The role of therapeutic drug monitoring in the management of safety of anticancer agents: a focus on 3 cytotoxics.
Expert Opin Drug Saf
; 18(11): 1009-1015, 2019 Nov.
Article
em En
| MEDLINE
| ID: mdl-31478396
ABSTRACT
Introduction:
Therapeutic drug monitoring in oncology is used to prevent major toxicities of selected anticancer agents due to overexposure by individualizing the dose based on a pharmacokinetic target. Areas covered Numerous studies relating a relation between pharmacokinetic variability and toxicity have been reported since the eighties but very few have been implemented in clinical practice due to a lack of validation and harmonization, logistical constraints and reluctance from oncologists. Following recent recommendations, this paper highlights the current-validated applications of pharmacokinetic monitoring in oncology focusing on the safety of anticancer therapies. Expert opinion Paradoxically given the oldness of the agents, guidelines of dose adjustment have been recently available for intravenous busulfan, 5-fluorouracil, and high-dose methotrexate. Interestingly, besides the enhancement of tolerability, it applies to potential curative clinical situations. In an era of personalized oncology that integrates complex molecular factors in the treatment of cancer, education is needed for oncologists to show the benefits of this valuable (even old) resource for the safety of patients. Therapeutic drug monitoring for busulfan, 5-fluorouracil and methotrexate will still hold in the future unless more active agents are available in the concerned indications.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Monitoramento de Medicamentos
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Neoplasias
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Antineoplásicos
Tipo de estudo:
Guideline
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Prognostic_studies
Idioma:
En
Revista:
Expert Opin Drug Saf
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
França