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Medline ® Abstract for Reference 21

of 'Chemotherapy-related nephrotoxicity and dose modification in patients with renal insufficiency'

Pharmacokinetically guided dosing of carboplatin and etoposide during peritoneal dialysis and haemodialysis.
English MW, Lowis SP, Peng B, Boddy A, Newell DR, Price L, Pearson AD
Br J Cancer. 1996;73(6):776.
Two patients with relapsed Wilms' tumour and renal failure requiring dialysis were given carboplatin and etoposide by pharmacokinetically guided dosing. The target area under the drug plasma concentration vs time curve (AUC) was 6 mg ml-1 min for carboplatin and 18 and 21 mg ml-1 min for etoposide. On course 1 measured AUCs of carboplatin and etoposide were 6 and 20 mg ml-1 min for patient 1 and 6 and 21 mg ml-1 min for patient 2 respectively. Peritoneal dialysis did not remove carboplatin or etoposide from the plasma, however carboplatin but not etoposide was cleared by haemodialysis. Therapy with carboplatin and etoposide is possible in children and adults with renal failure who require dialysis, but in this situation pharmacokinetic monitoring is essential.
Children's cancer Unit, Sir James Spence Institute of Child Health, Cancer Research Unit, The Medical School, Newcastle Upon Tyne, UK.