Pharmacokinetic Individualization of 5-Fluorouracil Doses in Colorectal Cancer
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Revista Brasileira de Cancerologia (Online) |
Texto Completo: | https://rbc.inca.gov.br/index.php/revista/article/view/535 |
Resumo: | Introduction: 5-FU is an antimetabolite widely used in the treatment of colorectal cancer, presenting a significant interindividual variability in both therapeutic response and occurrence of toxicity, which may be attributed to its variable pharmacokinetics. Objectives: The purpose of this study is to review the clinical and laboratory aspects of the pharmacokinetic individualization of 5-FU dose regimens in colorectal cancer. Method: It was performed a bibliographic search on the databases PubMed, Periodicals Capes, SciElo, Medline and Bireme, including studies published since 1997. Search key-words were 5-Fluorouracil; Pharmacokinetic individualization; Colorectal cancer; Therapeutic drug monitoring, both in English and Portuguese. Results: There are evidences of a relationship between the systemic exposure to 5-FU and treatment responses, with an area under the concentration-time curve of 20- 25 mg.h/L representing a compromise between efficacy maximization and toxicity reduction. It is also possible to evaluate the DPD enzyme activity prior to 5-FU treatment through phenotypic methods, identifying patients at risk of severe toxicity. Analytical methods based on high performance liquid chromatography are available to measure 5-FU concentrations in plasma, allowing the dissemination of therapeutic drug monitoring in 5-FU treatments. Conclusion: Pharmacokinetics individualization allows the tailoring of personalized 5-FU therapeutic regimens in colorectal cancer, with significant impacts on the results of the therapy. |
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Pharmacokinetic Individualization of 5-Fluorouracil Doses in Colorectal CancerIndividualización Farmacocinética de las Dosis de 5-Fluorouracil en el Cáncer ColorrectalIndividualização Farmacocinética das Doses de 5-Fluoruracil no Câncer ColorretalNeoplasias ColorretaisFamacocinéticaAntineoplásicos-uso terapêuticoAntineoplásicos-efeitos adversosQuimioterapiaColorectal NeoplasmsPharmacokineticsAntineoplastc Agents-therapeutic useAntineoplastc Agents –adverse effectsDrug TherapyNeoplasias ColorrectalesFamacocinéticaAntineoplásicos-uso terapéuticoAntineoplásicos-efctos adversosQuimioterapiaIntroduction: 5-FU is an antimetabolite widely used in the treatment of colorectal cancer, presenting a significant interindividual variability in both therapeutic response and occurrence of toxicity, which may be attributed to its variable pharmacokinetics. Objectives: The purpose of this study is to review the clinical and laboratory aspects of the pharmacokinetic individualization of 5-FU dose regimens in colorectal cancer. Method: It was performed a bibliographic search on the databases PubMed, Periodicals Capes, SciElo, Medline and Bireme, including studies published since 1997. Search key-words were 5-Fluorouracil; Pharmacokinetic individualization; Colorectal cancer; Therapeutic drug monitoring, both in English and Portuguese. Results: There are evidences of a relationship between the systemic exposure to 5-FU and treatment responses, with an area under the concentration-time curve of 20- 25 mg.h/L representing a compromise between efficacy maximization and toxicity reduction. It is also possible to evaluate the DPD enzyme activity prior to 5-FU treatment through phenotypic methods, identifying patients at risk of severe toxicity. Analytical methods based on high performance liquid chromatography are available to measure 5-FU concentrations in plasma, allowing the dissemination of therapeutic drug monitoring in 5-FU treatments. Conclusion: Pharmacokinetics individualization allows the tailoring of personalized 5-FU therapeutic regimens in colorectal cancer, with significant impacts on the results of the therapy. Introducción: El 5-Fluoruracil (5-FU) es un antimetabólito ampliamente utilizado en el tratamiento del cáncer colorrectal, con significativa variabilidad en la respuesta terapéutica y en la ocurrencia de toxicidad asociada a su farmacocinética variable. Objetivo: Revisar los aspectos clínicos y laboratoriales de la individualización farmacocinética de los tratamientos con 5-FU en pacientes con cáncer colorrectal. Método: Se realizó una revisión de literatura em las bases de datos PubMed, Periódicos Capes, SciElo, Medline y Bireme. Se incluyeron estudios publicados a partir de 1997, con las palabras clave 5-Fluoruracil; individualización farmacocinética; cancer