Optimization of therapy by pharmacokinetic-pharmacodynamic analyses

Chiyo Imamura

研究成果: Chapter

抄録

In cytotoxic anticancer agents, efficacy depends on tumor heterogeneity and is not evaluated immediately after administration, and toxicities are severe and life threatening such as neutropenia and thrombocytopenia. Therefore because toxicity is often more readily measured than efficacy, there are more reported pharmacodynamic (PD) studies defining relationships between pharmacokinetic (PK) parameters and the toxicity. However, retrospective studies have shown that molecular targeted agent systemic exposure correlates with treatment response (efficacy and toxicity) in various cancers including renal cell carcinoma (RCC). The evidence of the relationship between PK and PD for imatinib currently exists in the treatment of leukemia and gastrointestinal stromal tumor (GIST). It is important to evaluate the relationship between PK and PD prospectively in clinical trials rather than extrapolating from retrospective analyses. Based on these findings, therapeutic levels should be defined for molecular targeted agents in the treatment of RCC such as that that already occurs for antiepileptic, immunosuppressive, and antibiotic agents. Optimization of systemic exposure by dose modification to eliminate individual variability can increase the probability of efficacy, decrease the probability of toxicity, or both in each RCC patient treated with molecular targeted agents.

本文言語English
ホスト出版物のタイトルRenal Cell Carcinoma
ホスト出版物のサブタイトルMolecular Features and Treatment Updates
出版社Springer Japan
ページ369-381
ページ数13
ISBN(電子版)9784431555315
ISBN(印刷版)9784431555308
DOI
出版ステータスPublished - 2017 1月 1

ASJC Scopus subject areas

  • 医学(全般)
  • 生化学、遺伝学、分子生物学(全般)

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