CORRELATIVE STUDY OF LOW SERUM CREATININE AND HEMATOLOGICAL TOXIC EFFECTS IN JAPANESE PATIENTS WITH OVARIAN CANCER TREATED BY DOSE DENSE TC THERAPY

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Abstract

Background

Dose dense TC (ddTC) is a novel standard therapy for patients with advanced ovarian cancer, although hematological toxic effects (hemTX), especially anemia, may increase as observed in NOVEL trial (JGOG3016). Low serum creatinine (LCr), especially <0.7 mg/dl, may lead to overestimation of GFR. GOG announced that patients with LCr should use a minimum value of 0.7 mg/dl to estimate GFR. The correlation between LCr and hemTX treated by ddTC is unknown.

Methods

GFR was determined using the Cockcroft–Gault formula. Serum creatinine concentrations were measured using enzymatic assays. Minimum value of 0.7 mg/dl was not used during this period of time. The carboplatin clearance was then calculated by Calvert equation. HemTX were defined as, Grade 3 or 4 (by CTC-AE ver.4) neutropenia, anemia, and thrombocytopenia. Using electrical chart, the frequency of hemTX and correlation between serum creatinine (<0.7 or not) was examined.

Results

From February 2010 to December 2011, 61 consecutive patients were treated with ddTC. LCr was observed in 73% of patients. No treatment-related death occurred. Among 61 patients, 50 (82%), 31 (51%), and 12 (19.6 %) patients experienced Grade 3/4 neutropenia, anemia and thrombocytopenia, respectively. HemTX in patients with LCr and the others were as in Table 1.

Conclusions

LCr is frequent in Japanese female patients. ddTC in practice setting seems safe, and hemTX of ddTC are similar with those observed in NOVEL trial. The rationale using a minimum value of 0.7 mg/dl should be further studied by larger population, such as patients in NOVEL trial.

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