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- Title
Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study.
- Authors
Crosby, Vincent; D'Souza, Catherine; Bristow, Carina; Proffitt, Amy; Hussain, Asmah; Potter, Vanessa; Hennig, Ivo; O'Connor, Richard; Baracos, Vickie; Wilcock, Andrew
- Abstract
<bold>Purpose: </bold>Current methods of dosing platinum-based chemotherapy are suboptimal. Potentially, taking lean body mass into account may help. To inform the design of a future study, we first examined the feasibility and acceptability of such an approach using dual-energy X-ray absorptiometry (DEXA) and explored aspects suggestive of over- and under-dosing.<bold>Methods: </bold>Patients with lung cancer offered platinum-based chemotherapy over 1 year were identified and, if eligible, invited to take part in a prospective feasibility study. Questionnaires examined acceptability of the DEXA scan and of a future study that randomized between traditional dosing and one adjusted according to body composition. Dose-limiting toxicity (DLT) and a lack of neutropenia explored potential over- and under-dosing, respectively.<bold>Results: </bold>Of the 173 patients offered chemotherapy, 123 (71%) were ineligible, mostly because of failing entry criteria (84, 49%). Of the 50 approached, 18 (36%) participated, most receiving carboplatin, with 17 providing data. All found a DEXA scan acceptable; other assessments were fully completed, except nadir and pre-chemotherapy blood counts. Most (94%) were prepared to take part in a future study, although the additional hospital visits for a nadir blood count were unpopular with some. Five (29%) patients experienced six episodes of DLT which resulted in discontinuation (3), dose reduction (2) or change to a less toxic regimen (1). Nine (60%) patients experienced either no (2) or inconsistent (7) neutropenia.<bold>Conclusions: </bold>A randomized trial appears acceptable and feasible in patients receiving carboplatin. Adjustment of our entry criteria and avoiding a hospital visit for a nadir blood count should aid recruitment.
- Subjects
LUNG cancer treatment; NEUTROPENIA; LEAN body mass; CANCER chemotherapy; PLATINUM; DUAL-energy X-ray absorptiometry; THERAPEUTICS; ANTINEOPLASTIC agents; BODY composition; LUNG tumors; PILOT projects; PHARMACODYNAMICS
- Publication
Supportive Care in Cancer, 2017, Vol 25, Issue 4, p1257
- ISSN
0941-4355
- Publication type
journal article
- DOI
10.1007/s00520-016-3518-2