Renal Dialysis Treatment Outcome |
| title | Pharmacodynamic Study of the Saltz Regimen for Metastatic Colorectal Cancer in a Hemodialyzed Patient |
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