surveillance thérapeutique; drogue anticancéreuse; phamacocinétique; drug monitoring; cancer chemotherapy; pharmacokinetic
Abstract :
[fr] Les doses de médicaments utilisés dans les traitements anticancéreux se calculent le plus souvent à l'aide de critères cliniques, parfois en utilisant des abaques fournissant la posologie en fonction de la surface corporelle mais rarement en tenant compte des paramètres pharmacocinétiques classiques, comme on le fait habituellement pour optimaliser le traitement avec d'autres classes pharmacologiques (antibiotiques, antiépileptiques,…). Parce que l'intervalle thérapeutique est faible et que d'importantes variations intra- et interindividuelles des caractéristiques pharmacocinétiques existent, les médicaments anticancéreux constituent pourtant une classe pharmacologique dont la posologie devrait être définie par un contrôle thérapeutique classique.
Bien entendu, la détermination du taux plasmatique des anticancéreux ne suffit pas toujours à prédire leur efficacité pharmacologique et leur toxicité. Pour y parvenir, il est nécessaire de recourir à la détermination de la surface sous la courbe (AUC) obtenue à partir de plusieurs concentrations sanguines mesurées à distance du moment d'administration. [en] Drug monitoring of anticancer chemotherapies.Drug doses used in anticancer treatments are mostly calculated by the use of clinical criteria, sometimes by using nomograms providing a posology based on the body surface area (BSA) but rarely by taking into account classical pharmacokinetic parameters, as usually for optimizing the treatment with other pharmaceutical classes of drugs (antibiotics, antiepileptics,…). Because the narrow therapeutic index and important intra- and interindividual variations of the pharmacokinetic parameters, anticancer drugs could constitute a pharmacological class for which the posology could be defined by a classical therapeutic drug monitoring.
Of course, the determination of the plasmatic level of anticancer drug does not always permit to predict their pharmacological efficacy and toxicity. To reach it, it is necessary to calculate the area under the curve obtained on base of several blood concentrations.
Disciplines :
Oncology Pharmacy, pharmacology & toxicology
Author, co-author :
Gougnard, Th
Charlier, Corinne ; Université de Liège - ULiège > Département de pharmacie > Chimie toxicologique
Plomteux, Guy ; Université de Liège - ULiège > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine)
Language :
French
Title :
Surveillance thérapeutique des traitements anticancéreux
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