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Oral cancer chemotherapy in paediatric patients: obstacles and potential for development and utilisation
1Division of Pediatrics, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA. ableyer@mdanderson.org
Insights
Oral chemotherapy offers significant advantages for pediatric cancer patients, including improved safety, quality of life, and potential efficacy. Overcoming challenges like bioavailability and adherence is key to maximizing its benefits.
Area of Science:
- Pediatric Oncology
- Pharmacology
- Drug Delivery Systems
Background:
- Parenteral chemotherapy is standard for pediatric cancer.
- Oral formulations are increasingly available for infants and children.
- Oral chemotherapy offers benefits like safety, cost-effectiveness, and improved quality of life.
Purpose of the Study:
- To review the advantages and challenges of oral chemotherapy in pediatric patients.
- To explore strategies for overcoming limitations of oral chemotherapy in children.
- To highlight the potential of oral chemotherapy for future pediatric cancer treatment.
Main Methods:
- Literature review of existing studies on oral chemotherapy in pediatrics.
- Analysis of benefits, drawbacks, and solutions for oral chemotherapy administration.
- Discussion of future directions and research needs in pediatric oral chemotherapy.
Main Results:
- Oral chemotherapy provides enhanced safety, flexibility, and convenience for pediatric cancer treatment.
- Key challenges include dose limitations, variable bioavailability, malabsorption, and adherence issues.
- Technological advancements and pharmaceutical development can address many of these obstacles.
Conclusions:
- Oral chemotherapy represents a promising and evolving treatment modality for pediatric cancer.
- Addressing bioavailability and adherence is crucial for successful implementation.
- Future research should focus on expanding oral formulations and optimizing their use in children.
Abstract:
Although most cancer chemotherapy in children is administered parenterally, oral formulations are becoming increasingly available for use in patients as young as infants. Incentives for this approach include safety, flexibility, reduced financial cost, improved quality of life, and the potential for improved efficacy. The ability to deliver chemotherapy at home and apply schedules of administration that increase the agent's efficacy because patients do not require hospitalisation or visits to the clinic renders oral chemotherapy particularly attractive. Obstacles to oral chemotherapy in paediatric patients include restrictions in dose size and schedule, uncertain or low bioavailability, adverse effects of malabsorption, and adherence (noncompliance and refusal to take oral chemotherapy). Techniques to overcome most of these limitations are available or can be developed, and lack of an oral formulation can be solved in many instances by the pharmaceutical industry. Future developments in oral chemotherapy should not be limited to adult patient applications.
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