Therapeutic Drug Monitoring of Pazopanib in Renal Cell Carcinoma and Soft Tissue Sarcoma: A Systematic Review.

IF 2.8 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Therapeutic Drug Monitoring Pub Date : 2024-06-01 Epub Date: 2024-04-30 DOI:10.1097/FTD.0000000000001206

Miroslav Turjap, Marta Pelcová, Jana Gregorová, Pavel Šmak, Hiroko Martin, Jan Štingl, Ondřej Peš, Jan Juřica

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Abstract

Background: Pazopanib, an anti-angiogenic multitarget tyrosine kinase inhibitor, has been approved for the treatment of metastatic renal cell carcinoma and soft tissue sarcoma. However, its recommended dose does not always produce consistent outcomes, with some patients experiencing adverse effects or toxicity. This variability is due to differences in the systemic exposure to pazopanib. This review aimed to establish whether sufficient evidence exists for the routine or selective therapeutic drug monitoring of pazopanib in adult patients with approved indications.

Methods: A systematic search of the PubMed and Web of Science databases using search terms related to pazopanib and therapeutic drug monitoring yielded 186 and 275 articles, respectively. Ten articles associated with treatment outcomes or toxicity due to drug exposure were selected for review.

Results: The included studies were evaluated to determine the significance of the relationship between drug exposure/Ctrough and treatment outcomes and between drug exposure and toxicity. A relationship between exposure and treatment outcomes was observed in 5 studies, whereas the trend was nonsignificant in 4 studies. A relationship between exposure and toxicity was observed in 6 studies, whereas 2 studies did not find a significant relationship; significance was not reported in 3 studies.

Conclusions: Sufficient evidence supports the therapeutic drug monitoring of pazopanib in adult patients to improve its efficacy and/or safety in the approved indications.

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肾细胞癌和软组织肉瘤中帕唑帕尼的治疗药物监测：系统回顾

背景：帕唑帕尼是一种抗血管生成的多靶点酪氨酸激酶抑制剂：帕唑帕尼是一种抗血管生成多靶点酪氨酸激酶抑制剂，已被批准用于治疗转移性肾细胞癌和软组织肉瘤。然而，其推荐剂量并不总能产生一致的疗效，有些患者会出现不良反应或毒性。造成这种差异的原因是帕唑帕尼的全身暴露量不同。本综述旨在确定是否有足够的证据对已获批适应症的成年患者进行帕唑帕尼的常规或选择性治疗药物监测：使用与帕唑帕尼和治疗药物监测相关的检索词对PubMed和Web of Science数据库进行系统检索，分别获得了186篇和275篇文章。我们选择了10篇与治疗结果或药物暴露引起的毒性相关的文章进行回顾：对所纳入的研究进行了评估，以确定药物暴露/耐受量与治疗结果之间以及药物暴露与毒性之间关系的重要性。在 5 项研究中观察到了药物暴露与治疗结果之间的关系，而在 4 项研究中这一趋势并不显著。有 6 项研究观察到暴露量与毒性之间存在关系，有 2 项研究未发现显著关系；有 3 项研究未报告显著性：有足够的证据支持对成年患者进行帕唑帕尼治疗药物监测，以提高其在批准适应症中的疗效和/或安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Drug Monitoring 医学-毒理学

CiteScore

5.00

自引率

8.00%

发文量

213

审稿时长

4-8 weeks

期刊介绍： Therapeutic Drug Monitoring is a peer-reviewed, multidisciplinary journal directed to an audience of pharmacologists, clinical chemists, laboratorians, pharmacists, drug researchers and toxicologists. It fosters the exchange of knowledge among the various disciplines–clinical pharmacology, pathology, toxicology, analytical chemistry–that share a common interest in Therapeutic Drug Monitoring. The journal presents studies detailing the various factors that affect the rate and extent drugs are absorbed, metabolized, and excreted. Regular features include review articles on specific classes of drugs, original articles, case reports, technical notes, and continuing education articles.