Journal Article

Pharmacokinetic interaction between chemotherapy for non-Hodgkin's lymphoma and protease inhibitors in HIV-1-infected patients

Mario Cruciani, Giorgio Gatti, Emanuela Vaccher, Giampiero Di Gennaro, Roberta Cinelli, Matteo Bassetti, Umberto Tirelli and Dante Bassetti

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 55, issue 4, pages 546-549
Published in print April 2005 | ISSN: 0305-7453
Published online April 2005 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dki050
Pharmacokinetic interaction between chemotherapy for non-Hodgkin's lymphoma and protease inhibitors in HIV-1-infected patients

More Like This

Show all results sharing these subjects:

  • Medical Oncology
  • Critical Care

GO

Show Summary Details

Preview

Objectives: We have investigated whether chemotherapy for HIV-related systemic non-Hodgkin's lymphoma (NHL) affects the pharmacokinetics of protease inhibitors.

Patients and methods: This was a prospective, open-label, non-randomized, two-way crossover trial in HIV-1-infected patients treated with highly active antiretroviral therapy and chemotherapy for NHL. Seven patients received indinavir at a dosage of 800 mg three times daily and three patients received nelfinavir at a dosage of 750 mg three times daily. Chemotherapy consisted of adriamycin, cyclophosphamide, vincristine and prednisolone (CHOP). Each patient had blood samples for protease inhibitor pharmacokinetics drawn concomitantly with or independently of the CHOP cycle.

Results: When indinavir was given concomitantly with CHOP, the AUC0–8 increased by 38% (20.5 ± 9.0 versus 14.9 ± 9.5 mg·h/L; P=0.03), and was comparable to historical controls. By contrast, the AUC0–8 of indinavir administered without CHOP was lower than expected. A similar trend was observed with nelfinavir. Likewise, we observed a significant number of patients with C0 and C8 below the IC50 for the wild-type virus (0.1 mg/L) when the drug was administered without CHOP.

Conclusions: Therapeutic drug monitoring of protease inhibitors should be part of the work-up in HIV-infected patients receiving chemotherapy for NHL.

Keywords: indinavir; nelfinavir; CHOP; therapeutic drug monitoring

Journal Article.  2366 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.