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Cancer Chemotherapy and Pharmacology
Published in: Cancer Chemotherapy and Pharmacology 4/2014

01-10-2014 | Original Article

Pharmacokinetics and pharmacogenomics of daunorubicin in children: a report from the Children’s Oncology Group

Authors: Patrick Thompson, Heather E. Wheeler, Shannon M. Delaney, Rachel Lorier, Ulrich Broeckel, Meenakshi Devidas, Gregory H. Reaman, Kathleen Scorsone, Lillian Sung, M. Eileen Dolan, Stacey L. Berg

Published in: Cancer Chemotherapy and Pharmacology | Issue 4/2014

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Abstract

Purpose

We explored the impact of obesity, body composition, and genetic polymorphisms on the pharmacokinetics (PK) of daunorubicin in children with cancer.

Patients and methods

Patients ≤21 years receiving daunorubicin as an infusion of any duration <24 h for any type of cancer were eligible. Plasma drug concentrations were measured by high-performance liquid chromatography. Body composition was measured by dual-energy X-ray absorptiometry. Obesity was defined as a BMI >95 % for age or as body fat >30 %. NONMEM was used to perform PK model fitting. The Affymetrix DMET chip was used for genotyping. The impact of genetic polymorphisms was investigated using SNP/haplotype association analysis with estimated individual PK parameters.

Results

A total of 107 subjects were enrolled, 98 patients had PK sampling, and 50 patients underwent DNA analysis. Population estimates for daunorubicin clearance and volume of distribution were 116 L/m2/h ± 14 % and 68.1 L/m2 ± 24 %, respectively. Apparent daunorubicinol clearance and volume of distribution were 26.8 L/m2/h ± 5.6 % and 232 L/m2 ± 10 %, respectively. No effect of body composition or obesity was observed on PK. Forty-four genes with variant haplotypes were tested for association with PK. FMO3-H1/H3 genotype was associated with lower daunorubicin clearance than FMO3-H1/H1, p = 0.00829. GSTP1*B/*B genotype was also associated with lower daunorubicin clearance compared to GSTP1*A/*A, p = 0.0347. However, neither of these associations was significant after adjusting for multiple testing by either Bonferroni or false discovery rate correction.

Conclusions

We did not detect an effect of body composition or obesity on daunorubicin PK. We found suggestive associations between FMO3 and GSTP1 haplotypes with daunorubicin PK that could potentially affect efficacy and toxicity.
Appendix
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Metadata
Title
Pharmacokinetics and pharmacogenomics of daunorubicin in children: a report from the Children’s Oncology Group
Authors
Patrick Thompson
Heather E. Wheeler
Shannon M. Delaney
Rachel Lorier
Ulrich Broeckel
Meenakshi Devidas
Gregory H. Reaman
Kathleen Scorsone
Lillian Sung
M. Eileen Dolan
Stacey L. Berg
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
Cancer Chemotherapy and Pharmacology / Issue 4/2014
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI
https://doi.org/10.1007/s00280-014-2535-4

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