What is the clinical evidence from this study?

Study design: Observational. Population: Stage II-IV breast cancer and intermediate/high-grade stage III-IV non-Hodgkin's lymphoma (n=38). Intervention: BCNU AUC > 600 (micrograms/mL) x minute vs. BCNU AUC ≤ 600 (micrograms/mL) x minute. Primary outcome: Acute lung injury (p=<.03).

April 21, 1993JNCI Journal of the National Cancer Institute

Acute Lung Injury Following Treatment With High-Dose Cyclophosphamide, Cisplatin, and Carmustine: Pharmacodynamic Evaluation of Carmustine

Q: What are the key findings of this study?

BCNU exposure with an AUC greater than 600 (micrograms/mL) x minute was associated with a significantly increased risk of acute lung injury (86% vs 33.3%; P<.03).

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Key result

BCNU exposure with an AUC greater than 600 (micrograms/mL) x minute was associated with a significantly increased risk of acute lung injury (86% vs 33.3%; P<.03).

Why the study?

Does BCNU exposure (AUC) correlate with the risk of acute lung injury in patients receiving high-dose cyclophosphamide, cisplatin, and carmustine?

Population

38 patients treated following induction therapy or relapse, including 29 with stage II-IV breast cancer and…

Design

Cohort

Authors

RJR.B. JonesQueen Mary University of London SMSteven G. MatthesJena University Hospital ESE.J. ShpallThe University of Texas MD Anderson Cancer Center

Discussion

Member takes

Implication

May warrant AUC-guided BCNU dosing caution; hypothesis-generating and requires prospective validation before practice change.

Study Design

Type

Observational (n=38)

Structured PICO

Does BCNU exposure (AUC) correlate with the risk of acute lung injury in patients receiving high-dose cyclophosphamide, cisplatin, and carmustine?

Population

38 patients with stage II-IV breast cancer or intermediate/high-grade stage III-IV non-Hodgkin's lymphoma treated with high-dose cyclophosphamide, cisplatin, and BCNU.

Exposure

Cyclophosphamide (1875 mg/m2 daily as a 1-hour intravenous infusion for 3 days), cisplatin (55 mg/m2 per day as a 72-hour continuous intravenous infusion), and carmustine (BCNU) (600 mg/m2 as a 2-hour infusion immediately following completion of the cisplatin infusion).

Outcome

Acute lung injury determined on the basis of pulmonary function test results and histologic examination of lung biopsy specimens, and its association with BCNU pharmacokinetics (AUC).safety

Main Result

Absolute Event Rate: 86% vs 33.3%

p-value: p=<.03

BCNU exposure greater than 600 (micrograms/mL) x minute is significantly associated with an increased risk of acute lung injury following high-dose cyclophosphamide-cisplatin-BCNU therapy.

Cite This Study

Jones et al. (1993) conducted an observational in Stage II-IV breast cancer and intermediate/high-grade stage III-IV non-Hodgkin's lymphoma (n=38). BCNU AUC > 600 (micrograms/mL) x minute vs. BCNU AUC ≤ 600 (micrograms/mL) x minute was evaluated on Acute lung injury (p=<.03). BCNU exposure with an AUC greater than 600 (micrograms/mL) x minute was associated with a significantly increased risk of acute lung injury (86% vs 33.3%; P<.03).

synapsesocial.com/papers/6ab370e10092fc6cbf3b1e5b https://doi.org/10.1093/jnci/85.8.640

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Acute Lung Injury Following Treatment With High-Dose Cyclophosphamide, Cisplatin, and Carmustine: Pharmacodynamic Evaluation of Carmustine

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Acute Lung Injury Following Treatment With High-Dose Cyclophosphamide, Cisplatin, and Carmustine: Pharmacodynamic Evaluation of Carmustine

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider