Scholarlink

Purpose <p>Carboplatin is used in several chemotherapy regimens and is mainly excreted by kidneys. The recommended dose is calculated using a target exposure (area under the curve or AUC) and a predicted carboplatin clearance (CLcarbo). This clearance could be obtained by equations based on the estimation of glomerular filtration rate (GFR) including serum creatinine (SCr) alone or with plasma Cystatin C (CysC).</p> Case presentation <p>A 68-years-old woman with uterine carcinosarcoma and lymph node/lung metastases should be treated by carboplatin-paclitaxel. However, her SCr level was extremely low (i.e., 10 µmol/L) due to a spinal amyotrophy. Therefore, carboplatin clearance and dose calculation was estimated from an equation based on CysC, body weight, and age but not SCr proposed by Thomas et al. A therapeutic drug monitoring was performed to determine the patient’s actual CLcarbo.</p> Results <p>The patient presented an actual CLcarbo close to the value predicted by the equation based on CysC (93.7 and 92.8 mL/min, respectively). The other formulae based on SCr alone or with CysC would have been associated with a substantial overestimation of her CLcarbo and thus would have led to drug overexposure.</p> Conclusion <p>We concluded that the Thomas equation based on CysC alone represents a suitable alternative in patients with very low serum creatinine concentration due to amyotrophy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Benefit of plasma cystatin C for carboplatin individual dosing in a patient with spinal amyotrophy

  • 期刊论文

  • 发表日期：

    2025年12月11日

查看全文
  • Matthieu Gracia,
  • Sabrina Marsili,
  • Julien Vintejoux,
  • Laurence Gladieff,
  • Etienne Chatelut,
  • Fabienne Thomas

摘要

Purpose

Carboplatin is used in several chemotherapy regimens and is mainly excreted by kidneys. The recommended dose is calculated using a target exposure (area under the curve or AUC) and a predicted carboplatin clearance (CLcarbo). This clearance could be obtained by equations based on the estimation of glomerular filtration rate (GFR) including serum creatinine (SCr) alone or with plasma Cystatin C (CysC).

Case presentation

A 68-years-old woman with uterine carcinosarcoma and lymph node/lung metastases should be treated by carboplatin-paclitaxel. However, her SCr level was extremely low (i.e., 10 µmol/L) due to a spinal amyotrophy. Therefore, carboplatin clearance and dose calculation was estimated from an equation based on CysC, body weight, and age but not SCr proposed by Thomas et al. A therapeutic drug monitoring was performed to determine the patient’s actual CLcarbo.

Results

The patient presented an actual CLcarbo close to the value predicted by the equation based on CysC (93.7 and 92.8 mL/min, respectively). The other formulae based on SCr alone or with CysC would have been associated with a substantial overestimation of her CLcarbo and thus would have led to drug overexposure.

Conclusion

We concluded that the Thomas equation based on CysC alone represents a suitable alternative in patients with very low serum creatinine concentration due to amyotrophy.