Journal ArticleDOI
Chemotherapy dosing in overweight and obese patients with cancer.
Gary H. Lyman,Alex Sparreboom +1 more
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TLDR
Pharmacokinetic studies support the use of actual body weight to calculate chemotherapy doses for most chemotherapy drugs in obese patients, and recommend that, after considering any accompanying comorbidities, chemotherapy dosing should be calculated based on body surface area using actual weight, rather than an estimate or idealization of weight.Abstract:
Retrospective and prospective preclinical and clinical data have demonstrated an association between chemotherapy dose intensity and both clinical efficacy and toxicity. The optimum tolerable and effective dose and schedule of chemotherapeutic agents is based on data from dose-finding studies and early clinical trials. There is considerable evidence that reductions in the recommended dose intensity often occurs in actual clinical practice, particularly among overweight and obese patients with cancer. With increasing rates of obesity, and variation and uncertainty about appropriate dosing of chemotherapy in obese patients, ASCO has generated clinical practice guidelines for appropriate chemotherapy dosing for obese adult patients with cancer. Without evidence of any increase in treatment-related toxicity among obese patients receiving chemotherapy, the guidelines recommend that, after considering any accompanying comorbidities, chemotherapy dosing should be calculated based on body surface area using actual weight, rather than an estimate or idealization of weight. While further research is needed, pharmacokinetic studies support the use of actual body weight to calculate chemotherapy doses for most chemotherapy drugs in obese patients. We highlight the issue of chemotherapy dosing in this population, how a more personalized approach can be achieved, as well as discussing areas for further research.read more
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Insulin-like growth factor (IGF) signaling in tumorigenesis and the development of cancer drug resistance.
Sahitya K. Denduluri,Olumuyiwa Idowu,Zhongliang Wang,Zhan Liao,Zhengjian Yan,Maryam K. Mohammed,Jixing Ye,Qiang Wei,Jing Jing Wang,Lianggong Zhao,Hue H. Luu +10 more
TL;DR: This review summarizes and synthesizes numerous recent investigations looking at the role of the IGF pathway in drug resistance, and hopes that such a compilation of evidence will compel investigators to carry out much needed studies looking at combination treatment with IGF signaling modulators to overcome current therapy resistance.
Journal ArticleDOI
Obesity and Breast Cancer Prognosis: Evidence, Challenges, and Opportunities
TL;DR: Obesity is associated with inferior survival in breast cancer and weight loss and lifestyle interventions, as well as metformin and other obesity-targeted therapies, are promising avenues that require further study.
Journal ArticleDOI
Risk factors for febrile neutropenia among patients with cancer receiving chemotherapy: A systematic review.
TL;DR: A systematic review of the literature was performed to gain a comprehensive and updated understanding of FN risk factors and found older age, poor performance status, advanced disease, certain comorbidities, low baseline blood cell counts, low body surface area/body mass index, treatment with myelosuppressive chemotherapies, and specific genetic polymorphisms correlated with the risk of developing FN.
Journal ArticleDOI
Obesity and cancer pathogenesis
TL;DR: The relationship between type 2 diabetes mellitus and cancer, lessons learned from the use of murine models to study the association, the impact of obesity on pancreatic cancer, the effects of dietary fats and cholesterol on cancer promotion, and the mechanisms by which the intestinal microbiome affects obesity and cancer are reviewed.
Journal ArticleDOI
Irinotecan, a key chemotherapeutic drug for metastatic colorectal cancer.
TL;DR: This review discusses the optimal dosing of irinotecan based on the aforementioned factors affecting systemic exposure to SN-38, with the ultimate goal of achieving personalized irinOTecan-based chemotherapy.
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Journal ArticleDOI
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TL;DR: The 10-year and 15-year effects of various systemic adjuvant therapies on breast cancer recurrence and survival are reported and it is found that the cumulative reduction in mortality is more than twice as big at 15 years as at 5 years after diagnosis.
Journal ArticleDOI
Dose translation from animal to human studies revisited
TL;DR: BSA correlates well across several mammalian species with several parameters of biology, including oxygen utilization, caloric expenditure, basal metabolism, blood volume, circulating plasma proteins, and renal function, and is advocated as a factor when converting a dose for translation from animals to humans.