Pharmacokinetics & drug resistance of melphalan in regional chemotherapy: ILP versus ILI
Two forms of regional chemotherapy for the treatment of advanced melanoma or sarcoma of the extremity are isolated limb perfusion (ILP) and the more recently described isolated limb infusion (ILI). Melphalan is the most commonly employed agent in both ILP and ILI, although it is often used in conjun...
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| Veröffentlicht in: | International journal of hyperthermia 2008-05, Vol.24 (3), p.239-249 |
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| container_title | International journal of hyperthermia |
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| creator | Padussis, James C. Steerman, Samuel N. Tyler, Douglas S. Mosca, Paul J. |
| description | Two forms of regional chemotherapy for the treatment of advanced melanoma or sarcoma of the extremity are isolated limb perfusion (ILP) and the more recently described isolated limb infusion (ILI). Melphalan is the most commonly employed agent in both ILP and ILI, although it is often used in conjunction with other cytotoxic and/or biologic therapies. While ILP and ILI are far more effective for the treatment of extremity disease than is systemic therapy, there is still significant room for improvement in outcomes, from the standpoint of both response rate and toxicity. An understanding of the pharmacokinetics of regional chemotherapy would allow for the prediction of tumor response and toxicity and therefore patient outcomes. In addition, elucidating the mechanisms of drug resistance would lead to opportunities to develop effective chemo-modulators that enhance the effectiveness of ILP and ILI. This paper reviews progress in these two key areas of active investigation. |
| doi_str_mv | 10.1080/02656730701816410 |
| format | Article |
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Melphalan is the most commonly employed agent in both ILP and ILI, although it is often used in conjunction with other cytotoxic and/or biologic therapies. While ILP and ILI are far more effective for the treatment of extremity disease than is systemic therapy, there is still significant room for improvement in outcomes, from the standpoint of both response rate and toxicity. An understanding of the pharmacokinetics of regional chemotherapy would allow for the prediction of tumor response and toxicity and therefore patient outcomes. In addition, elucidating the mechanisms of drug resistance would lead to opportunities to develop effective chemo-modulators that enhance the effectiveness of ILP and ILI. 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Melphalan is the most commonly employed agent in both ILP and ILI, although it is often used in conjunction with other cytotoxic and/or biologic therapies. While ILP and ILI are far more effective for the treatment of extremity disease than is systemic therapy, there is still significant room for improvement in outcomes, from the standpoint of both response rate and toxicity. An understanding of the pharmacokinetics of regional chemotherapy would allow for the prediction of tumor response and toxicity and therefore patient outcomes. In addition, elucidating the mechanisms of drug resistance would lead to opportunities to develop effective chemo-modulators that enhance the effectiveness of ILP and ILI. This paper reviews progress in these two key areas of active investigation.</description><subject>Antineoplastic Agents - pharmacokinetics</subject><subject>chemo-modulator</subject><subject>Chemotherapy, Cancer, Regional Perfusion - methods</subject><subject>Combined Modality Therapy - methods</subject><subject>Drug Resistance, Neoplasm</subject><subject>glutathione</subject><subject>Humans</subject><subject>Hyperthermia, Induced - methods</subject><subject>isolated limb infusion</subject><subject>Isolated limb perfusion</subject><subject>Melanoma - drug therapy</subject><subject>Melanoma - metabolism</subject><subject>Melphalan - pharmacokinetics</subject><subject>Sarcoma - drug therapy</subject><subject>Sarcoma - metabolism</subject><subject>two-compartment model</subject><issn>0265-6736</issn><issn>1464-5157</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kM9LwzAUx4Mobk7_AC-Sk7fqS5OmrXqR4Y_BwB0UvJU0TdbMthlJq-y_N2OCiLDTe_D9wXsfhM4JXBHI4BpinvCUQgokI5wROEBjwjiLEpKkh2i81aNg4CN04v0KAFgSp8doRDKaU4B4jN4XtXCtkPbDdKo30uNLXLlhiZ3yxveikwpbjVvVrGvRiA6bLkhLYzvRYFmr1va1cmK9ucGz-QJ_KucHH9bZKTrSovHq7GdO0Nvjw-v0OZq_PM2m9_NIMmB9VOqKK9ApLXMiZSYIBxpeg7JkuiIJjSGrpEwUqIzRPJVMpEIKoiHTpc5jTieI7Hqls947pYu1M61wm4JAsaVU_KMUMhe7zHooW1X9Jn6wBMPdzmA6bQOeL-uaqujFprFOuwDF-ILu67_9E6-VaPpaCqeKlR1cQOf3XPcND2qHwQ</recordid><startdate>20080501</startdate><enddate>20080501</enddate><creator>Padussis, James C.