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Dosing anticancer drugs in infants: Current approach and recommendations from the Children's Oncology Group's

Frank M Balis1, Richard B Womer1, Stacey Berg2

  • 1Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Pediatric Blood & Cancer
|May 17, 2017
PubMed

Insights

This study analyzed infant dosing for anticancer drugs, finding varied criteria and methods. A new approach uses body surface area (BSA) dose banding for infants and children to improve drug safety and efficacy.

Area of Science:

  • Pediatric Oncology
  • Pharmacology
  • Drug Dosing

Background:

  • Infant dosing for anticancer drugs lacks standardization, with 11 criteria and 8 methods identified across 29 protocols.
  • Existing dose modifications primarily aim to reduce non-specific toxicity, not optimize cancer treatment.

Purpose of the Study:

  • To analyze existing dose modification criteria and methods for infants in pediatric oncology protocols.
  • To develop a novel, more rational method for dosing anticancer drugs in infants.

Main Methods:

  • Analysis of dose modification criteria (age, weight, BSA) and methods in 29 Children's Oncology Group protocols.
  • Development of a new dosing method based on body surface area (BSA) dose banding.

Main Results:

  • Identified 11 distinct criteria for defining the infant population and 8 different dose modification methods.
  • Proposed a new method using BSA dose banding for infants and children with BSA <0.6 m².
  • The new method transitions from weight-based to BSA-based dosing.

Conclusions:

  • Current infant dosing strategies for anticancer drugs are heterogeneous and may not be optimal.
  • The proposed BSA dose banding method offers a standardized and potentially safer approach to pediatric cancer drug dosing.

Keywords:
anticancer drugsbody surface areadoseinfants

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