Smoking Does Not Impact Taxane PK

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(ChemotherapyAdvisor) – Smoking status does not impact the pharmacokinetic profile of taxane chemotherapy, according to an international team of researchers. This conclusion is based on an article entitled “Influence of Smoking on the Pharmacokinetics and Toxicity Profiles of Taxane Therapy,” which was published in the August issue of Clinical Cancer Research.

The design of this study is based on previously published studies that observed the interaction of cigarette smoke with the metabolism of several anticancer drugs and its impact on incidence and severity of adverse events and efficacy of chemotherapy. In the current study, the investigators aimed to examine the impact of smoking on the pharmacokinetics and toxicities of docetaxel or paclitaxel.

To meet this aim, 566 patients (429 nonsmokers and 137 smokers) were first treated with docetaxel or paclitaxel then their smoking status was determined. An analysis of the toxicity profile and pharmacokinetics of these treatment modalities was also determine to measure the impact of smoking status on treatment.

The investigators reported that smokers treated with docetaxel experienced fewer grade 4 neutropenia (35% vs. 52%; P=.01) than nonsmokers. Similarly, they reported that smokers treated with paclitaxel experienced fewer grade 3/4 leukopenia than nonsmokers (12% vs. 25%; P=.03). In paclitaxel-treated patients, even white blood cell (WBC) counts were lower in nonsmokers (median, 2.7 × 109/L; range, 0.05 × 109 to 11.6 × 109/L) than in smokers (median, 3.3 × 109/L; range 0.8 × 109 to 10.2 × 109/L; P=.02). WBC counts and absolute neutrophil counts were lower at baseline in nonsmokers than in smokers treated with paclitaxel (P=.0001). No difference was observed between the groups in the pharmacokinetic parameters for both taxanes.

Based on their findings, the investigators concluded that cigarette smoking does not alter the pharmacokinetic determinants of docetaxel and paclitaxel. “Smokers treated with docetaxel and paclitaxel have less neutropenia and leukopenia, but further research is warranted to elucidate this potential protective effect,” the investigators concluded.



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