Evidence map›Paper›PMID 40300860›Full record

ArticleTherapeutic drug monitoring2025

Pharmacokinetic Study of Carboplatin Using Various Overweight-Correcting Dosing Algorithms and Biomarkers in Patients With Varying BMI Categories.

Mart P Kicken, Corine Bethlehem, Karin Beunen, Peter de Jong, Theo van Voorthuizen, Jeanine J van den Hudding, Dirk-Jan A R Moes, Matthijs van Luin, Rob Ter Heine, Hans J M Smit and 2 more

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Article in Therapeutic drug monitoring, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

12 authors.

Mart P KickenDepartment of Clinical Pharmacy, Rijnstate Hospital, Arnhem, the Netherlands.ORCID 0000-0002-5321-0816
Corine BethlehemDepartment of Clinical Pharmacy, Rijnstate Hospital, Arnhem, the Netherlands.
Karin BeunenDepartment of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands.
Peter de JongDepartment of Pulmonology, Rijnstate Hospital, Arnhem, the Netherlands.
Theo van VoorthuizenDepartment of Internal Medicine, Rijnstate Hospital, Arnhem, the Netherlands.
Jeanine J van den HuddingDepartment of Clinical Pharmacy, Rijnstate Hospital, Arnhem, the Netherlands.
Dirk-Jan A R MoesDepartment of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, the Netherlands; and.
Matthijs van LuinDepartment of Clinical Pharmacy, Rijnstate Hospital, Arnhem, the Netherlands.
Rob Ter HeineDepartment of Pharmacy, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.
Hans J M SmitDepartment of Pulmonology, Rijnstate Hospital, Arnhem, the Netherlands.
P Margreet G FiliusDepartment of Clinical Pharmacy, Rijnstate Hospital, Arnhem, the Netherlands.
Maarten J DeenenDepartment of Clinical Pharmacy, Rijnstate Hospital, Arnhem, the Netherlands.

Funding

Rijnstate Vriendenfonds
6 · The paper itself

Abstract

backgroundThe Cockcroft-Gault (CG) formula is more likely to overestimate renal function and carboplatin dosing in patients who are overweight. In this prospective pharmacokinetic study, the use of an adjusted Cockcroft-Gault formula (aCG) was evaluated to correct for overweight status.

methodsaCG was adjusted in patients with body mass index (BMI) >25 kg/m 2 using adjusted ideal body weight, capping low serum creatinine values at 60 μmol/L, and high creatinine clearance values at 125 mL/min. Patients were categorized as follows: BMI <25.0 (normal weight), 25.0-29.9 (overweight), and ≥30.0 kg/m 2 (obese). To assess the pharmacokinetics, blood samples were collected and carboplatin ultrafiltrate concentrations were analyzed. Exposure was estimated using a population pharmacokinetic model and compared with the target area under the curve (AUC) regarding bias mean prediction error (MPE%) and imprecision mean absolute prediction error (MAPE%). In addition, substitutes for renal function, including weight descriptors, cystatin C, 24-hour creatinine clearance, and glomerular filtration rate estimators, were compared.

resultsEighteen patients were included in this study. aCG slightly underestimated individual carboplatin clearance across all weight groups, with the highest deviation in patients who had obesity (MPE%: -10.5%) versus +8.8% using CG. aCG underestimated -5.7% in patients with a normal weight and overestimated by +1.1% in those who were overweight, compared with -4.2% and +2.8%, respectively, using CG. The most accurate predictor of the target AUC for all weight categories was cystatin C (MPE%: +0.2%, -2.0%, and -0.1% for patients with a normal weight, those who were overweight, and those who had obesity, respectively) with low imprecision (MAPE%: 9.8%, 9.5%, and 13.3%, respectively).

conclusionsThis study did not find evidence to support using aCG to predict carboplatin clearance better than CG. However, cystatin C was found to be the most precise and accurate biomarker for carboplatin clearance.

Indexed as

Antineoplastic AgentsCarboplatinOverweightAdultAgedAlgorithmsArea Under CurveBiomarkersBody Mass IndexCreatinineFemaleGlomerular Filtration RateHumansMaleMiddle AgedObesityAntineoplastic AgentsBiomarkersCarboplatinCreatininebody weightcarboplatinCockcroft–Gault formuladose adaptationpharmacokinetics

Identifiers

PMID40300860
PMCPMC12588668

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.