Tyrosine Kinase Inhibitors in Cancers: Treatment optimization - Part II.

Real-life populations are more heterogeneous than those included in prospective clinical studies. In cancer patients, comorbidities and co-medications favor the appearance of severe adverse effects which can significantly impact quality of life and treatment effectiveness. Most of tyrosine kinase inhibitors (TKI) have been developed with flat oral dosing exposing patients to the risk of poor adherence due to side effects. Additionally, genetic or physiological factors, differences in diet, and drug-drug interactions can lead to inter-individual variability affecting treatment outcomes and increasing the risk of adverse events. Knowledge of the different factors of variability allows individualized patient management. This review examines the effects of adherence, food intake, and pharmaceutical form on the pharmacokinetics of oral TKI, as well as evaluating pharmacokinetics considerations improving TKI management. Concentration-effectiveness and concentration-toxicity data are presented for the selected TKI, and a simple therapeutic drug monitoring schema is outlined to help individualize dosing of oral TKI.

Informations de copyright

Copyright © 2024. Published by Elsevier B.V.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: CL has benefitted from assistance from BMS, MSD, Novartis, Amgen, Roche, Avantis Medical Systems, Pierre Fabre, Pfizer and Incyte. NM declare has benefited from assistance from BMS, MSD, Novartis, Pierre Fabre, Sanofi, Merck and Sun Pharma. Conflict of interest CL has benefitted from assistance from BMS, MSD, Novartis, Amgen, Roche, Avantis Medical Systems, Pierre Fabre, Pfizer and Incyte. NM declare has benefited from assistance from BMS, MSD, Novartis, Pierre Fabre, Sanofi, Merck and Sun Pharma. FF declare the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.