Chemotherapy in patients with organ dysfunction

Abstract

Clinical studies of chemotherapy, or other antineoplastic therapies, are usually conducted in physiologically otherwise normal patients with cancer. As a result, limited information is typically available about the optimal dosage and schedule of chemotherapy for patients with organ dysfunction and the impact of chemotherapy in such patients. This is a potentially important problem, because most chemotherapies, as with other pharmacologic agents, are metabolized by the liver or kidney. Over the past decade, a concerted effort has been made to focus on chemotherapy in this patient population. The new generation of biologic therapies may not possess this difficulty, as the monoclonal antibodies that, to date, comprise the most successful of these agents are metabolized by the reticuloendothelial system and may not require these modifications. However, these concerns regarding the appropriate administration of antineoplastic agents will persist with the new small molecule inhibitors, including tyrosine kinase inhibitors, which also may require individual evaluation in patients with organ dysfunction. © 2006 Springer Science+Business Media, Inc.