Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study
Purpose Current methods of dosing platinum-based chemotherapy are suboptimal. Potentially, taking lean body mass into account may help. To inform the design of a future study, we first examined the feasibility and acceptability of such an approach using dual-energy X-ray absorptiometry (DEXA) and ex...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Published: |
Springer
2016
|
| Subjects: | |
| Online Access: | https://eprints.nottingham.ac.uk/48276/ |
| _version_ | 1848797730231549952 |
|---|---|
| author | Crosby, Vincent D'Souza, Catherine Bristow, Carina Proffitt, Amy Hussain, Asmah Potter, Vanessa Hennig, Ivo M. O'Connor, Richard Baracos, Vickie E. Wilcock, Andrew |
| author_facet | Crosby, Vincent D'Souza, Catherine Bristow, Carina Proffitt, Amy Hussain, Asmah Potter, Vanessa Hennig, Ivo M. O'Connor, Richard Baracos, Vickie E. Wilcock, Andrew |
| author_sort | Crosby, Vincent |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Purpose Current methods of dosing platinum-based chemotherapy are suboptimal. Potentially, taking lean body mass into account may help. To inform the design of a future study, we first examined the feasibility and acceptability of such an approach using dual-energy X-ray absorptiometry (DEXA) and explored aspects suggestive of over- and under-dosing.
Methods Patients with lung cancer offered platinum-based chemotherapy over 1 year were identified and, if eligible, invited to take part in a prospective feasibility study. Questionnaires examined acceptability of the DEXA scan and of a future study that randomized between traditional dosing and one adjusted according to body composition. Dose-limiting toxicity (DLT) and a lack of neutropenia explored potential over- and under-dosing, respectively.
Results Of the 173 patients offered chemotherapy, 123 (71%) were ineligible, mostly because of failing entry criteria (84, 49%). Of the 50 approached, 18 (36%) participated, most receiving carboplatin, with 17 providing data. All found a DEXA scan acceptable; other assessments were fully completed, except nadir and pre-chemotherapy blood counts. Most (94%) were prepared to take part in a future study, although the additional hospital visits for a nadir blood count were unpopular with some. Five (29%) patients experienced six episodes of DLT which resulted in discontinuation (3), dose reduction (2) or change to a less toxic regimen (1). Nine (60%) patients experienced either no (2) or inconsistent (7) neutropenia.
Conclusions A randomized trial appears acceptable and feasible in patients receiving carboplatin. Adjustment of our entry criteria and avoiding a hospital visit for a nadir blood count should aid recruitment. |
| first_indexed | 2025-11-14T20:08:31Z |
| format | Article |
| id | nottingham-48276 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:08:31Z |
| publishDate | 2016 |
| publisher | Springer |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-482762020-05-04T18:26:54Z https://eprints.nottingham.ac.uk/48276/ Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study Crosby, Vincent D'Souza, Catherine Bristow, Carina Proffitt, Amy Hussain, Asmah Potter, Vanessa Hennig, Ivo M. O'Connor, Richard Baracos, Vickie E. Wilcock, Andrew Purpose Current methods of dosing platinum-based chemotherapy are suboptimal. Potentially, taking lean body mass into account may help. To inform the design of a future study, we first examined the feasibility and acceptability of such an approach using dual-energy X-ray absorptiometry (DEXA) and explored aspects suggestive of over- and under-dosing. Methods Patients with lung cancer offered platinum-based chemotherapy over 1 year were identified and, if eligible, invited to take part in a prospective feasibility study. Questionnaires examined acceptability of the DEXA scan and of a future study that randomized between traditional dosing and one adjusted according to body composition. Dose-limiting toxicity (DLT) and a lack of neutropenia explored potential over- and under-dosing, respectively. Results Of the 173 patients offered chemotherapy, 123 (71%) were ineligible, mostly because of failing entry criteria (84, 49%). Of the 50 approached, 18 (36%) participated, most receiving carboplatin, with 17 providing data. All found a DEXA scan acceptable; other assessments were fully completed, except nadir and pre-chemotherapy blood counts. Most (94%) were prepared to take part in a future study, although the additional hospital visits for a nadir blood count were unpopular with some. Five (29%) patients experienced six episodes of DLT which resulted in discontinuation (3), dose reduction (2) or change to a less toxic regimen (1). Nine (60%) patients experienced either no (2) or inconsistent (7) neutropenia. Conclusions A randomized trial appears acceptable and feasible in patients receiving carboplatin. Adjustment of our entry criteria and avoiding a hospital visit for a nadir blood count should aid recruitment. Springer 2016-12-08 Article PeerReviewed Crosby, Vincent, D'Souza, Catherine, Bristow, Carina, Proffitt, Amy, Hussain, Asmah, Potter, Vanessa, Hennig, Ivo M., O'Connor, Richard, Baracos, Vickie E. and Wilcock, Andrew (2016) Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study. Supportive Care in Cancer, 25 (4). pp. 1257-1261. ISSN 1433-7339 Chemotherapy Lean body mass Lung cancer Pharmacology Toxicity https://link.springer.com/article/10.1007/s00520-016-3518-2 doi:10.1007/s00520-016-3518-2 doi:10.1007/s00520-016-3518-2 |
| spellingShingle | Chemotherapy Lean body mass Lung cancer Pharmacology Toxicity Crosby, Vincent D'Souza, Catherine Bristow, Carina Proffitt, Amy Hussain, Asmah Potter, Vanessa Hennig, Ivo M. O'Connor, Richard Baracos, Vickie E. Wilcock, Andrew Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study |
| title | Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study |
| title_full | Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study |
| title_fullStr | Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study |
| title_full_unstemmed | Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study |
| title_short | Can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? A feasibility study |
| title_sort | can body composition be used to optimize the dose of platinum chemotherapy in lung cancer? a feasibility study |
| topic | Chemotherapy Lean body mass Lung cancer Pharmacology Toxicity |
| url | https://eprints.nottingham.ac.uk/48276/ https://eprints.nottingham.ac.uk/48276/ https://eprints.nottingham.ac.uk/48276/ |