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Irinotecan Dosage Adjustment for Colon Cancer and Hepatic Dysfunction

Purpose: To adjust the recommended dose of irinotecan for a patient with colon cancer based on the level of hepatic dysfunction as reported by Raymond et al.

Description

Many patients with colon cancer have a degree of hepatic dysfunction., and patients with hepatic dysfunction are at greater risk for toxicity after therapy with irinotecan. Raymond et al proposed dose adjustment for these patients. The authors are from Gustave-Roussy Institute in Villejuif and Aventis Pharma in Vitry-sur-Seine in France.


 

Patients with colon cancer and hepatic dysfunction:

(1) may show decreased clearance of irinotecan with accumulation

(2) more likely to develop Grade 4 febrile neutropenia and diarrhea after irinotecan therapy

Serum Total Bilirubin

Group

Recommended Dose of Irinotecan

<= upper limit of normal (ULN)

I

350 mg per square meter BSA

1.01 to 1.5 time ULN

II

350 mg per square meter BSA

1.51 to 3.0 times ULN

III

200 mg per square meter BSA

>3 times ULN

IV

NA

 

where:

• Patients in Group IV tended to have rapidly progressive disease and no recommendation was made for this group.

 


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Specialty

Objective

ICD-10