Dose Intensity Analysis May Help Resolve Issues in Chemotherapy with Platinum Compounds
Attempts to define optimum chemotherapy in the clinical setting have resulted in a plethora of schedules and combinations. In addition various schemes are used to reduce doses and delay treatments in order to reduce toxicity. These schedules and schemes have obscured dose-response relationships which, however, can be rediscovered and studied by reducing all to how much drug is given per unit time, as mg/m2/wk regardless of the protocol schedule used. This is dose intensity (1). Dose intensity can be calculated from intended drug doses (“projected dose intensity”) or doses received after reductions and delays for toxicity (“received dose intensity”) and can be derived for single agent treatments as well as for combinations. In the calculation of dose intensity, treatment delays are assumed to be equivalent to dose reductions and are accorded equal weight arithmetically. Dose intensity correlates very well with outcome for a variety of single agents and drug combinations in various malignant diseases (2).
KeywordsOvarian Cancer Clin Oncol Dose Intensity Testicular Cancer Advance Ovarian Cancer
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- 2.W. Hryniuk, The Importance of Dose Intensity in Outcome of Chemotherapy In: Advances in Oncology, pp 121–141, Eds: Hellman S., Devita V., Rosenberg S., J.B. Lippincott Company, Philadelphia, PA.Google Scholar
- 3.F.A. Greco, C.G. Julian, R.L., Richardson, et al: Advanced Ovarian Cancer: Brief intensive combination chemotherapy in second-look operation, Obstet Gynecol 58:200–205, 1981.Google Scholar
- 7.L. Levin, W. Hryniuk, The Application of Dose Intensity to Problems in chemotherapy of Ovarian and Endometrial Cancer. Sem. in Onc. 14: 12–19, 1987.Google Scholar
- 10.D.R. Gandara, M.W. DeGregorio, H.J. Wold, B.J. Wilbur, M. Kohler, H.J. Lawrence, A.B. Deisseroth, and C.B. George: High-dose cisplatin in hypertonic saline: Reduced toxicity of a modified dose schedule and correlation with plasma pharmacokinetics. A Northern California Oncology Group (NCOG) pilot study in non-small cell lung cancer. J Clin Oncol, 4:1787–1793, 1986.PubMedGoogle Scholar
- 11.J.E. Mortimer, J. Chestnut, C.S. Higano, and G. Goodman, High Dose Cisplatin in Metastatic Melanoma: Comparison of Two Schedules, Proc Amer Soc Clin Oncol, 7:254, 1988.Google Scholar
- 12.N. Colombo, M.R. Pittelli, M. Marzola, A. Lissoni, L. Redaelli, & C. Mangioni., Randomized Study of Two Cisplatin (P) Dose-Intensity Regimens in Patients With Stage III/IV Epithelial Ovarian Cancer (EOC) Proc Amer Soc Clin Oncol, 9:160,1990.Google Scholar
- 13.C. Boni, G. Cocconi, R. Lottici, M. Bella, F. Leonardi, G. Ceci, R. Passalaequa, M. Melpignano, D. DeBiasi, C. Bordi, B. Biscottni, C. Finardi, Conventional vs High Dose-Intensity Cisplatin in Advanced Ovarian Cancer. Preliminary Report of a Randomized Trial, Proc Amer Soc Clin Oncol, 9:168, 1990.Google Scholar