Body Composition Adjusted Dosing of Gemcitabine-Nab-Paclitaxel in Pancreatic Cancer Does Not Predict Toxicity Compared to Body Surface Area Dosing

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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 languageEnglish
Pages (from-to)624-628
Number of pages5
JournalNutrition and Cancer
Volume71
Issue number4
DOIs
Publication statusPublished - 1 May 2019

Cite this

@article{7a849f7532b84263b531affc088ad40d,
title = "Body Composition Adjusted Dosing of Gemcitabine-Nab-Paclitaxel in Pancreatic Cancer Does Not Predict Toxicity Compared to Body Surface Area Dosing",
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.",
author = "Julia Freckelton and Daniel Croagh and Holt, {Darcy Quinn} and Adrian Fox and Rachel Wong and Margaret Lee and Moore, {Gregory Thomas}",
year = "2019",
month = "5",
day = "1",
doi = "10.1080/01635581.2018.1542011",
language = "English",
volume = "71",
pages = "624--628",
journal = "Nutrition and Cancer-An International Journal",
issn = "0163-5581",
publisher = "Taylor & Francis",
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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.

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DO - 10.1080/01635581.2018.1542011

M3 - Article

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EP - 628

JO - Nutrition and Cancer-An International Journal

JF - Nutrition and Cancer-An International Journal

SN - 0163-5581

IS - 4

ER -