Onycholysis secondary to multiple paclitaxel 1-hour infusions: possible role for its vehicle (Cremophor EL).

anastrozole for 10 weeks; after 4 weeks they received quinapril for 28 days; blood samples were taken at the same time as group A. Blood pressure was measured at the time of entry, before starting quinapril and twice a day during the 4 weeks of treatment with ACE inhibitor. Primary assessment was the steady-state plasma anastrozole concentrations following once-daily anastrozole alone or anastrozole plus quinapril. The evaluation of plasma anastrozole concentrations started after 21 days of drug administration, to ensure the steady-state had been obtained. Blood samples were taken from each patient 12 h after each dose of anastrozole: at days 21 and 28 for baseline measurements; days 42 and 56 for on-treatment measurements; and day 70 for post-treatment evaluation. Anastrozole analysis in plasma was carried out according to the Bock et al. validated method of solvent extraction, capillary gas chromatography separation and electron capture detection [4]. The plasma levels of quinapril and of its active metabolite, quinaprilat, were determined according to the method of Hengy and Most [5]. Plasma levels of anastrozole and quinapril were analysed using validated methods. The sensitivity limit was ∼3 ng/ml. Comparisons of the plasma anastrozole levels between the two groups were obtained through the non-parametric Mann–Whitney test. The mean plasma anastrozole concentration in group A was 59.2 ng/ml on day 21 and 62.6 ng/ml on day 56. For group B, the mean concentration was 49.43 ng/ml on day 21 and 49.80 ng/ml on day 56. None of the mean values were significant at a 5% confidence level (Table 1). In both groups of patients, the steady-state anastrozole concentrations remained similar during treatment with anastrozole 1 mg once daily, alone or in combination with quinapril; there were no statistically significant differences in plasma levels between patients who received anastrozole alone or in association with quinapril. Hypertension, monitored during the study period, was well controlled in all patients (Table 2). In conclusion, these data show that the combination of quinapril and anastrozole can be safely and effectively administered to older patients with breast cancer and moderate hypertension. Also, the administration of quinapril to patients treated with anastrozole does not modify the plasma concentration of anastrozole and a dose modification is not required.