Chemotherapy dosing in obese patients. Current position of the Committee for Clinical Initiatives of the Polish Society of Clinical Oncology

Abstract

Overweight and obesity represent an important epidemiological problem. Also among cancer patients
the incidence of these metabolic conditions is continuously increasing. The dosage of chemotherapy
drugs is usually calculated according to patient’s body surface area (BSA). However, many oncologist
consider to use either ideal body weight or adjusted ideal body weight or to cap the BSA at, for example
2.0 m2 rather than use actual body weight to calculate BSA. It leads to inappropriate dosage of cytotoxic
drugs in obese or overweight patients whose BSA exceeds 2 m2 that may decrease the efficacy of
systemic treatment and worsen patients’ outcomes. The following article reflects the position of Polish
Society of Clinical Oncology (PTOK) regarding the recently published guidelines of American Society
of Clinical Oncology on appropriate chemotherapy dosing for obese adult patients with cancer. PTOK recommends that full weight-based cytotoxic chemotherapy doses be used to treat obese patients with
cancer, particularly when the goal of treatment is cure.