TY - JOUR
T1 - Risks and benefits of phase I liver dysfunction studies
T2 - should patients with severe liver dysfunction be included in these trials?
AU - Fountzilas, Christos
AU - Stuart, Selena
AU - Hernandez, Brian
AU - Bowhay-Carnes, Elizabeth
AU - Michalek, Joel E
AU - Sarantopoulos, John
AU - Karnad, Anand B
AU - Patel, Sukeshi
AU - Weitman, Steven D
AU - Mahalingam, Devalingam
PY - 2017/1/19
Y1 - 2017/1/19
N2 - Summary: Introduction The goal of organ dysfunction Phase I trials is to characterize the safety and pharmacokinetics of novel agents in cancer patients with liver or kidney dysfunction, but the clinical benefit is not well established. Methods We reviewed 170 patients across 15 liver dysfunction studies at our institution, grouped based on the NCI-Organ Dysfunction Working Group criteria or Child-Pugh Score. Results The median survival for the entire cohort was two months and just one month amongst patients with severe liver dysfunction. Patients with normal or mild liver dysfunction, absence of tumor in liver, good performance status, higher serum albumin and lower bilirubin, aspartate transaminase and alkaline phosphatase had improved survival by univariate analysis. Serum albumin and liver function classification remained significant by multivariate analysis. Conclusion Given poor survival of patients with liver dysfunction, we need better criteria, such as albumin levels, for optimally selecting patients for liver dysfunction studies.
AB - Summary: Introduction The goal of organ dysfunction Phase I trials is to characterize the safety and pharmacokinetics of novel agents in cancer patients with liver or kidney dysfunction, but the clinical benefit is not well established. Methods We reviewed 170 patients across 15 liver dysfunction studies at our institution, grouped based on the NCI-Organ Dysfunction Working Group criteria or Child-Pugh Score. Results The median survival for the entire cohort was two months and just one month amongst patients with severe liver dysfunction. Patients with normal or mild liver dysfunction, absence of tumor in liver, good performance status, higher serum albumin and lower bilirubin, aspartate transaminase and alkaline phosphatase had improved survival by univariate analysis. Serum albumin and liver function classification remained significant by multivariate analysis. Conclusion Given poor survival of patients with liver dysfunction, we need better criteria, such as albumin levels, for optimally selecting patients for liver dysfunction studies.
KW - Liver dysfunction
KW - Phase I study
KW - Prognostic model
KW - Survival
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U2 - 10.1007/s10637-017-0425-4
DO - 10.1007/s10637-017-0425-4
M3 - Article
C2 - 28102465
AN - SCOPUS:85009927010
SP - 1
EP - 6
JO - Investigational New Drugs
JF - Investigational New Drugs
SN - 0167-6997
ER -