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There is no personalized anticancer treatment without individualized dosing. Clearly, BSA-based chemotherapy dosing does not improve the substantial pharmacokinetic variability of individual drugs. Similarly, the new oral kinase inhibitors and endocrine compounds exhibit a marked pharmacokinetic variability due to variable absorption, hepatic metabolism and potential drug-drug and food-drug interactions. Therapeutic drug monitoring and genotyping may allow more individualized dosing of anticancer compounds in the future. However, the large number of anticancer drugs that are newly approved or undergoing preclinical development are a substantial challenge for the development of substance-specific dosing algorithms. It will be necessary to implement individual dosing strategies in the early clinical development of new anticancer drugs to inform clinicians at the time of first approval.