Co-variables influencing 5-fluorouracil clearance during continuous venous infusion. A NONMEM analysis

Eur J Cancer. 1998 Jan;34(1):92-7. doi: 10.1016/s0959-8049(97)00345-6.

Abstract

The objective of this study was to attempt to identify patient co-variables which could influence interpatient variability in 5-fluorouracil (5-FU) clearance during a 5-day continuous venous infusion (CVI, cisplatin 100 mg/m2 day 1 then 5-FU 1 g/m2/day days 2-6). The analysis was performed using a NONMEM program according to a linear one-compartment model. A total of 186 cycles (2 samples per day, 8 a.m. and 5 p.m.) were analysed from 104 patients with various cancers (the majority of head and neck and oesophagus). The study co-variables were age, sex, body surface area, hepatic metastases, peripheral mononuclear cell dihydropyrimidine dehydrogenase activity (PMNC-DPD), liver enzymes, clock-time (8 a.m. versus 5 p.m.), elapsed time during CVI. The data showed that 5-FU clearance was significantly reduced by increased age, low PMNC-DPD, high serum alkaline phosphatase and elapsed time during infusion. These data may be useful for improving knowledge of predictive factors which can influence 5-FU exposure and thus predispose to toxic manifestations.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antimetabolites, Antineoplastic / pharmacokinetics*
  • Body Surface Area
  • Dihydrouracil Dehydrogenase (NADP)
  • Esophageal Neoplasms / drug therapy
  • Esophageal Neoplasms / metabolism
  • Female
  • Fluorouracil / pharmacokinetics*
  • Head and Neck Neoplasms / drug therapy
  • Head and Neck Neoplasms / metabolism
  • Humans
  • Infusions, Intravenous
  • Liver Function Tests
  • Male
  • Middle Aged
  • Neoplasms / drug therapy
  • Neoplasms / metabolism*
  • Oxidoreductases / metabolism
  • Sex Factors
  • Time Factors

Substances

  • Antimetabolites, Antineoplastic
  • Oxidoreductases
  • Dihydrouracil Dehydrogenase (NADP)
  • Fluorouracil