Interpatient variability in bioavailability of the intravenous formulation of topotecan given orally to children with recurrent solid tumors

William C. Zamboni, Laura C. Bowman, Ming Tan, Victor M. Santana, Peter J. Houghton, William H. Meyer, Charles B. Pratt, Richard L. Heideman, Amar J. Gajjar, Alberto S. Pappo, Clinton F. Stewart

Research output: Contribution to journalArticlepeer-review

61 Scopus citations


Purpose: Evaluation of inter- and intrapatient variability of topotecan oral bioavailability and disposition was performed in children with malignant solid tumors. Patients and methods: Topotecan i.v. formulation was given orally on schedules of daily for 21 consecutive days (d x 21) or daily for 5 days per week for 3 weeks [(d x 5)3], in both cases repeated every 28 days. Topotecan doses of 0.8 and 1.1 mg/m2 per day were evaluated on both schedules. Serial plasma samples were obtained after oral and i.v. administration of topotecan at the beginning and end of the first course of therapy. Topotecan lactone and total concentrations were measured by a high- performance liquid chromatography (HPLC) assay, and a one-or two-compartment model was fit to the plasma concentration-time data after oral or i.v. administration, respectively. Topotecan oral bioavailability (F) was calculated as the ratio of the AUC determined after oral treatment (AUC(po)) divided by the AUC calculated after i.v. administration. Results: Pharmacokinetics studies were performed on 15 and 11 patients receiving 0.8 and 1.1 mg/m2 per day, respectively. After oral administration the topotecan lactone AUC(po) and F determined for 0.8 and 1.1 mg/m2 per day were 13.6 ± 5.8 and 25.1 ± 12.9 ng ml-1 h and 0.34 ± 0.14 and 0.34 ± 0.16, respectively. The within-patient variance for AUC(po) and F was much smaller than the between-patient variance. The ratio of topotecan lactone to total concentration was consistently higher after oral as compared with i.v. administration. Conclusions: Large interpatient variability was noted in topotecan pharmacokinetics, whereas intrapatient variability was relatively small. Further studies of oral topotecan are warranted to evaluate the tolerance of shorter courses and to define further the interpatient variability.

Original languageEnglish (US)
Pages (from-to)454-460
Number of pages7
JournalCancer chemotherapy and pharmacology
Issue number6
StatePublished - 1999
Externally publishedYes


  • Oral bioavailability
  • Pediatric solid tumors
  • Topotecan

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Oncology
  • Cancer Research
  • Toxicology
  • Pharmacology


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