Renal or hepatic impairment is a common comorbidity for patients with cancer either because of the disease itself, toxicity of previous anticancer treatments, or because of other factors affecting organ function, such as increased age.Because renal and hepatic function are among the main determinants of drug exposure, the pharmacokinetic profile might be altered for patients with cancer who have renal or hepatic impairment, necessitating dose adjustments. Most anticancer drugs are dosed near their maximum tolerated dose and are characterised by a narrow therapeutic index. Consequently, selecting an adequate dose for patients who have either hepatic or renal impairment, or both, is challenging and definitive recommendations on dose adjustments are scarce.
In the Lancet Oncology, Raboudumc researchers from the department of Pharmacy (Stefanie Krens, Nielka van Erp, David Burger) and the department of Medical oncology (Gerben Lassche, Ingrid Desar, Carla van Herpen) wrote a comprehensive review in which they discuss the effect of renal and hepatic impairment on the pharmacokinetics of anticancer drugs. To guide clinicians in selecting appropriate dose adjustments, information from available drug labels and from the published literature were combined to provide a practical set of recommendations for dose adjustments of 160 anticancer drugs for patients with hepatic and renal impairment.
See publication in Lancet Oncology
Related news items
Step-up approach vs open necrosectomy for necrotizing pancreatitis18 April 2019
Another publication of the successful Dutch collaborative group on pancreatitis research with substantial contribution from Radboudumc researchers, Harry van Goor and Kees van Laarhoven.read more
Prophylactic antibiotics reduce hospitalisations and cost in head and neck cancer patients18 April 2019
In European journal of cancer Janneke Ham and colleagues showed that prophylactic antibiotics in locally advanced head and neck cancer patients treated with chemoradiotherapy did not reduce the incidence of (aspiration) pneumonias, but did reduce hospitalisations and tended to be cost-effective.read more
Nontuberculous mycobacteria and fungal co-infections Bonnie and Clyde?18 April 2019
In The European respiratory journal Jakko van Ingen and Sanne Zweijpfenning showed that 40% of patients diagnosed with nontuberculous mycobacterial pulmonary disease also meet diagnostic criteria for chronic pulmonary aspergillosis.read more
ESCMID award for groundbreaking studies on NTM disease18 April 2019
Jakko van Ingen received the ESCMID Young Investigator Award for his groundbreaking work on nontuberculous mycobacterial disease.read more
EU funded project BIOMAP led by Ellen van den Bogaard12 April 2019
Ellen van den Bogaard, theme Inflammatory diseases, leads the research on the experimental validation and functional analysis of identified biomarkers by using advanced organotypic skin models and receives a grant of €258,000.read more