Oral targeted therapies represent an increasingly important group of drugs in modern oncology. With the shift from intravenously to orally administered drugs, drug absorption often limits the full potential of these drugs.Limited absorption and differences in metabolic capacity is a prominent cause for variability in systemic exposure and, as exposure correlates with therapeutic response, treatment outcome. Many of the oral anticancer drugs show modest bioavailability which can be majorly enhanced by food intake.
Examples of oral anticancer drugs that are much better absorbed when taken with food are abiraterone acetate and pazopanib. Our group showed that 600mg pazopanib QD taken with a continental breakfast (160-300 calories) is bio-equivalent to the licensed 800mg pazopanib QD taken fasted (presented at ASCO annual meeting 2016). This bio-equivalent lower dose results in an immediate saving of €850,/month/patient.
Currently, the primary goal of the intervention with food, to reduce gastro-intestinal toxicity and improve patients comfort is being investigated, by Nielka van Erp, hospital pharmacist and clinical pharmacologist at Radboudumc. Additionally the study on the effect of food on abiraterone uptake is currently ongoing.
Paragraph Volkskrant 27-03-2017