Improving the use of anticancer drugs: clinical pharmacokinetic approaches.

There are many areas in which clinical oncologists and pharmacologists can work together to improve the chemotherapy of cancer. In new drug development, the conduct of Phase I clinical trials is greatly facilitated by cooperative selection of appropriate schedules and dose escalation procedures. For established anticancer agents, continual surveillance is necessary to assure that new insights regarding a drug's mechanism of action can be translated into rational clinical trends, which are intended to improve response rates and/or reduce toxicity. Specific areas of optimization include alternate schedules or routes of drug delivery and selection of agents that penetrate the CNS. Adjustment of drug dosage for an individual patient and assessment of drug interactions can also be facilitated by collaboration between clinicians and pharmacologists.