Doxorubicin clearance in the obese

K. A. Rodvold, D. A. Rushing, D. A. Tewksbury

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170 Scopus citations


A study was carried out to examine the effect, if any, of obesity on doxorubicin pharmacokinetics. Body weight was found to be significantly related to doxorubicin clearance (r = -.75; P < .001) and elimination half-life (r = .62; P = .003). Thus, the contribution of obesity on pharmacokinetics of antineoplastic agents should be taken into consideration in the analysis of clinical data with respect to toxicity and tumor response. Twenty-one patients were studied with their first course of doxorubicin (50 to 70 mg/m2) administered as a 60-minute intravenous (IV) infusion. Patients were divided into three groups on the basis of percentage of ideal body weight (IBW): normal (< 115% IBW), mildly obese (115% to 130% IBW), and obese (> 130% IBW). Blood samples were collected up to 48 hours after the infusion and analyzed for doxorubicin and its metabolite, doxorubicinol, by high performance liquid chromatography. Doxorubicin area under the curve (AUC) was greater in obese than in normal patients (2,209 v 1,190 ng h/mL; P < .05), yielding correspondingly reduced systemic clearance of the agent in obese patients (891 v 1,569 mL/min; P < .001). The mean elimination half-life (T 1/2 ) was 20.4 hours in the obese patients and 13.0 hours in the normal patients. The apparent volume of distribution (Vss) was not significantly different among the three groups of patients, indicating that the prolonged T 1/2 in the obese patients is due to the reduction in clearance. The AUC and T 1/2 of doxorubicinol were similar among all patient groups.

Original languageEnglish (US)
Pages (from-to)1321-1327
Number of pages7
JournalJournal of Clinical Oncology
Issue number8
StatePublished - Jan 1 1988

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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