title: Pharmacokinetically guided algorithm of 5-fluorouracil dosing, a reliable strategy of precision chemotherapy for solid tumors: a meta-analysis.
abstract: Precision medicine characterizes a new era of cancer care and provides each patient with the right drug at the right dose and time. However, the practice of precision dosing is hampered by a lack of smart dosing algorithms. A pharmacokinetically guided (PKG) dosing algorithm is considered to be the leading strategy for precision chemotherapy, although the effects of PKG dosing are not completely confirmed. Hence, we conducted a meta-analysis to evaluate the effects of the PKG algorithm of 5-fluorouracil (5-FU) dosing on patients with solid tumors. A comprehensive retrieval was performed to identify all of the prospective controlled studies that compared the body surface area (BSA)-based algorithm with the PKG algorithm of 5-FU in patients with solid tumors. Overall, four studies with 504 patients were included. The PKG algorithm significantly improved the objective response rate of 5-FU-based chemotherapy compared with the BSA-based algorithm. Furthermore, PKG dosing markedly decreased the risk of total grade 3/4 adverse drug reactions, especially those related to hematological toxicity. Overall, the PKG algorithm may serve as a reliable strategy for individualized dosing of 5-FU.
authors.affiliation: Laboratory of Clinical Pharmacy, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Luo
authors.initials: L
authors.lastname: Fang
authors.affiliation: Laboratory of Clinical Pharmacy, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Wenxiu
authors.initials: W
authors.lastname: Xin
authors.affiliation: Laboratory of Clinical Pharmacy, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Haiying
authors.initials: H
authors.lastname: Ding
authors.affiliation: Laboratory of Clinical Pharmacy, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Yiwen
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Laboratory of Clinical Pharmacy, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Like
authors.initials: L
authors.lastname: Zhong
authors.affiliation: Laboratory of Clinical Pharmacy, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Luo
authors.affiliation: Department of Chemotherapy, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Chemotherapy, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Yunshan
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Laboratory of Clinical Pharmacy, Zhejiang Cancer Hospital, Hangzhou, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Huang
mesh_terms: D000465:Algorithms; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D001830:Body Surface Area; D002986:Clinical Trials as Topic; D054796:Drug Dosage Calculations; D016903:Drug Monitoring; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy*; D057285:Precision Medicine; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil