[Anticancer drug dose individualisation: from body surface area to physiology].
The doses of anticancer drugs are usually calculated according to the body surface area. This practice is based on the hypothesis that clearance is proportional to this morphologic parameter. That is rarely true, thus the pharmacodynamic effects (particularly haematological toxicity) are often better correlated with plasma drug concentrations than with doses. The elimination pathways of anticancer drugs will be presented, together with their main sources of interindividual variability. Methods of estimation of renal function will be discussed. These pharmacokinetic concepts allow understanding new alternative methods for individual dosing in oncology.
Pétain
Aurélie
A
Institut Claudius-Regaud et EA3035, Université de Toulouse, 20, rue du Pont-Saint-Pierre, 31052 Toulouse cedex, France.
Chatelut
Etienne
E
D000284:Administration, Oral; D000818:Animals; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood / Q000493:pharmacokinetics*; D049628:Body Size; D001830:Body Surface Area; D051544:Cytochrome P-450 CYP3A / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D005919:Glomerular Filtration Rate; D022781:Hepatocytes / Q000378:metabolism; D006801:Humans; D007275:Injections, Intravenous; D007668:Kidney / Q000378:metabolism; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy*
D000970:Antineoplastic Agents; D051544:Cytochrome P-450 CYP3A; C510163:CYP3A4 protein, human