Jinan University, Institute of Traditional Chinese Medicine and Natural Products, Guangzhou, Guangdong 510632, China.
Expert Opin Drug Metab Toxicol. 2013 Sep;9(9):1085-95. doi: 10.1517/17425255.2013.802771. Epub 2013 May 20.
Breast cancer is the most common female cancer, with more than one million new patients diagnosed annually worldwide. Generally speaking, there are three types of drugs used in management of breast cancer namely: hormonal treatment, chemotherapeutic agents and target-based agents. There is increasing evidence that hormones play an important role in development of both hormone-dependent and hormone-independent breast cancers.
This review summarizes the pharmacokinetics of various types of drugs used to treat breast cancer. Furthermore, the authors discuss hormone-related variations including: the menstrual status, gender and exogenous hormones influencing drug absorption, distribution, metabolism or excretion (ADME). The authors also describe the physiological factors such as body weight and age that affect the pharmacokinetics of several drugs.
The factors affecting the pharmacokinetics of anti-breast cancer drugs are multifaceted. Hormones appear to be a key factor determining the pharmacokinetics (and efficacy) of hormonal therapy due to their role in cancer progression. In chemotherapy, the effects of hormones on the drug pharmacokinetics are possibly mediated through P-glycoprotein (P-gp) efflux and/or cytochrome P450 metabolism. In many cases, dosing regimen should be adjusted for drugs used in treatment of breast cancers based on the hormone levels in the body.
乳腺癌是最常见的女性癌症，全球每年有超过 100 万名新患者被诊断出来。一般来说，有三种类型的药物用于乳腺癌的治疗，即：激素治疗、化疗药物和靶向治疗药物。越来越多的证据表明，激素在激素依赖性和非激素依赖性乳腺癌的发展中起着重要作用。
这篇综述总结了用于治疗乳腺癌的各种类型药物的药代动力学。此外，作者还讨论了与激素相关的变化，包括：月经状况、性别和外源性激素对药物吸收、分布、代谢或排泄（ADME）的影响。作者还描述了影响几种药物药代动力学的生理因素，如体重和年龄。
影响抗乳腺癌药物药代动力学的因素是多方面的。由于激素在癌症进展中的作用，激素似乎是决定激素治疗药代动力学（和疗效）的关键因素。在化疗中，激素对药物药代动力学的影响可能是通过 P-糖蛋白（P-gp）外排和/或细胞色素 P450 代谢介导的。在许多情况下，应根据体内激素水平调整用于治疗乳腺癌的药物的剂量方案。
