Pharmacokinetic and pharmacogenetic determinants and considerations in chemotherapy selection and dosing in infants

Abstract

Optimal chemotherapy for children and infants in particular has lagged behind the remarkable progress in cancer treatment and it is clear that far more basic and clinical research are needed with respect to the mechanistic basis of age-dependent differences in pharmacokinetic parameters. More recent studies which have combined pharmacokinetic data with clinical toxicity and outcome data have resulted in a number of more evidence-based guidelines at least for the initial chemotherapy dosing; however, at present, the dosing of chemotherapy drugs in neonates and infants remains largely empiric.

Clinical characterisation and long‐term survival of paediatric and juvenile lymphoma in cats: 33 cases (2008‐2022)

“…As studies investigating pharmacokinetic and pharmacodynamic properties of chemotherapy drugs in paediatric and juvenile cats are lacking, chemotherapy agents and dosing regimens were administered at clinician's discretion and according to therapeutic ranges described for adult cats. In human medicine, recent studies have resulted in more evidence-based recommendations and guidelines, and although dosing of chemotherapy in infants and children remains to certain degree empirical, dose reductions are generally recommended at the start of treatment (Hutson et al 2012, Veal et al 2016, Nijstad et al 2022. In our study, none of the long-term survivors had stunted growth, a second cancer or chronic disease reported within the time of follow-up.…”

“…In human medicine, recent studies have resulted in more evidence‐based recommendations and guidelines, and although dosing of chemotherapy in infants and children remains to certain degree empirical, dose reductions are generally recommended at the start of treatment (Hutson et al . 2012, Veal et al . 2016, Nijstad et al .…”