Crombag Marie-Rose B S, Joerger Markus, Thürlimann Beat, Schellens Jan H M, Beijnen Jos H, Huitema Alwin D R
Department of Pharmacy & Pharmacology, The Netherlands Cancer Institute/Slotervaart Hospital, Amsterdam 1066 CX, The Netherlands.
Department of Clinical Pharmacology, The Netherlands Cancer Institute, Amsterdam 1066 CX, The Netherlands.
Cancers (Basel). 2016 Jan 2;8(1):6. doi: 10.3390/cancers8010006.
Elderly patients receiving anticancer drugs may have an increased risk to develop treatment-related toxicities compared to their younger peers. However, a potential pharmacokinetic (PK) basis for this increased risk has not consistently been established yet. Therefore, the objective of this study was to systematically review the influence of age on the PK of anticancer agents frequently administered to elderly breast cancer patients.
A literature search was performed using the PubMed electronic database, Summary of Product Characteristics (SmPC) and available drug approval reviews, as published by EMA and FDA. Publications that describe age-related PK profiles of selected anticancer drugs against breast cancer, excluding endocrine compounds, were selected and included.
This review presents an overview of the available data that describe the influence of increasing age on the PK of selected anticancer drugs used for the treatment of breast cancer.
Selected published data revealed differences in the effect and magnitude of increasing age on the PK of several anticancer drugs. There may be clinically-relevant, age-related PK differences for anthracyclines and platina agents. In the majority of cases, age is not a good surrogate marker for anticancer drug PK, and the physiological state of the individual patient may better be approached by looking at organ function, Charlson Comorbidity Score or geriatric functional assessment.
与年轻患者相比,接受抗癌药物治疗的老年患者发生治疗相关毒性的风险可能更高。然而,这种风险增加的潜在药代动力学(PK)基础尚未得到一致确立。因此,本研究的目的是系统评价年龄对老年乳腺癌患者常用抗癌药物药代动力学的影响。
使用PubMed电子数据库、产品特性摘要(SmPC)以及欧洲药品管理局(EMA)和美国食品药品监督管理局(FDA)发布的可用药物批准审查进行文献检索。选择并纳入描述所选抗癌药物(不包括内分泌化合物)针对乳腺癌的年龄相关药代动力学特征的出版物。
本综述概述了现有数据,这些数据描述了年龄增长对用于治疗乳腺癌的所选抗癌药物药代动力学的影响。
部分已发表的数据显示,年龄增长对几种抗癌药物药代动力学的影响及其程度存在差异。蒽环类药物和铂类药物可能存在与年龄相关的、具有临床相关性的药代动力学差异。在大多数情况下,年龄并非抗癌药物药代动力学的良好替代指标,通过评估器官功能、查尔森合并症评分或老年功能评估来了解个体患者的生理状态可能更为合适。