A review of body composition and pharmacokinetics in oncology

ABSTRACT

Introduction: Body surface area dosing of chemotherapeutic agents is based on limited scientific data, and often results in unpredictable plasma drug levels. Cross-sectional computed tomography (CT) imaging provides an accurate measurement of lean mass. This review summarizes emerging roles of lean mass in predicting pharmacokinetics and drug toxicities in cancer patients.

Areas covered: A concise review of body composition measurement with CT cross-sectional imaging and its relationship to drug pharmacokinetics and toxicities. A comprehensive review of the predictive value of low lean mass (sarcopenia) in dose-limiting toxicities is also included.

Expert commentary: Drug dosing in medical oncology faces many challenges, including heterogeneous body composition profiles. The emerging role of sarcopenia in predicting lean mass may provide the tool needed to more accurately dose patients and prevent dose-limiting toxicities.

KEYWORDS:

• Body composition
• body surface area
• chemotherapy
• dose-limiting toxicity
• lean mass
• pharmacokinetics
• sarcopenia

Declaration of interest

MB Sawyer discloses honoraria from Nutricia and Fresnoius Kabi. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

JJ Hopkins was supported by Clinician Investigator Program of the University of Alberta.