Detailed Information on Publication Record
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.Basic information
Original name
Therapeutic Drug Monitoring of Sunitinib in Gastrointestinal Stromal Tumors and Metastatic Renal Cell Carcinoma in Adults-A Review
Authors
DEMLOVÁ, Regina (203 Czech Republic, belonging to the institution), Miroslav TURJAP (203 Czech Republic), Ondřej PEŠ (203 Czech Republic, belonging to the institution), Katarína KOSTOLANSKÁ (703 Slovakia, belonging to the institution) and Jan JUŘICA (203 Czech Republic, guarantor, belonging to the institution)
Edition
THERAPEUTIC DRUG MONITORING, PHILADELPHIA, LIPPINCOTT WILLIAMS & WILKINS, 2020, 0163-4356
Other information
Language
English
Type of outcome
Článek v odborném periodiku
Field of Study
30104 Pharmacology and pharmacy
Country of publisher
United States of America
Confidentiality degree
není předmětem státního či obchodního tajemství
References:
Impact factor
Impact factor: 3.681
RIV identification code
RIV/00216224:14110/20:00115974
Organization unit
Faculty of Medicine
UT WoS
000523689800003
Keywords in English
sunitinib; N-desethylsunitinib; mRCC; GIST; therapeutic drug monitoring; toxicity-adjusted dosing
Tags
International impact, Reviewed
Změněno: 4/4/2022 13:01, Mgr. Tereza Miškechová
Abstract
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.
Links
| CZ.02.1.01/0.0/0.0/16_013/0001826, interní kód MU (CEP code: EF16_013/0001826) |
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| LM2018128, research and development project |
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| MUNI/A/0976/2018, interní kód MU |
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| MUNI/A/1167/2019, interní kód MU |
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| MUNI/A/1550/2018, interní kód MU |
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