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Cano JP, Bruno R, Lena N, et al. Dosage predictions in high-dose methotrexate infusions. Part 1: Evaluation of the classic test-dose protocol. Cancer Drug Deliv. 1985;2(4):271-6doi: 10.1089/cdd.1985.2.271.
Cano, J. P., Bruno, R., Lena, N., Favre, R., Iliadis, A., & Imbert, A. M. (1985). Dosage predictions in high-dose methotrexate infusions. Part 1: Evaluation of the classic test-dose protocol. Cancer drug delivery, 2(4), 271-6. https://doi.org/10.1089/cdd.1985.2.271
Cano, J P, et al. "Dosage predictions in high-dose methotrexate infusions. Part 1: Evaluation of the classic test-dose protocol." Cancer drug delivery vol. 2,4 (1985): 271-6. doi: https://doi.org/10.1089/cdd.1985.2.271
Cano JP, Bruno R, Lena N, Favre R, Iliadis A, Imbert AM. Dosage predictions in high-dose methotrexate infusions. Part 1: Evaluation of the classic test-dose protocol. Cancer Drug Deliv. 1985;2(4):271-6. doi: 10.1089/cdd.1985.2.271. PMID: 3864520.
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Cancer Drug Deliv. 1985;2(4):271-6. doi: 10.1089/cdd.1985.2.271.

Dosage predictions in high-dose methotrexate infusions. Part 1: Evaluation of the classic test-dose protocol.

Cancer drug delivery

J P Cano, R Bruno, N Lena, R Favre, A Iliadis, A M Imbert

PMID: 3864520 DOI: 10.1089/cdd.1985.2.271

Abstract

A preliminary methotrexate (MTX) kinetic evaluation following administration of an IV bolus (test-dose) allowed individualization of high-dose infusions (HD-MTX). This approach combined with therapeutic drug monitoring was found to have good performance over a large scale of predicted steady-state levels (Css) (10(-5) to 10(-4) M over 24 to 36 h) corresponding to 17 to 650 mg/h deliveries (root mean squared error : rmse (precision) = 1.54 X 10(-5) M (21.4%) and mean error : me (bias) = 0.043 X 10(-5) M (NS)). However a significative (p less than 0.05) but rather low over-estimation of dosage (me = 7.38 X 10(-5) M (14.8%)) associated to a decrease in the prediction precision (rmse = 13.3 X 10(-5) M (26.6%)) occurred in 5 X 10(-4) M predicted Css over 8 h (970 to 1970 mg/h deliveries). However in a number of cases (6 out of 29) important deviations from predicted Css occurred, implying the need to stop the infusion before 8 h. These results indicated that MTX pharmacokinetics was linear from low test-dose bolus injections to high-dose infusions. This allowed dosage predictions based upon preliminary estimation of MTX clearance and associated to therapeutic drug monitoring during and following infusion.

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