Review of therapeutic drug monitoring of anticancer drugs part one - Cytotoxics.

Détails

ID Serval
serval:BIB_12C5E5648A7D
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Titre
Review of therapeutic drug monitoring of anticancer drugs part one - Cytotoxics.
Périodique
European Journal of Cancer
Auteur(s)
Paci A., Veal G., Bardin C., Levêque D., Widmer N., Beijnen J., Astier A., Chatelut E.
ISSN
1879-0852 (Electronic)
ISSN-L
0959-8049
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
50
Numéro
12
Pages
2010-2019
Langue
anglais
Notes
Publication types: REVIEWPublication Status: ppublish
Résumé
Most anticancer drugs are characterised by a steep dose-response relationship and narrow therapeutic window. Inter-individual pharmacokinetic (PK) variability is often substantial. The most relevant PK parameter for cytotoxic drugs is the area under the plasma concentration versus time curve (AUC). Thus it is somewhat surprising that therapeutic drug monitoring (TDM) is still uncommon for the majority of agents. Goals of the review were to assess the rationale for more widely used TDM of cytotoxics in oncology. There are several reasons why TDM has never been fully implemented into daily oncology practice. These include difficulties in establishing appropriate concentration target ranges, common use of combination chemotherapies for many tumour types, analytical challenges with prodrugs, intracellular compounds, the paucity of published data from pharmacological trials and 'Day1=Day21' administration schedules. There are some specific situations for which these limitations are overcome, including high dose methotrexate, 5-fluorouracil infusion, mitotane and some high dose chemotherapy regimens. TDM in paediatric oncology represents an important challenge. Established TDM approaches includes the widely used anticancer agents carboplatin, busulfan and methotrexate, with 13-cis-retinoic acid also recently of interest. Considerable effort should be made to better define concentration-effect relationships and to utilise tools such as population PK/PD models and comparative randomised trials of classic dosing versus pharmacokinetically guided adaptive dosing. There is an important heterogeneity among clinical practices and a strong need to promote TDM guidelines among the oncological community.
Mots-clé
5-Fluorouracil, Busulfan, Chemotherapy, Cytotoxics, Methotrexate, Mitotane, Oncology, Paediatric oncology, Pharmacokinetics, Therapeutic drug monitoring
Pubmed
Web of science
Création de la notice
07/06/2014 21:59
Dernière modification de la notice
20/08/2019 12:41
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