Inté^et du dosage du platine en cancérologie clinique

Role of platinum therapeutic drug monitoring in oncology Determination of platinum level in biological samples concern pharmacology of platinum derivatives anticancer drugs : cisplatin, carboplatin, oxaliplatin. Flameless Atomic Absorption Spectrometry (FAAS) and Inductively Coupled Plasma Mass Spectrometry (ICP-MS) are two reference techniques. The three drugs undergo metabolism conducting to reactiv and cytotoxic products. The pharmacokinetic in plasma of the three derivatives show a wide interindividual variability, resulting in differences in term of toxicity and efficacy. For the three of them, plasma clearance is correlated to creatinine clearance and relationships have been shown between ultrafilterable platinum pharmacokinetic and efficacy or toxicity, Nevertheless, carboplatin is still the only platinum derivative drug for which dose is individualised not according to the surface body area but according to pharmacokinetic parameters. Dose individualisation of carboplatin is based on Calvert or Chatelut equations and choice of target of AUC. It is also possible to adjust the last doses according to determination of plasma platinum level with a limited number of blood samples following the first infusion. Cisplatin and oxaliplatin dosages are based on body surface area.