Levêque Dominique
Pôle de pharmacie-pharmacologie, Hôpitaux Universitaires de Strasbourg, avenue Molière, 67098 Strasbourg Cedex.
Bull Cancer. 2007 Jul;94(7):647-51.
Dosing of anticancer drugs in adults is mostly adjusted to estimated body surface area or body weight. Dose normalisation to body size is assumed to decrease the interindividual pharmacokinetic and pharmacodynamic variability. This approach is rarely validated before approval. Theoritically, body size should be used only if it has been demonstrated that it constitues a significant factor affecting clinical variability. Recent studies have shown, a posteriori, that several marketed anticancer agents could be administered at a fixed dose. Moreover, the abandon of body surface area in dosing of new drugs in phase I trials has been recommended. At the present time, body size continues to be used in the dosing of new agents in adult patients. This review presents the concepts and the limits of weight and body surface area-based dosing of anticancer drugs in adult patients.
成人抗癌药物的剂量大多根据估计的体表面积或体重进行调整。将剂量按体型标准化被认为可减少个体间的药代动力学和药效学变异性。这种方法在获批前很少得到验证。从理论上讲，只有在证明体型是影响临床变异性的重要因素时才应使用。事后的近期研究表明，几种已上市的抗癌药物可以固定剂量给药。此外，有人建议在I期试验中新药给药时放弃使用体表面积。目前，在成年患者新药给药中仍继续使用体型。本综述介绍了基于体重和体表面积的成人抗癌药物给药的概念和局限性。
