title: The use of novel agents in multiple myeloma patients with hepatic impairment.
abstract: Novel drugs such as immunomodulators and proteasome inhibitors have improved the survival of patients with multiple myeloma. Like all therapeutic agents, appropriate dosing based on metabolism and clearance is important to maintain efficacy while avoiding toxicity. Hepatic impairment (HI) in multiple myeloma patients is rare but well described either due to disease or therapy-related factors. However, limited data are available on the appropriate use and dosing of the novel agent therapeutics in myeloma patients with HI. Furthermore, data on HI secondary to the novel agent toxicity are also sparse. This systematic review highlights the evidence on the use of novel agents like thalidomide, lenalidomide, pomalidomide, bortezomib and carfilzomib in patients with HI as well as their associated hepatic toxicities.
authors: Department of Pharmacy, Denver Health, Denver, CO 80204, USA.
authors: Lindsay C
authors: LC
authors: Stansfield
authors: Wilson I
authors: WI
authors: Gonsalves
authors: Francis K
authors: FK
authors: Buadi
mesh_terms: D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007155:Immunologic Factors / Q000494:pharmacology / Q000627:therapeutic use*; D008107:Liver Diseases / Q000150:complications*; D009101:Multiple Myeloma / Q000150:complications* / Q000188:drug therapy* / Q000401:mortality; D061988:Proteasome Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D007155:Immunologic Factors; D061988:Proteasome Inhibitors
keywords: hepatic impairment; myeloma; novel agents