Pharmacodynamics of high-dose chemotherapy.
There is usually considerable variability in anticancer drug plasma levels when delivered at high doses requiringstem-cell support. Given their narrow therapeuticwindows and wide interpatient pharmacokinetic variability, drug monitoring and pharmacokinetic-directed dosing representan attractive strategy in this setting. A major previous requirement to successful application of therapeuticdrug monitoringis identificationof a significant and clinically meaningful pharmacodynamic correlation between a pharmacokinetic parameter and a toxic or therapeutic outcome, or preferably, both. In this review, we will analyze the current knowledge of identified pharmacodynamic correlations in high-dose chemotherapy. We will summarize the observations from other authors and our own, on drugs employed at high doses, such as cyclophosphamide, melphalan, busulfan, carmustine, paclitaxel, or docetaxel.
Nieto
Y
Y
University of Colorado Bone Marrow Transplant Program, Denver 80262, USA. yago.nieto@uchsc.edu
D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy*
D000970:Antineoplastic Agents