Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study

Crosby, Vincent and D'Souza, Catherine and Bristow, Carina and Proffitt, Amy and Hussain, Asmah and Potter, Vanessa and Hennig, Ivo M. and O'Connor, Richard and Baracos, Vickie E. and Wilcock, Andrew (2016) Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study. Supportive Care in Cancer, 25 (4). pp. 1257-1261. ISSN 1433-7339

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Abstract

Purpose 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.

Methods 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.

Results 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.

Conclusions 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.

Item Type: Article
Keywords: Chemotherapy, Lean body mass, Lung cancer, Pharmacology, Toxicity
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Medicine
Identification Number: 10.1007/s00520-016-3518-2
Depositing User: Eprints, Support
Date Deposited: 20 Nov 2017 14:58
Last Modified: 20 Nov 2017 17:29
URI: http://eprints.nottingham.ac.uk/id/eprint/48276

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