Abstract
The influence of liver biochemistry tests on epirubicin pharmacokinetics has been investigated in 52 women with advanced breast cancer, 27 of whom had radiologically proven liver metastases. Patients received epirubicin 12.5-120 mg m-2 given as an i.v. bolus. Epirubicin levels were measured by HPLC following the first cycle of treatment. Epirubicin elimination, expressed as clearance (dose/AUC), in the 22 patients with normal AST and bilirubin was compared with that of 30 patients with a raised AST +/- raised bilirubin. Epirubicin clearance was significantly reduced in the patients with a raised AST, whether their serum bilirubin was normal (22 patients) or elevated (eight patients). In the 30 patients with a raised AST +/- raised bilirubin, epirubicin clearance correlated strongly with the level of AST (r = -0.72) but not with serum bilirubin, alkaline phosphatase, albumin or creatinine. Using a multiple regression analysis, AST was the only one of these biochemical variables predictive of epirubicin clearance (r2 = 0.47, P = 0.0006). We conclude that a raised serum AST is a more sensitive and reliable measure of abnormal epirubicin pharmacokinetics than increased bilirubin. These findings have implications for anthracycline treatment in patients with abnormal liver biochemistry.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 24 print issues and online access
$259.00 per year
only $10.79 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Twelves, C., Dobbs, N., Michael, Y. et al. Clinical pharmacokinetics of epirubicin: the importance of liver biochemistry tests. Br J Cancer 66, 765–769 (1992). https://doi.org/10.1038/bjc.1992.353
Issue Date:
DOI: https://doi.org/10.1038/bjc.1992.353
This article is cited by
-
Evaluation of safety parameters and changes in serum concentration in liver transplant recipients treated with doxorubicin during the anhepatic period
Cancer Chemotherapy and Pharmacology (2013)
-
An exploratory study of body composition as a determinant of epirubicin pharmacokinetics and toxicity
Cancer Chemotherapy and Pharmacology (2011)
-
Population analysis of the pharmacokinetics and the haematological toxicity of the fluorouracil-epirubicin-cyclophosphamide regimen in breast cancer patients
Cancer Chemotherapy and Pharmacology (2006)
-
A population model of epirubicin pharmacokinetics and application to dosage guidelines
Cancer Chemotherapy and Pharmacology (2003)
-
Gender affects doxorubicin pharmacokinetics in patients with normal liver biochemistry
Cancer Chemotherapy and Pharmacology (1995)