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[Not Available].

Michèle Boisdron-Celle1, Chantal Le Guellec2,

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Summary
This summary is machine-generated.

Therapeutic drug monitoring of fluorouracil (5-FU) helps personalize chemotherapy. Adjusting doses based on plasma levels improves treatment effectiveness and reduces severe toxicities in cancer patients.

Keywords:
5-fluorouracil5-fluorouracile haute dosesuivi thérapeutique pharmacologiquetherapeutic drug monitoring

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Area of Science:

  • Pharmacology
  • Oncology
  • Clinical Pharmacy

Context:

  • Therapeutic drug monitoring (TDM) is being explored for prolonged continuous infusion of fluorouracil (5-FU), alone or with other chemotherapy agents.
  • Growing evidence links plasma 5-FU concentrations to patient outcomes, including toxicity and efficacy.
  • Threshold exposure levels, measured by area under the concentration-time curve (AUC), correlate with increased toxicity risk in colorectal and head and neck cancers.

Purpose:

  • To investigate the role of therapeutic drug monitoring in optimizing fluorouracil chemotherapy.
  • To establish the relationship between plasma fluorouracil concentrations and treatment outcomes.
  • To explore the potential for kinetically guided dose adjustments in chemotherapy regimens.

Summary:

  • A phase III multicenter randomized study in metastatic colorectal cancer demonstrated that dose-adapted fluorouracil significantly improved objective response rates.
  • This approach also showed a trend toward higher survival rates and reduced severe (grade III-IV) toxicities.
  • Real-time monitoring can identify patients with unexpectedly high exposure, enabling enhanced supportive care.

Impact:

  • Kinetically guided dose adjustment of fluorouracil can be proposed for current or subsequent chemotherapy cycles.
  • Personalized dosing strategies based on drug concentration monitoring can improve cancer treatment efficacy.
  • Optimized supportive care for patients with high fluorouracil exposure can mitigate adverse events.