</creator><creator>Steerman, Samuel N.</creator><creator>Tyler, Douglas S.</creator><creator>Mosca, Paul J.</creator><general>Informa UK Ltd</general><general>Taylor & Francis</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>20080501</creationdate><title>Pharmacokinetics & drug resistance of melphalan in regional chemotherapy: ILP versus ILI</title><author>Padussis, James C. ; Steerman, Samuel N. ; Tyler, Douglas S. ; Mosca, Paul J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-bfd6e0f73b91cc8a16030800bb4fd153208dcc5e0e84397c4a7aca1f08fbf9263</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Antineoplastic Agents - pharmacokinetics</topic><topic>chemo-modulator</topic><topic>Chemotherapy, Cancer, Regional Perfusion - methods</topic><topic>Combined Modality Therapy - methods</topic><topic>Drug Resistance, Neoplasm</topic><topic>glutathione</topic><topic>Humans</topic><topic>Hyperthermia, Induced - methods</topic><topic>isolated limb infusion</topic><topic>Isolated limb perfusion</topic><topic>Melanoma - drug therapy</topic><topic>Melanoma - metabolism</topic><topic>Melphalan - pharmacokinetics</topic><topic>Sarcoma - drug therapy</topic><topic>Sarcoma - metabolism</topic><topic>two-compartment model</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Padussis, James C.</creatorcontrib><creatorcontrib>Steerman, Samuel N.</creatorcontrib><creatorcontrib>Tyler, Douglas S.</creatorcontrib><creatorcontrib>Mosca, Paul J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>International journal of hyperthermia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Padussis, James C.</au><au>Steerman, Samuel N.</au><au>Tyler, Douglas S.</au><au>Mosca, Paul J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pharmacokinetics & drug resistance of melphalan in regional chemotherapy: ILP versus ILI</atitle><jtitle>International journal of hyperthermia</jtitle><addtitle>Int J Hyperthermia</addtitle><date>2008-05-01</date><risdate>2008</risdate><volume>24</volume><issue>3</issue><spage>239</spage><epage>249</epage><pages>239-249</pages><issn>0265-6736</issn><eissn>1464-5157</eissn><abstract>Two forms of regional chemotherapy for the treatment of advanced melanoma or sarcoma of the extremity are isolated limb perfusion (ILP) and the more recently described isolated limb infusion (ILI). Melphalan is the most commonly employed agent in both ILP and ILI, although it is often used in conjunction with other cytotoxic and/or biologic therapies. While ILP and ILI are far more effective for the treatment of extremity disease than is systemic therapy, there is still significant room for improvement in outcomes, from the standpoint of both response rate and toxicity. An understanding of the pharmacokinetics of regional chemotherapy would allow for the prediction of tumor response and toxicity and therefore patient outcomes. In addition, elucidating the mechanisms of drug resistance would lead to opportunities to develop effective chemo-modulators that enhance the effectiveness of ILP and ILI. This paper reviews progress in these two key areas of active investigation.</abstract><cop>England</cop><pub>Informa UK Ltd</pub><pmid>18393002</pmid><doi>10.1080/02656730701816410</doi><tpages>11</tpages></addata></record> |
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| ispartof | International journal of hyperthermia, 2008-05, Vol.24 (3), p.239-249 |
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| source | Taylor & Francis:Master (3349 titles); MEDLINE |
| subjects | Antineoplastic Agents - pharmacokinetics chemo-modulator Chemotherapy, Cancer, Regional Perfusion - methods Combined Modality Therapy - methods Drug Resistance, Neoplasm glutathione Humans Hyperthermia, Induced - methods isolated limb infusion Isolated limb perfusion Melanoma - drug therapy Melanoma - metabolism Melphalan - pharmacokinetics Sarcoma - drug therapy Sarcoma - metabolism two-compartment model |
| title | Pharmacokinetics & drug resistance of melphalan in regional chemotherapy: ILP versus ILI |
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