colorrectal; monitoreo terapéutico de fármacos. Resultados: Existen evidencias de una relación entre la exposición sistémica al 5-FU y las respuestas terapéuticas en el tratamiento, siendo que áreas bajo la curva concentración-tiempo entre 20 y 25 mg.h/L permiten un adecuado balance entre maximización de la eficacia y reducción de la toxicidad. Tambien, es posible evaluar la actividad de la enzima dihidropirimidina desidrogenasis (DPD) previamente al tratamiento con 5-FU a traves de métodos fenotípicos, identificando los pacientes en riesgo de toxicidad grave. Métodos analíticos basados en cromatografía líquida de alta eficiencia están disponibles para determinar 5-FU en plasma de manera fiable, permitiendo la diseminación del monitoreo terapéutico de este fármaco. Conclusión: A través de la individualización farmacocinética es posible desarrollar regimenes terapéuticos de 5-FU personalizados en el cáncer colorrectal, com impactos significativos en los resultados terapéuticos. Introdução: O 5-Fluoruracil (5-FU) é um antimetabólito amplamente utilizado no tratamento do câncer colorretal, com significativa variabilidade na resposta terapêutica e na ocorrência de toxicidade associada à sua farmacocinética variável. Objetivo: Revisar os aspectos clínicos e laboratoriais da individualização farmacocinética dos tratamentos com 5-FU em pacientes com cáncer colorretal. Método: Realizou-se uma revisão de literatura nas bases de dados PubMed, Periódicos Capes, SciElo, Medline e Bireme. Foram incluídos estudos publicados a partir de 1997, com as palavras-chave: 5-Fluoruracil; Individualização farmacocinética; Câncer colorretal; Monitoramento terapêutico de fármacos. Resultados: Existem evidências de uma relação entre a exposição sistêmica ao 5-FU e as respostas terapêuticas no tratamento, sendo que áreas sob a curva concentração- tempo entre 20 a 25 mg. h/L permitem um adequado balanço entre maximização da eficacia e redução da toxicidade. Também é possível avaliar a atividade da enzima diidropirimidina desidrogenase (DPD) previamente ao tratamento com 5-FU através de metodos fenotípicos, identificando os pacientes em risco de toxicidade grave. Métodos analíticos baseados em cromatografia líquida de alta eficiência estão disponíveis para determinar 5-FU em plasma de forma confiável, permitindo a disseminação do monitoramento terapêutico desse fármaco. Conclusão: Através da individualização farmacocinética é possível desenvolver regimes terapêuticos de 5-FU personalizados no câncer colorretal, com impactos significativos nos resultados terapêuticos. INCA2013-06-28info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionRevisão de literaturaapplication/pdfhttps://rbc.inca.gov.br/index.php/revista/article/view/53510.32635/2176-9745.RBC.2013v59n2.535Revista Brasileira de Cancerologia; Vol. 59 No. 2 (2013): Apr./May/June; 271-280Revista Brasileira de Cancerologia; Vol. 59 Núm. 2 (2013): abr./mayo/jun.; 271-280Revista Brasileira de Cancerologia; v. 59 n. 2 (2013): abr./maio/jun. ; 271-2802176-9745reponame:Revista Brasileira de Cancerologia (Online)instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)instacron:INCAporhttps://rbc.inca.gov.br/index.php/revista/article/view/535/327Martins, Carina Gomes Wagner, Sandrine Comparsi Linden, Rafael info:eu-repo/semantics/openAccess2021-11-29T20:11:42Zoai:rbc.inca.gov.br:article/535Revistahttps://rbc.inca.gov.br/index.php/revistaPUBhttps://rbc.inca.gov.br/index.php/revista/oairbc@inca.gov.br0034-71162176-9745opendoar:2021-11-29T20:11:42Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA)false |
dc.title.none.fl_str_mv |
Pharmacokinetic Individualization of 5-Fluorouracil Doses in Colorectal Cancer Individualización Farmacocinética de las Dosis de 5-Fluorouracil en el Cáncer Colorrectal Individualização Farmacocinética das Doses de 5-Fluoruracil no Câncer Colorretal |
title |
Pharmacokinetic Individualization of 5-Fluorouracil Doses in Colorectal Cancer |
spellingShingle |
Pharmacokinetic Individualization of 5-Fluorouracil Doses in Colorectal Cancer Martins, Carina Gomes Neoplasias Colorretais Famacocinética Antineoplásicos-uso terapêutico Antineoplásicos-efeitos adversos Quimioterapia Colorectal Neoplasms Pharmacokinetics Antineoplastc Agents-therapeutic use Antineoplastc Agents –adverse effects Drug Therapy Neoplasias ColorrectalesFamacocinética Antineoplásicos-uso terapéutico Antineoplásicos-efctos adversos Quimioterapia |
title_short |
Pharmacokinetic Individualization of 5-Fluorouracil Doses in Colorectal Cancer |
title_full |
Pharmacokinetic Individualization of 5-Fluorouracil Doses in Colorectal Cancer |
title_fullStr |
