転移性大腸癌に対して塩酸イリノテカンを使用した血液透析患者の1例 : 塩酸イリノテカンの薬物動態の検討

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Irinotecan hydrochloride (CPT-11), one of the anticancer agents that inactivate DNA topoisomerase I and inhibit DNA synthesis, has a strong antitumor activity in a broad spectrum of malignant tumors; however, the pharmacokinetics of CPT-11 has not been previously determined in hemodialysis patients with chronic renal failure.We describe the pharmacokinetics and pharmacodynamics of CPT-11 in a 58-year-old patient on hemodialysis, who developed pulmonary and liver metastasis from colorectal cancer. After he and his wife were fully informed and gave consent, he received one dose of 80mg (50mg/m2) of CPT-11 as a 90-minute infusion. Hemodialysis was performed for 4 hours after administration. We measured the plasma levels of CPT-11 and metabolic products (SN-38, SN-38G) using HPLC at 0, 0.5, 1, 2, 4, 8, 12, 24 hours after the beginning of hemodialysis. At 0.5 hours, blood samples were collected at both the entrance and exit of the hemodialyzer, and samples of dialysate were also collected.Single passage of blood through the hemodialyzer resulted in an approximate 50% reduction in CPT-11 and SN-38G concentrations with little change in SN-38 concentration. However, during the entire time course of dialysis, there were substantial reduction in the plasma concentration of CPT-11 and its metabolites. After hemodialysis, the extensions of half-lives of CPT-11 and its metabolites were observed as compared with those in patients with normal renal function. Chronic administration of a low dose (60mg/m2/week) of CPT-11 to a patient on regular hemodialysis was well tolerated and there was no evidence of toxicity.In this case report, we show that the half-lives of CPT-11 and its metabolites was extended in a chronic hemodialysis patient.
社団法人日本透析医学会の論文
2003-11-28

転移性大腸癌に対して塩酸イリノテカンを使用した血液透析患者の1例 : 塩酸イリノテカンの薬物動態の検討

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