2020
Therapeutic Drug Monitoring of Sunitinib in Gastrointestinal Stromal Tumors and Metastatic Renal Cell Carcinoma in Adults-A Review
DEMLOVÁ, Regina, Miroslav TURJAP, Ondřej PEŠ, Katarína KOSTOLANSKÁ, Jan JUŘICA et. al.Základní údaje
Originální název
Therapeutic Drug Monitoring of Sunitinib in Gastrointestinal Stromal Tumors and Metastatic Renal Cell Carcinoma in Adults-A Review
Autoři
DEMLOVÁ, Regina (203 Česká republika, domácí), Miroslav TURJAP (203 Česká republika), Ondřej PEŠ (203 Česká republika, domácí), Katarína KOSTOLANSKÁ (703 Slovensko, domácí) a Jan JUŘICA (203 Česká republika, garant, domácí)
Vydání
THERAPEUTIC DRUG MONITORING, PHILADELPHIA, LIPPINCOTT WILLIAMS & WILKINS, 2020, 0163-4356
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30104 Pharmacology and pharmacy
Stát vydavatele
Spojené státy
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 3.681
Kód RIV
RIV/00216224:14110/20:00115974
Organizační jednotka
Lékařská fakulta
UT WoS
000523689800003
Klíčová slova anglicky
sunitinib; N-desethylsunitinib; mRCC; GIST; therapeutic drug monitoring; toxicity-adjusted dosing
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 4. 4. 2022 13:01, Mgr. Tereza Miškechová
Anotace
V originále
Background: Sunitinib is an inhibitor of multiple receptor tyrosine kinases and is a standard-of-care treatment for advanced and metastatic renal cell carcinoma and a second-line treatment in locally advanced inoperable and metastatic gastrointestinal stromal tumors. A fixed dose of the drug, however, does not produce a uniform therapeutic outcome in all patients, and many face adverse effects and/or toxicity. One of the possible causes of the interindividual variability in the efficacy and toxicity response is the highly variable systemic exposure to sunitinib and its active metabolite. This review aims to summarize all available clinical evidence of the treatment of adult patients using sunitinib in approved indications, addressing the necessity to introduce proper and robust therapeutic drug monitoring (TDM) of sunitinib and its major metabolite, N-desethylsunitinib. Methods: The authors performed a systematic search of the available scientific literature using the PubMed online database. The search terms were "sunitinib" AND "therapeutic drug monitoring" OR "TDM" OR "plasma levels" OR "concentration" OR "exposure." The search yielded 520 journal articles. In total, 447 publications were excluded because they lacked sufficient relevance to the reviewed topic. The remaining 73 articles were, together with currently valid guidelines, thoroughly reviewed. Results: There is sufficient evidence confirming the concentration-efficacy and concentration-toxicity relationship in the indications of gastrointestinal stromal tumors and metastatic renal clear-cell carcinoma. For optimal therapeutic response, total (sunitinib + N-desethylsunitinib) trough levels of 50-100 ng/mL serve as a reasonable target therapeutic range. To avoid toxicity, the total trough levels should not exceed 100 ng/mL. Conclusions: According to the current evidence presented in this review, a TDM-guided dose modification of sunitinib in selected groups of patients could provide a better treatment outcome while simultaneously preventing sunitinib toxicity.
Návaznosti
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