Journal
EUROPEAN JOURNAL OF CANCER
Volume 38, Issue 13, Pages 1677-1684Publisher
ELSEVIER SCI LTD
DOI: 10.1016/S0959-8049(02)00151-X
Keywords
anticancer drugs; body-surface area; pharmacokinetics; dosing strategies
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Most anticancer drugs are characterised by a narrow therapeutic window, hence, a small change in dose can lead to poor antitumour effects or an unacceptable degree of toxicity. The rationale for using body surface area (BSA) to dose antineoplastic agents is to normalise the effects of drugs, and accordingly, it has been routinely employed as the only independent variable In the last 10 years, however, several studies have shown a poor relationship of BSA for predicting drug exposure, and an irrelevant correlation between this variable and pharmacokinetic (PK) parameters. In this paper, the results of this relationship for various commonly used antineoplastic agents are reviewed, and the influence of BSA to decrease the total variability in clearance among patients is underlined. As reported, BSA failed to individualise the effects of the majority of the agents explored. The criteria that can predict a clinically meaningful relationship between BSA and drug clearance are discussed, and some alternative strategies to dose agents when BSA has proven to be useless are proposed. (C) 2002 Elsevier Science Ltd. All rights reserved.
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