title: [Management of targeted therapies in hemodialysis patients].
abstract: BACKGROUND
  The increased incidence of cancer in dialysis patients has been discussed since the mid 1970s. Furthermore, the emergence of targeted therapies (TT) requires oncologists, nephrologists and pharmacists to question themselves about the handling of these new classes of drugs in dialysis patients. While the cytotoxic drugs have been used in oncology for a long time, these new molecules are recent and clinical studies on their management in dialysis patients are missing.
  
  
  METHODS
  We reviewed the international literature on the pharmacokinetics, efficacy, tolerance and dosage adjustment of TT used in hemodialysis cancer patients, using the following keywords: kidney; renal; dialysis; hemodialysis; end-stage renal disease and the name of each drug.
  
  
  RESULTS
  As described for cytotoxic drugs, there are only case reports or series published in the international literature. However, it is possible to propose some recommendations on TT handling in dialysis patients. It is not necessary to adapt the dose of monoclonal antibodies in dialysis patients. But it is important to considerer that this "class effect" is not true for all the other classes of drugs. In fact, the pharmacokinetic of tyrosine kinase inhibitors varies from drug to drug.
  
  
  CONCLUSIONS
  The use of TT is possible in dialysis patients. However, many drugs require special attention in dialysis. In addition, because these drugs are new, it is important that oncologists, nephrologists, and pharmacists remain up to date about the management of TT in dialysis patients.
authors: Hôpital de la Pitié-Salpêtrière, service ICAR, Paris, France. nicolas.janus@psl.aphp.fr
authors: Nicolas
authors: N
authors: Janus
authors: Vincent
authors: V
authors: Launay-Vacher
authors: Gilbert
authors: G
authors: Deray
authors: Mohamed Shariful
authors: MS
authors: Islam
authors: Antoine
authors: A
authors: Thyss
authors: Juliette
authors: J
authors: Thariat
mesh_terms: D000911:Antibodies, Monoclonal / Q000008:administration & dosage* / Q000493:pharmacokinetics; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D019468:Disease Management; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism*; D058990:Molecular Targeted Therapy / Q000379:methods*; D009369:Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D006435:Renal Dialysis
chemical_list: D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents