The dynamic detection of drug area under curve (AUC) guides clinical usage of docetaxel in solid tumors.

Abstract

3024 Background: The dosage of most chemotherapy drugs were performed based on the patients’ body surface area (BSA), including docetaxel (DTX). Previous studies showed that this conventional administration of DTX might cause adverse event, such as neutropenia, and neutropenia was proved to associate with DTX area under curve (AUC). This study was designed to evaluate the effect of dose-administration of DTX based on dynamic detection of DTX AUC on clinical outcomes. Methods: A total of 209 patients with DTX chemotherapy (one cycle every 3 weeks) were enrolled, and all patients received 2-6 cycles of treatment. In the first cycle, dosage of DTX based on BSA was administrated in all study population. From the second cycle, one group patients (control group) received DTX according to traditional BSA and the other group patients (experimental group) on the basis of dynamic detection of DTX AUC. The primary outcome was incidence rate of neutropenia and the second outcome was disease control rate (DCR). Results: Patients with grade 3 or higher neutropenia from the fourth to sixth cycle of DTX chemotherapy were significantly lower in the experimental group compared with the control group (P= 0.039, 0.012, and 0.001, respectively). In the experimental group, compared with the first cycle, and the number of patients falling within the therapeutic window increased by 27.19% in the sixth cycle after dose adjustment according to the AUC value of previous cycle. The DCR in the experimental and control group is 85.32% and 72.00%, respectively (P= 0.018). Conclusions: The administration method based on dynamic detection of AUC of DTX could significantly reduce incidence rate of neutropenia and received a higher DCR, but the result needed to be confirmed in further studies.