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儿科患者中抗癌药物的临床药代动力学和药效学(综述)

Clinical pharmacokinetics and pharmacodynamics of anticancer agents in pediatric patients (review).

作者信息

Knoester P D, Underberg W J, Beijnen J H

机构信息

Department of Pharmacy, Slotervaart Hospital/Netherlands Cancer Institute, Amsterdam.

出版信息

Anticancer Res. 1993 Sep-Oct;13(5C):1795-808.

PMID:8267385
Abstract

The pharmacokinetics of several important anticancer agents used in pediatric oncology are reviewed. Many of the anticancer agents described showed age-dependent pharmacokinetics, the disposition in children being different compared to the adult pharmacokinetics. These age-dependent pharmacokinetics imply that it is inappropriate to extrapolate pharmacokinetic data from studies in adult patients. Interpatient pharmacokinetic variability in pediatric patients was large, and of a greater magnitude compared to the variability observed in adult patients. This variability in pharmacokinetics resulted in similar large variability in systemic exposure after administration of standardized doses (e.g. the maximum tolerated dose) of these anticancer agents. The variability of some of these agents is correlated with their clinical effects (either tumor response or toxicity). It is possible, using these anticancer agents, to monitor pediatric patients, identifying those patients at risk of severe toxicity (high systemic exposure) or those patients who may not benefit from treatment (Low systemic exposure). These pharmacodynamic relationships are described in this paper, since such correlations may contribute to further optimization of chemotherapy in pediatric patients.

摘要

本文综述了儿科肿瘤学中使用的几种重要抗癌药物的药代动力学。所描述的许多抗癌药物表现出年龄依赖性药代动力学,儿童体内的处置情况与成人药代动力学不同。这些年龄依赖性药代动力学意味着从成年患者研究中推断药代动力学数据是不合适的。儿科患者间的药代动力学变异性很大,与成年患者中观察到的变异性相比幅度更大。这种药代动力学变异性导致在给予这些抗癌药物标准化剂量(如最大耐受剂量)后全身暴露也有类似的大变异性。其中一些药物的变异性与其临床效果(肿瘤反应或毒性)相关。使用这些抗癌药物,可以监测儿科患者,识别有严重毒性风险(全身暴露高)的患者或可能无法从治疗中获益(全身暴露低)的患者。本文描述了这些药效学关系,因为此类相关性可能有助于进一步优化儿科患者的化疗。

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