Pharmacokinetics of paclitaxel and carboplatin in a hemodialysis patient with advanced ovarian cancer.

Paclitaxel and carboplatin combination chemotherapy (TC) is increasingly performed in ovarian cancer patients undergoing hemodialysis. However, appropriate dosage and time interval between the end of carboplatin administration and the initiation of hemodialysis remain unclear. We performed TC in a hemodialysis patient with ovarian cancer. Paclitaxel was administered at 150 mg/m2 for 3 h, followed by administration of 125 mg of carboplatin within 30 min to achieve a target area under the concentration/time curve (AUC) of 5.0 mg/ml x min by Calvert's formula. At 1 h after completing carboplatin administration, hemodialysis was performed for 4 h. Pharmacokinetic analysis showed we had achieved the desired serum concentration of paclitaxel. However, AUC of free platinum was very low (AUC = 0.98 mg/ml x min). Although the appropriate time interval between the end of carboplatin administration and the initiation of hemodialysis remains a controversial issue, our findings suggest that an interval of at least 1 h is required.