Case Report of Oral Temozolomide Therapy by Total Gastrectomy Patient

• Published in: Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences) Vol. 47; no. 7; pp. 380 - 386
• Main Authors: Sakata, Noriko, Mastuoka, Hiroaki, Kodawara, Takaaki, Higashi, Takashi, Yano, Ryoichi, Watanabe, Kyohei, Tsukamoto, Hitoshi, Higashino, Yoshifumi, Yamauchi, Takahiro, Kitai, Ryuhei, Kikuta, Kenichiro, Goto, Nobuyuki
• Format: Journal Article
• Language: Japanese; English
• Published: Japanese Society of Pharmaceutical Health Care and Sciences 10.07.2021
• Subjects: AUC; gastrectomy; hydrolysis; oral temozolomide; side effect
• ISSN: 1346-342X; 1882-1499
• DOI: 10.5649/jjphcs.47.380

We experienced oral temozolomide treatment for total gastrectomy in a high-grade glioma patient. In this case, as there was concern about hydrolysis of temozolomide due to total gastrectomy, we measured the temozolomide concentration during the treatment period. Furthermore, the side effects of 18 non-total gastrectomy patients who had been treated with oral temozolomide therapy in the past were evaluated and compared with the side effects of this gastrectomy patient.The concentration of temozolomide showed the highest peak value (3.59 µg/mL) at 1.0 hour after the start of dosing, and AUC0-6 up to 6 hours after administration was 11.0 µg/mL · hr (trapezoidal method). In addition, the decrease of myelosuppression of the gastrectomy patient that occurred after the start of treatment was similar to that of non-total gastrectomy patients. The concentration profile of oral temozolomide showed similar values to the pharmacokinetic parameters of temozolomide (Tmax, Cmax and AUC) reported so far, and it was considered that there was no effect on the hydrolysis of temozolomide.Therefore, it is suggested that oral temozolomide may be well absorbed even in patients with total gastrectomy.