Pharmacokinetic Individualization of 5-Fluorouracil Doses in Colorectal Cancer |
title_full_unstemmed |
Pharmacokinetic Individualization of 5-Fluorouracil Doses in Colorectal Cancer |
title_sort |
Pharmacokinetic Individualization of 5-Fluorouracil Doses in Colorectal Cancer |
author |
Martins, Carina Gomes |
author_facet |
Martins, Carina Gomes Wagner, Sandrine Comparsi Linden, Rafael |
author_role |
author |
author2 |
Wagner, Sandrine Comparsi Linden, Rafael |
author2_role |
author author |
dc.contributor.author.fl_str_mv |
Martins, Carina Gomes Wagner, Sandrine Comparsi Linden, Rafael |
dc.subject.por.fl_str_mv |
Neoplasias Colorretais Famacocinética Antineoplásicos-uso terapêutico Antineoplásicos-efeitos adversos Quimioterapia Colorectal Neoplasms Pharmacokinetics Antineoplastc Agents-therapeutic use Antineoplastc Agents –adverse effects Drug Therapy Neoplasias ColorrectalesFamacocinética Antineoplásicos-uso terapéutico Antineoplásicos-efctos adversos Quimioterapia |
topic |
Neoplasias Colorretais Famacocinética Antineoplásicos-uso terapêutico Antineoplásicos-efeitos adversos Quimioterapia Colorectal Neoplasms Pharmacokinetics Antineoplastc Agents-therapeutic use Antineoplastc Agents –adverse effects Drug Therapy Neoplasias ColorrectalesFamacocinética Antineoplásicos-uso terapéutico Antineoplásicos-efctos adversos Quimioterapia |
description |
Introduction: 5-FU is an antimetabolite widely used in the treatment of colorectal cancer, presenting a significant interindividual variability in both therapeutic response and occurrence of toxicity, which may be attributed to its variable pharmacokinetics. Objectives: The purpose of this study is to review the clinical and laboratory aspects of the pharmacokinetic individualization of 5-FU dose regimens in colorectal cancer. Method: It was performed a bibliographic search on the databases PubMed, Periodicals Capes, SciElo, Medline and Bireme, including studies published since 1997. Search key-words were 5-Fluorouracil; Pharmacokinetic individualization; Colorectal cancer; Therapeutic drug monitoring, both in English and Portuguese. Results: There are evidences of a relationship between the systemic exposure to 5-FU and treatment responses, with an area under the concentration-time curve of 20- 25 mg.h/L representing a compromise between efficacy maximization and toxicity reduction. It is also possible to evaluate the DPD enzyme activity prior to 5-FU treatment through phenotypic methods, identifying patients at risk of severe toxicity. Analytical methods based on high performance liquid chromatography are available to measure 5-FU concentrations in plasma, allowing the dissemination of therapeutic drug monitoring in 5-FU treatments. Conclusion: Pharmacokinetics individualization allows the tailoring of personalized 5-FU therapeutic regimens in colorectal cancer, with significant impacts on the results of the therapy. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-06-28 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Revisão de literatura |
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article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://rbc.inca.gov.br/index.php/revista/article/view/535 10.32635/2176-9745.RBC.2013v59n2.535 |
url |
https://rbc.inca.gov.br/index.php/revista/article/view/535 |
identifier_str_mv |
10.32635/2176-9745.RBC.2013v59n2.535 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
https://rbc.inca.gov.br/index.php/revista/article/view/535/327 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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INCA |
publisher.none.fl_str_mv |
INCA |
dc.source.none.fl_str_mv |
Revista Brasileira de Cancerologia; Vol. 59 No. 2 (2013): Apr./May/June; 271-280 Revista Brasileira de Cancerologia; Vol. 59 Núm. 2 (2013): abr./mayo/jun.; 271-280 Revista Brasileira de Cancerologia; v. 59 n. 2 (2013): abr./maio/jun. ; 271-280 2176-9745 reponame:Revista Brasileira de Cancerologia (Online) instname:Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) instacron:INCA |
instname_str |
Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) |
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INCA |
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INCA |
reponame_str |
Revista Brasileira de Cancerologia (Online) |
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Revista Brasileira de Cancerologia (Online) |
repository.name.fl_str_mv |
Revista Brasileira de Cancerologia (Online) - Instituto Nacional de Câncer José Alencar Gomes da Silva (INCA) |
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rbc@inca.gov.br |
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