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As the pharmacokinetics of carboplatin are largely determined by the renal function of the patient being treated, dosing formulae have been devised to calculate the dose of carboplatin required to achieve the desired target exposure or area under the plasma concentration time curve (AUC) (Calvert et al, 1989; Newell et al, 1993; Ando et al, 2000).
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This dosing formula for conventional-dosed carboplatin has been approved by regulatory agencies, for example, FDA in 1997.
Pharmacogenetically-guided dosing formulas have been developed to predict the coumarin maintenance dose [ 10, 11].
The impact of genotype-guided dosing formulas might differ among coumarins with markedly different pharmacokinetic characteristics.
However, no data from an independent prospective study were available to validate our dosing formula.
Although the Calvert dosing formula has been applied to high-dose treatment (Motzer et al, 2000), so far pharmacokinetic/pharmacodynamic analysis is rare (Huitema et al, 2002).
Prospective clinical trials are warranted to investigate whether genotype-guided dosing formulas are superior to standardised dosing protocols for improved safety and cost-effectiveness of coumarin therapy.
To estimate the predictive value of the dosing formula, we recalculated the daily phenprocoumon dose for each patient according to the regression equation (Fig. 3).
Using this target AUC concept, they suggested two different dosing formulas depending on whether patients had been pretreated with chemotherapy or not.
Therefore, 100 was substituted for 80 in the dosing formula, which subsequently allowed most subjects to reach the desired serum 25-OHD level.
Calvert et al (1989) presented a dosing formula to individualise the dose based on the patient's renal function, pretreatment with cytotoxic agents and chemotherapy protocol (monotherapy or combination therapy).
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