Chemotherapy Dosing in Obese Cancer PatientsWednesday, July 31, 2013
Last week, I posted on the diagnostic challenges in the management of cancer patients with obesity.
Readers interested in the care of such patients may also be interested in the review by Gary Lyman and Alex Sparreboom published in Nature Reviews Clinical Oncology on the appropriate dosing of chemotherapy in overweight and obese cancer patients.
As the authors point out, there is considerable evidence that clinicians often reduce the dose intensity of chemotherapeutic agents in clinical practice, perhaps in fear of excess toxicity.
The paper references new clinical practice guidelines for appropriate chemotherapy dosing for obese adult patients with cancer, which recommend that chemotherapy dosing should generally be calculated based on body surface area using actual weight, rather than an estimate or idealization of weight.
However, the authors also point out the need for more pharmacokinetic studies to support the use of actual body weight to calculate chemotherapy doses for most chemotherapy drugs in obese patients.
Clearly, this is an area for future research in order to ensure that overweight and obese patients with cancer are optimally treated with the best possible balance between clinical benefits and risks from these agents.
Lyman GH, & Sparreboom A (2013). Chemotherapy dosing in overweight and obese patients with cancer. Nature reviews. Clinical oncology PMID: 23856744