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Japanese Journal of Clinical Oncology Advance Access originally published online on February 12, 2008
Japanese Journal of Clinical Oncology 2008 38(3):182-185; doi:10.1093/jjco/hym171
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© The Author (2008). Published by Oxford University Press. All rights reserved

Measurement of Plasma Concentration of Gemcitabine and Its Metabolite dFdU in Hemodialysis Patients with Advanced Urothelial Cancer

Naoya Masumori1,, Yasuharu Kunishima1, Megumi Hirobe1, Motoi Takeuchi1, Akio Takayanagi1, Taiji Tsukamoto1 and Tatsuya Itoh2

1 Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Japan
2 Division of Hospital Pharmacy, Sapporo Health Insurance General Hospital, Sapporo, Japan

For reprints and all correspondence: Naoya Masumori, Department of Urology, Sapporo Medical University, S1, W16, Chuo-ku, Sapporo 060-8543, Japan. E-mail: masumori{at}sapmed.ac.jp

Received October 19, 2007; accepted December 2, 2007

Objective: We investigated the pharmacokinetics of gemcitabine and its metabolite in two male patients (52 and 56-year-old) with advanced urothelial cancer receiving hemodialysis three times a week.

Methods: Gemcitabine, 1000 mg/m2 in 100 ml of saline, was intravenously administered for 30 min. The concentration of gemcitabine and its metabolite 2',2'-difluorodeoxyuridine (dFdU) was measured at several given time points using a high-pressure liquid chromatography assay. Pharmacokinetic parameters were determined using the two-compartment modeling program.

Results: Gemcitabine was rapidly eliminated from plasma even in patients with renal dysfunction. No obvious differences in pharmacokinetic parameters such as the t1/2, AUC and Cmax of gemcitabine were observed between the patients on hemodialysis and those with normal renal function in previous reports. On the other hand, dFdU showed a sustained level until hemodialysis was initiated. Hemodialysis could reduce the plasma dFdU level by approximately 50%.

Conclusions: According to the previous information, no dose modification of gemcitabine may be required for patients with renal impairment or hemodialysis. However, gemcitabine should be given with caution because only limited information is available, and the clinical effect of sustained and/or accumulated dFdU is unknown.

Key Words: urothelial neoplasm • gemcitabine • renal impairment • hemodialysis • pharmacokinetics


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