We were talking about allometry around here the other day, which prompts me to mention this paper. It used the reports of resveratrol dosing in animals, crudely extrapolated to humans, to argue that the body surface area normalization (BSA) method was a superior technique for dose estimation across species.
Over the years, though, the BSA method has taken some flak in the literature. It's most widely used in oncology, especially with cytotoxics, but there have been calls to move away from the practice, calling it a relic with little scientific foundation. (The rise of a very obese patient population has also led to controversy about whether body weight or surface area is a more appropriate dose-estimation method in those situations). At the same time, it's proven useful in some other situations, so it can't be completely ignored.
But it seems that the FASEB paper referenced in the first paragraph, which has been cited hundreds of times since 2008, may be overstating its conclusions. For example, it says that "BSA normalization of doses must be used to determine safe starting doses of new drugs because initial studies conducted in humans, by definition, lack formal allometric comparison of the pharmacokinetics of absorption, distribution, and elimination parameters", and cites its reference 13 for support. But when you go to that reference, you find that paper's authors concluding with things like this:
The customary use of BSA in dose calculations may contribute to the omission of these factors, give a false sense of accuracy and introduce error. It is questionable whether all current cancer treatment strategies are near optimal, or even ethical. BSA should be used for allometric scaling purposes in phase I clinical trials, as the scaling of toxicity data from animals is important for selecting starting doses in man, but the gradual discontinuation of BSA-based dosing of cytotoxic drugs in clinical practice is seemingly justified.
Citing a paper for support that flatly disagrees with your conclusions gets some points for bravado, but otherwise seems a bit odd. And there are others - that reference that I linked to in the second paragraph above, under "taken some flak", is cited in the FASEB paper as its reference 17, as something to do with choosing between various BSA equations. And it does address that, to be sure, but in the context of wondering whether the whole BSA technique has any clinical validity at all.
This is currently being argued out over at PubPeer, and it should be interesting to see what comes of it. I'll be glad to hear from pharmacokinetics and clinical research folks to see what they make of the whole situation.