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Optimizing melphalan pharmacokinetics in regional melanoma therapy: does correcting for ideal body weight alter regional response or toxicity?

Publication ,  Journal Article
McMahon, N; Cheng, TY; Beasley, GM; Spasojevic, I; Petros, W; Augustine, CK; Zipfel, P; Padussis, JC; Sanders, G; Tyler, DS
Published in: Ann Surg Oncol
April 2009

BACKGROUND: This study aims to determine what effect correcting melphalan dosing for ideal body weight (IBW) has on toxicity and response in isolated limb infusion (ILI) in patients with advanced extremity melanoma. METHODS: This was an open observational study examining whether correcting the melphalan dose for IBW will influence response and toxicity in patients undergoing ILI for advanced extremity melanoma in 41 patients undergoing 42 procedures (13 without correction for IBW; and 29 with correction for IBW). Melphalan pharmacokinetics, limb toxicity, serologic toxicity, and response at 3 months were compared. RESULTS: The corrected group had a lower estimated limb volume (V (esti)) to melphalan volume at steady state (V (ss)) (P < .0001) ratio as well as lower incidence of grade > or =3 regional toxicity, serologic toxicity, and compartment syndrome (P = .0249, P = .027, P = .02). There was a positive correlation of V (esti)/V (ss) to toxicity (P = .0127, r = .382). No significant difference in response (P = .3609) between the groups was found, although there was a trend of association between V (esti)/V (ss) and response (P = .051, r = .3383). CONCLUSIONS: Correcting for IBW in ILI lowers toxicity without significantly altering response rates.

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Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

April 2009

Volume

16

Issue

4

Start / End Page

953 / 961

Location

United States

Related Subject Headings

  • Skin Neoplasms
  • Oncology & Carcinogenesis
  • Middle Aged
  • Melphalan
  • Melanoma
  • Male
  • Humans
  • Female
  • Extremities
  • Dose-Response Relationship, Drug
 

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McMahon, N., Cheng, T. Y., Beasley, G. M., Spasojevic, I., Petros, W., Augustine, C. K., … Tyler, D. S. (2009). Optimizing melphalan pharmacokinetics in regional melanoma therapy: does correcting for ideal body weight alter regional response or toxicity? Ann Surg Oncol, 16(4), 953–961. https://doi.org/10.1245/s10434-008-0288-1
McMahon, N., T. Y. Cheng, G. M. Beasley, I. Spasojevic, W. Petros, C. K. Augustine, P. Zipfel, J. C. Padussis, G. Sanders, and Douglas S. Tyler. “Optimizing melphalan pharmacokinetics in regional melanoma therapy: does correcting for ideal body weight alter regional response or toxicity?Ann Surg Oncol 16, no. 4 (April 2009): 953–61. https://doi.org/10.1245/s10434-008-0288-1.
McMahon N, Cheng TY, Beasley GM, Spasojevic I, Petros W, Augustine CK, et al. Optimizing melphalan pharmacokinetics in regional melanoma therapy: does correcting for ideal body weight alter regional response or toxicity? Ann Surg Oncol. 2009 Apr;16(4):953–61.
McMahon, N., et al. “Optimizing melphalan pharmacokinetics in regional melanoma therapy: does correcting for ideal body weight alter regional response or toxicity?Ann Surg Oncol, vol. 16, no. 4, Apr. 2009, pp. 953–61. Pubmed, doi:10.1245/s10434-008-0288-1.
McMahon N, Cheng TY, Beasley GM, Spasojevic I, Petros W, Augustine CK, Zipfel P, Padussis JC, Sanders G, Tyler DS. Optimizing melphalan pharmacokinetics in regional melanoma therapy: does correcting for ideal body weight alter regional response or toxicity? Ann Surg Oncol. 2009 Apr;16(4):953–961.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

April 2009

Volume

16

Issue

4

Start / End Page

953 / 961

Location

United States

Related Subject Headings

  • Skin Neoplasms
  • Oncology & Carcinogenesis
  • Middle Aged
  • Melphalan
  • Melanoma
  • Male
  • Humans
  • Female
  • Extremities
  • Dose-Response Relationship, Drug