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抗癌药物的临床实践与研究中的标签外使用:意大利经验。

Off-label use of anti-cancer drugs between clinical practice and research: the Italian experience.

机构信息

Hospital Pharmacy, IRCCS Centro di Riferimento Oncologico di Basilicata, Via Padre Pio 1, 85028 Rionero in Vulture, PZ, Italy.

出版信息

Eur J Clin Pharmacol. 2012 May;68(5):505-12. doi: 10.1007/s00228-011-1173-6. Epub 2011 Dec 14.

Abstract

BACKGROUND

Off-label use is the practice of prescribing a drug outside the terms of its official labeling. Worldwide, about 20% of the commonly prescribed medications are off-label, and the percentage increases in specific patient populations, such as children, pregnant women, and cancer patients. Off-label use is particularly widespread in oncology for many reasons, including the wide variety of cancer subtypes, the difficulties involved in performing clinical trials, the rapid diffusion of preliminary results, and delays in the approval of new drugs by regulatory organizations/agencies.

OBJECTIVE

The aim of this article is to describe the use of off-label drugs in oncology, with an emphasis on the role of the world's leading regulatory agencies and an assessment of current Italian legislation.

CONCLUSION

Off-label drug utilization is essential in oncology when based on evidence. However, off-label drugs must be prescribed in accordance with existing national laws and only when the potential benefit outweighs the potential toxic effects.

摘要

背景

超适应证用药是指在药品的官方标签规定之外使用药物。在全球范围内,约有 20%的常用药物属于超适应证用药,在某些特定患者群体(如儿童、孕妇和癌症患者)中,这一比例会更高。超适应证用药在肿瘤学领域尤其普遍,原因有很多,包括癌症亚型的多样性、临床试验开展的难度、初步结果的快速传播以及监管机构对新药批准的延迟等。

目的

本文旨在描述肿瘤学中超适应证药物的使用情况,重点介绍世界主要监管机构的作用,并评估当前意大利的立法情况。

结论

基于证据的超适应证药物使用在肿瘤学中至关重要。但是,超适应证药物的使用必须符合现行国家法律,并且只有在潜在获益超过潜在毒副作用的情况下才可以使用。

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