Abstract
Combination gemcitabine and nab-paclitaxel (Gem-Nab-P) is a common regimen used to treat metastatic pancreatic ductal adenocarcinoma (PDAC). Toxicity from this regimen is associated with significant morbidity. Currently, Gem-Nab-P is dosed using estimated body surface area, derived from height and weight. This study investigates whether skeletal muscle assessment could be a useful tool in the dosing of Gem-Nab-P in metastatic PDAC. This study included 52 patients who had received first-line treatment with Gem-Nab-P for PDAC. Demographic and chemotherapy treatment information was gathered from medical records and body composition analysis was performed using single slice computed tomography methods, at spinal level L3. Patients who experienced first-cycle chemotherapy-associated toxicity did not have a different median skeletal muscle area (SkMA) to those who did not (128.6 cm 2 vs. 111.4 cm 2 , P =0.2). There was also no difference in the gemcitabine dose to SkMA ratio (14.1 mg/cm 2 vs. 14.4 mg/cm 2 , P = 0.8), nab-paclitaxel to SkMA ratio (1.8 mg/cm 2 vs. 1.8 mg/cm 2 , P = 0.6) or combined dose equivalent to SkMA ratio (2.8 mg/cm 2 vs. 2.9 mg/cm 2 , P = 0.9) between the patients that experienced first cycle toxicity versus those that did not. This study suggests that a PDAC patient’s SkMA is unlikely to be a useful addition to conventional body surface area in the dosing of first-line Gem-Nab-P, to reduce first-cycle toxicity.
| Original language | English |
|---|---|
| Pages (from-to) | 624-628 |
| Number of pages | 5 |
| Journal | Nutrition and Cancer |
| Volume | 71 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 1 May 2019 |
Cite this
}
Body Composition Adjusted Dosing of Gemcitabine-Nab-Paclitaxel in Pancreatic Cancer Does Not Predict Toxicity Compared to Body Surface Area Dosing. / Freckelton, Julia; Croagh, Daniel; Holt, Darcy Quinn; Fox, Adrian; Wong, Rachel; Lee, Margaret; Moore, Gregory Thomas.
In: Nutrition and Cancer, Vol. 71, No. 4, 01.05.2019, p. 624-628.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Body Composition Adjusted Dosing of Gemcitabine-Nab-Paclitaxel in Pancreatic Cancer Does Not Predict Toxicity Compared to Body Surface Area Dosing
AU - Freckelton, Julia
AU - Croagh, Daniel
AU - Holt, Darcy Quinn
AU - Fox, Adrian
AU - Wong, Rachel
AU - Lee, Margaret
AU - Moore, Gregory Thomas
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Combination gemcitabine and nab-paclitaxel (Gem-Nab-P) is a common regimen used to treat metastatic pancreatic ductal adenocarcinoma (PDAC). Toxicity from this regimen is associated with significant morbidity. Currently, Gem-Nab-P is dosed using estimated body surface area, derived from height and weight. This study investigates whether skeletal muscle assessment could be a useful tool in the dosing of Gem-Nab-P in metastatic PDAC. This study included 52 patients who had received first-line treatment with Gem-Nab-P for PDAC. Demographic and chemotherapy treatment information was gathered from medical records and body composition analysis was performed using single slice computed tomography methods, at spinal level L3. Patients who experienced first-cycle chemotherapy-associated toxicity did not have a different median skeletal muscle area (SkMA) to those who did not (128.6 cm 2 vs. 111.4 cm 2 , P =0.2). There was also no difference in the gemcitabine dose to SkMA ratio (14.1 mg/cm 2 vs. 14.4 mg/cm 2 , P = 0.8), nab-paclitaxel to SkMA ratio (1.8 mg/cm 2 vs. 1.8 mg/cm 2 , P = 0.6) or combined dose equivalent to SkMA ratio (2.8 mg/cm 2 vs. 2.9 mg/cm 2 , P = 0.9) between the patients that experienced first cycle toxicity versus those that did not. This study suggests that a PDAC patient’s SkMA is unlikely to be a useful addition to conventional body surface area in the dosing of first-line Gem-Nab-P, to reduce first-cycle toxicity.
AB - Combination gemcitabine and nab-paclitaxel (Gem-Nab-P) is a common regimen used to treat metastatic pancreatic ductal adenocarcinoma (PDAC). Toxicity from this regimen is associated with significant morbidity. Currently, Gem-Nab-P is dosed using estimated body surface area, derived from height and weight. This study investigates whether skeletal muscle assessment could be a useful tool in the dosing of Gem-Nab-P in metastatic PDAC. This study included 52 patients who had received first-line treatment with Gem-Nab-P for PDAC. Demographic and chemotherapy treatment information was gathered from medical records and body composition analysis was performed using single slice computed tomography methods, at spinal level L3. Patients who experienced first-cycle chemotherapy-associated toxicity did not have a different median skeletal muscle area (SkMA) to those who did not (128.6 cm 2 vs. 111.4 cm 2 , P =0.2). There was also no difference in the gemcitabine dose to SkMA ratio (14.1 mg/cm 2 vs. 14.4 mg/cm 2 , P = 0.8), nab-paclitaxel to SkMA ratio (1.8 mg/cm 2 vs. 1.8 mg/cm 2 , P = 0.6) or combined dose equivalent to SkMA ratio (2.8 mg/cm 2 vs. 2.9 mg/cm 2 , P = 0.9) between the patients that experienced first cycle toxicity versus those that did not. This study suggests that a PDAC patient’s SkMA is unlikely to be a useful addition to conventional body surface area in the dosing of first-line Gem-Nab-P, to reduce first-cycle toxicity.
UR - http://www.scopus.com/inward/record.url?scp=85061256200&partnerID=8YFLogxK
U2 - 10.1080/01635581.2018.1542011
DO - 10.1080/01635581.2018.1542011
M3 - Article
VL - 71
SP - 624
EP - 628
JO - Nutrition and Cancer-An International Journal
JF - Nutrition and Cancer-An International Journal
SN - 0163-5581
IS - 4
ER -