Please use this identifier to cite or link to this item:
Title: Body fat composition impacts the hematologic toxicities and pharmacokinetics of doxorubicin in Asian breast cancer patients
Authors: Wong, A.L.
Seng, K.Y.
Ong, E.M.
Wang, L.Z.
Oscar, H.
Cordero, M.T.
Copones, R.
Fan, L.
Tan, S.H.
Goh, B.C.
Lee, S.C. 
Keywords: Body composition
Breast cancer
Doxorubicin pharmacokinetics
Doxorubicin toxicities
Inter-ethnic variability
Issue Date: 2014
Citation: Wong, A.L., Seng, K.Y., Ong, E.M., Wang, L.Z., Oscar, H., Cordero, M.T., Copones, R., Fan, L., Tan, S.H., Goh, B.C., Lee, S.C. (2014). Body fat composition impacts the hematologic toxicities and pharmacokinetics of doxorubicin in Asian breast cancer patients. Breast Cancer Research and Treatment 144 (1) : 143-152. ScholarBank@NUS Repository.
Abstract: Body surface area (BSA)-based dosing leads to wide inter-individual variations in drug pharmacokinetics and pharmacodynamics, whereas body composition has been shown to be a more robust determinant of efficacy and toxicity of certain chemotherapeutic agents. We correlated various parameters of body composition with doxorubicin pharmacokinetics and hematologic toxicities in Asian patients with locally advanced or metastatic breast cancer. Our analysis included 84 patients from two studies who received pre- or post-operative single-agent doxorubicin; pharmacokinetic parameters were available for 44 patients. Body composition parameters were derived from CT cross-sectional images and population pharmacokinetic analysis was conducted using mixed-effects modeling. Higher intra-abdominal fat volume and fat ratio (intra-abdominal:total abdominal fat volume) correlated with greater incidence of grade 4 leukopenia on cycle 1 day 15 (mean intra-abdominal fat volume: 97.4 ± 46.5 cm3 vs 63.4 ± 30.9 cm3, p = 0.014; mean fat ratio: 0.43 ± 0.11 vs 0.33 ± 0.09, p = 0.012, grade 4 vs grade 0-3 leukopenia). On subset analysis, this relationship was maintained even in underweight patients. Concordantly, there were positive correlations between doxorubicin AUC and intra-abdominal fat volume as well as total abdominal fat volume (r 2 = 0.324 and 0.262, respectively, all p < 0.001). BSA and muscle volume did not predict for doxorubicin pharmacokinetics or toxicities. High-intra-abdominal fat volume but not BSA predicted for greater doxorubicin exposure and hematologic toxicities, suggesting that body composition is superior to BSA in determining doxorubicin pharmacokinetics and pharmacodynamics. Body composition has an emerging role in chemotherapy dose determination. © 2014 Springer Science+Business Media New York.
Source Title: Breast Cancer Research and Treatment
ISSN: 15737217
DOI: 10.1007/s10549-014-2843-8
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
There are no files associated with this item.


checked on Mar 21, 2019


checked on Mar 12, 2019

Page view(s)

checked on Feb 8, 2019

Google ScholarTM



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.