Myelosuppression Caused by Nanoparticle Albumin-Bound Paclitaxel in the Northern Chinese Population and the Role of Body Composition

J Clin Pharmacol. 2023 Sep;63(9):1009-1016. doi: 10.1002/jcph.2259. Epub 2023 May 28.

Abstract

The aim of this study was to examine the relationship between lean body mass (LBM) and the incidence and severity of neutropenia in patients with malignant tumors from Northern China who have received nanoparticle albumin-bound paclitaxel. Twenty-six patients with pathologically confirmed malignant tumors were prospectively included in this study. These 26 patients were divided into Group A (sarcopenia) and Group B (nonsarcopenia). Group A comprised 50% (13/26) of the patients, while Group B comprised the other 50% (13/26). There was no statistically significant difference between both groups in terms of body surface area (P = .052). The incidence of neutropenia in Group A was 76.9% compared to 61.5% in Group B (P = .0673). The incidence of Grade 3 and severe neutropenia was 76.9% versus 61.5% in Groups A and B, respectively (P = .645). These 26 patients were divided into Groups 1 and 2 based on the administered nab-paclitaxel dose per kilogram of LBM, with both groups receiving a body surface area dose of 260 mg/m2 . Group 1 received a nab-paclitaxel dose of 14.19 mg/kg of LBM, whereas Group 2 received 11.37 mg/kg of LBM. In Group 1, the incidence of neutropenia was 71.4%, whereas it was 66.7% in Group 2. Grade 3 or higher neutropenia incidence was 28.6% in Group 1 versus 16.7% in Group 2. Patients with sarcopenia in northern China experienced a higher incidence of severe neutropenia after receiving nab-paclitaxel than patients without sarcopenia. Higher drug dose intensity per unit of LBM may be a contributing factor.

Keywords: L3SMI; body composition; nab-paclitaxel; neutropenia.

MeSH terms

  • Albumin-Bound Paclitaxel* / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Body Composition
  • East Asian People
  • Humans
  • Nanoparticles*
  • Neoplasms* / drug therapy
  • Neutropenia* / chemically induced
  • Neutropenia* / epidemiology
  • Sarcopenia* / chemically induced

Substances

  • 130-nm albumin-bound paclitaxel
  • Albumin-Bound Paclitaxel