Dose standardisation of anticancer drugs

Abstract

Objective of the study: Body size based dosing is often used for prescribing anticancer drugs. However the scientific and the clinical rationales of this historical method have recently been criticized. As a result, alternative dosing strategies have been suggested, as flat-fixed dosing regimens, but not implemented in routine practice. Dose standardisation is a first step in order to rationalise chemotherapy dose calculation. A new method, derived from dose-banding, was developed, taking into account prescription and economic criteria.

Setting: Feasibility and interest of this concept were studied in two French cancer centres Institut Curie and Hôpital Saint-Louis.

Main outcome measures: The aim of our study was to assess dose standardisation of expensive anticancer drugs in objectives of quality and economy.

Method: Nine candidate drugs were selected and standardized rounded doses (SRD) were proposed. To determine the specific standard doses of these two centres, two theoretical and practical methods were applied, and then, their results were compared. For each anticancer drug the objective was to fix SRD in order to cover all the doses most frequently prescribed.

Results: It has been possible to propose SRD for six of the nine drugs. These SRD have been implemented with the agreement of the medical staff. These doses are, whenever possible, rounded to the nearest vial size, or correspond to a combination of the different strength of the commercial drug.

Conclusion: Our study shows that dose standardisation is a help to optimise the productivity and improve the organisation of the preparation unit.