Optimizing melphalan pharmacokinetics in regional melanoma therapy: Does correcting for ideal body weight alter regional response or toxicity?

N. McMahon, T. Y. Cheng, G. M. Beasley, I. Spasojevic, W. Petros, C. K. Augustine, P. Zipfel, J. C. Padussis, G. Sanders, Douglas Tyler

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: This study aims to determine what effect correcting melphalan dosing for ideal body weight (IBW) has on toxicity and response in isolated limb infusion (ILI) in patients with advanced extremity melanoma. Methods: This was an open observational study examining whether correcting the melphalan dose for IBW will influence response and toxicity in patients undergoing ILI for advanced extremity melanoma in 41 patients undergoing 42 procedures (13 without correction for IBW; and 29 with correction for IBW). Melphalan pharmacokinetics, limb toxicity, serologic toxicity, and response at 3 months were compared. Results: The corrected group had a lower estimated limb volume (V esti) to melphalan volume at steady state (V ss) (P < .0001) ratio as well as lower incidence of grade ≥3 regional toxicity, serologic toxicity, and compartment syndrome (P = .0249, P = .027, P = .02). There was a positive correlation of V esti/V ss to toxicity (P = .0127, r = .382). No significant difference in response (P = .3609) between the groups was found, although there was a trend of association between V esti/V ss and response (P = .051, r = .3383). Conclusions: Correcting for IBW in ILI lowers toxicity without significantly altering response rates.

Original languageEnglish (US)
Pages (from-to)953-961
Number of pages9
JournalAnnals of Surgical Oncology
Volume16
Issue number4
DOIs
StatePublished - Apr 2009
Externally publishedYes

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Ideal Body Weight
Melphalan
Melanoma
Extremities
Pharmacokinetics
Therapeutics
Compartment Syndromes
Observational Studies
Lower Extremity
Incidence

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Optimizing melphalan pharmacokinetics in regional melanoma therapy : Does correcting for ideal body weight alter regional response or toxicity? / McMahon, N.; Cheng, T. Y.; Beasley, G. M.; Spasojevic, I.; Petros, W.; Augustine, C. K.; Zipfel, P.; Padussis, J. C.; Sanders, G.; Tyler, Douglas.

In: Annals of Surgical Oncology, Vol. 16, No. 4, 04.2009, p. 953-961.

Research output: Contribution to journalArticle

McMahon, N, Cheng, TY, Beasley, GM, Spasojevic, I, Petros, W, Augustine, CK, Zipfel, P, Padussis, JC, Sanders, G & Tyler, D 2009, 'Optimizing melphalan pharmacokinetics in regional melanoma therapy: Does correcting for ideal body weight alter regional response or toxicity?', Annals of Surgical Oncology, vol. 16, no. 4, pp. 953-961. https://doi.org/10.1245/s10434-008-0288-1
McMahon, N. ; Cheng, T. Y. ; Beasley, G. M. ; Spasojevic, I. ; Petros, W. ; Augustine, C. K. ; Zipfel, P. ; Padussis, J. C. ; Sanders, G. ; Tyler, Douglas. / Optimizing melphalan pharmacokinetics in regional melanoma therapy : Does correcting for ideal body weight alter regional response or toxicity?. In: Annals of Surgical Oncology. 2009 ; Vol. 16, No. 4. pp. 953-961.
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AU - Spasojevic, I.

AU - Petros, W.

AU - Augustine, C. K.

AU - Zipfel, P.

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