Dosing modifications of targeted cancer therapies in patients with special needs: evidence and controversies

Area of Science:

• Oncology
• Pharmacology
• Clinical Therapeutics

Background:

• Targeted therapies offer improved cancer treatment with fewer side effects than traditional chemotherapy.
• Organ dysfunction and drug interactions necessitate dose adjustments for targeted cancer drugs.
• Current guidelines for targeted therapy dosing modifications lack consensus and robust evidence.

Purpose of the Study:

• To review existing literature on dosing modification strategies for 30 commercially available targeted cancer drugs.
• To evaluate current recommendations and controversies surrounding dose adjustments.
• To provide a comprehensive overview for clinicians managing targeted therapy toxicity.

Main Methods:

• Systematic literature review of studies addressing dosing modifications for targeted cancer therapies.
• Analysis of dosing recommendations for 30 specific targeted agents.
• Identification and synthesis of reported controversies and consensus statements.

Main Results:

• Significant variability exists in recommended dosing modifications across different targeted therapies.
• Lack of high-quality evidence contributes to ongoing controversies in dose adjustment strategies.
• Specific patient populations (e.g., renal or hepatic impairment) often require tailored modifications.

Conclusions:

• Standardized dosing modification guidelines for targeted cancer therapies are needed.
• Further research is essential to establish evidence-based recommendations for dose adjustments.
• Clinicians must carefully consider individual patient factors when modifying targeted therapy doses.