Practical guidelines for dose individualization of anticancer targeted drugs.
For drugs such as anticancer agents every effort should be made to minimize inter-patient variability in drug exposure in order to maximize the benefit while maintaining an acceptable risk level of serious adverse effects. Anticancer drugs generally have a preferential route of elimination, either in urine or in bile and feces. In consequence, dose individualization to renal and liver function permits excessive toxicity to be avoided and expected therapeutic benefit to be achieved. However, less is known about the most appropriate starting doses of antineoplastic agents in these individuals. In this review, we discuss trials that have specifically assessed new targeted agents dosing strategies (mainly monoclonal antibodies and tyrosine kinase inhibitors) in the setting of overt biochemical renal and liver dysfunction and we proportionate recommendations and practical guidelines for dose individualization.
Department of Medical Oncology, Hospital Universitario Virgen de la Victoria, Campus Universitario Teatinos s/n, 29010, Málaga, Spain. msaez.med@gmail.com
María Isabel
MI
Sáez
Cristina
C
Quero
José Manuel
JM
Trigo
Begoña
B
Muros
Emilio
E
Alba
D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology; D008099:Liver / Q000187:drug effects / Q000503:physiopathology; D058990:Molecular Targeted Therapy; D009369:Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors
D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D011505:Protein-Tyrosine Kinases