Affiliations of authors: Saitama Medical School, Saitama, Japan (YA, FO, FN, MN, YS); National Cancer Center Hospital East, Chiba, Japan (TO); Kyoto University, Kyoto, Japan (MA); National Cancer Center Hospital, Tokyo, Japan (NS).
Correspondence to: Yuichi Ando, MD, PhD, Department of Clinical Oncology, Saitama Medical School, 38 Morohongo, Moroyama, Iruma-gun, Saitama 350-0495, Japan (e-mail: yando{at}saitama-med.ac.jp).
In a recent article in the Journal, Baker et al. (1) reported that body surface area (BSA)-based dosing was not associated with a decrease in interpatient variability in the pharmacokinetics of most anticancer agents. Interestingly, a BSA-based dosing strategy was associated with a decrease in interpatient variability in paclitaxel clearance, a finding that has been recently validated in a prospective study (2). Because the pharmacokinetic variability among patients reflects complex interactions between genes and environmental factors, it is possible that the role of BSA in paclitaxel dosing may differ for different ethnic groups. Therefore, we examined the role of BSA in paclitaxel dosing using data from a previous phase I study (3) conducted in Japan.
According to results of simple linear regression analysis, variability in the paclitaxel area under the concentration versus time curve (AUC) was related more to the BSA-based doses than to the actual doses per individual (Fig. 1). Thus, the traditional use of BSA in paclitaxel dosing is also supported by results in Japanese patients, suggesting that the role of BSA is similar in Japanese and non-Japanese patients. We note that approximately 80% of the variability in AUC could be accounted for by the actual doses per individual.
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