Publications by authors named "Eduard Schmulenson"
Background: The body composition of patients has been associated with tolerability and effectiveness of anticancer therapy. This study aimed to assess the influence of the skeletal muscle index (SMI) on the pharmacokinetics and toxicity of fluorouracil.
Methods: Patients treated in an oncological practice with fluorouracil-based chemotherapy and undergoing therapeutic drug monitoring were retrospectively investigated.
Article Synopsis
- The study aimed to improve treatment for locally advanced rectal cancer (LARC), where one-third of patients unfortunately die from the disease, by testing if adding regorafenib to existing neoadjuvant chemo-radiotherapy with capecitabine gives better outcomes.
- Researchers treated patients with different doses of regorafenib and analyzed the effects on drug interactions and absorption using population pharmacokinetic models to evaluate how these drugs and their metabolites behaved in the body.
- Findings indicated that regorafenib significantly reduced capecitabine clearance, suggesting a notable drug-drug interaction, which is essential for future clinical developments of this combination treatment strategy.
Current status and future outlooks on therapeutic drug monitoring of fluorouracil.
Expert Opin Drug Metab Toxicol
December 2021
Introduction: Therapeutic drug monitoring (TDM) of the anticancer drug fluorouracil (5FU) as a method to support dose adjustments has been researched and discussed extensively. Despite manifold evidence of the advantages of 5FU-TDM, traditional body surface area (BSA)-guided dosing is still widely applied.
Areas Covered: This review covers the latest evidence on 5FU-TDM based on a literature search in PubMed between June and September 2021.
Exposure-efficacy and/or exposure-toxicity relationships have been identified for up to 80% of oral anticancer drugs (OADs). Usually, OADs are administered at fixed doses despite their high interindividual pharmacokinetic variability resulting in large differences in drug exposure. Consequently, a substantial proportion of patients receive a suboptimal dose.
View Article and Find Full Text PDFPurpose: The inclusion of the patient's perspective has become increasingly important when reporting adverse events and may assist in management of toxicity. The relationship between drug exposure and toxicity can be quantified by combining Markov elements with pharmacometric models. A minimal continuous-time Markov model (mCTMM) was applied to patient-reported outcomes using hand-foot syndrome (HFS) induced by capecitabine anti-cancer therapy as an example.
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