@article{2e48ecd99cd74d1abcd9ca1b477155b6,
title = "Carboplatin dosing in obese women with ovarian cancer: A Gynecologic Oncology Group study",
abstract = "Background: Carboplatin dosing for gynecologic malignancies is traditionally based on the Jelliffe formula that lacks dose adjustment for weight. Obese women may therefore receive a sub-therapeutic carboplatin dose. This study assessed the association between BMI and outcome for ovarian cancer patients treated with carboplatin-based chemotherapy. Methods: An analysis of patients treated with carboplatin and paclitaxel on Gynecologic Oncology Group (GOG) protocol 158 was performed. The dose of carboplatin for each patient was based on an area under the curve of 7.5 and a glomerular filtration rate (GFR) derived from the Jelliffe formula which is derived from age and serum creatinine. Patients were stratified based on body mass index (BMI). Results: A total of 387 patients were included in the analysis. The patients were stratified into three groups: normal weight (BMI < 25.0, 50%), overweight (BMI 25-29.9, 32%) and obese (BMI ≥ 30.0, 18%). Compared to pretreatment values, the obese patients had a lower relative decrease in their platelet counts (- 25% for BMI ≥ 30 vs. - 61% for BMI < 25) (p = 0.01). Similar trends were noted for relative changes in hemoglobin (p = 0.006) and hematocrit (p = 0.002). Dose reductions were required in 34% of normal weight compared to 21% of the obese women (p = 0.004). There was a trend toward increased risk for disease progression in women with a BMI ≥ 30 (RR: 1.25, 95% CI: 0.93-1.69, p = 0.14). Conclusion: Obese ovarian cancer patients treated with carboplatin experience substantially less toxicity than normal weight women. The lower toxicity suggests that obese patients may be receiving a substandard drug dose.",
keywords = "Carboplatin, Obesity, Ovarian cancer",
author = "Wright, {Jason D.} and Chunqiao Tian and Mutch, {David G.} and Herzog, {Thomas J.} and Shoji Nagao and Keiichi Fujiwara and Powell, {Matthew A.}",
note = "Funding Information: This study was supported by the National Cancer Institute grants to the Gynecologic Oncology Group Administrative Office (CA 27469) and the Gynecologic Oncology Group Statistical and Data Center (CA 37517). The following Gynecologic Oncology Group member institutions participated in this study: University of Alabama at Birmingham, Duke University Medical Center, Abington Memorial Hospital, University of Rochester Medical Center, Walter Reed Army Medical Center, Wayne State University, University of Minnesota Medical School, Emory University Clinic, University of Mississippi Medical Center, Colorado Gynecologic Oncology Group P.C., University of California at Los Angeles, University of Washington, University of Pennsylvania Cancer Center, Milton S. Hershey Medical Center, Georgetown University Hospital, University of Cincinnati, University of North Carolina School of Medicine, University of Texas Southwestern Medical Center at Dallas, Indiana University School of Medicine, Wake Forest University School of Medicine, Albany Medical College, University of California Medical Center at Irvine, Tufts-New England Medical Center, Rush-Presbyterian-St. Luke's Medical Center, SUNY Downstate Medical Center, University of Kentucky, Community Clinical Oncology Program, The Cleveland Clinic Foundation, Johns Hopkins Oncology Center, State University of New York at Stony Brook, Eastern Pennsylvania GYN/ONC Center, P.C., Washington University School of Medicine, Cooper Hospital/University Medical Center, Columbus Cancer Council, University of Massachusetts Medical School, Fox Chase Cancer Center, Medical University of South Carolina, Women's Cancer Center, University of Oklahoma, University of Virginia Health Sciences Center, University of Chicago, Tacoma General Hospital, Thomas Jefferson University Hospital, Case Western Reserve University, Tampa Bay Cancer Consortium, North Shore University Hospital, Gynecologic Oncology Network, Oregon Health Sciences University, University of Southern California at Los Angeles, University of Miami School of Medicine, Stanford University Medical Center, Eastern Virginia Medical School, University of Arizona Health Science Center, Mayo Clinic, and Long Island Jewish Medical Center. ",
year = "2008",
month = jun,
doi = "10.1016/j.ygyno.2008.02.023",
language = "English",
volume = "109",
pages = "353--358",
journal = "Gynecologic oncology",
issn = "0090-8258",
number = "3",
}