Pharmacology and pharmacokinetics of imatinib in pediatric patients
Autor: | Frédéric Millot, Martin Bornhäuser, M Suttorp, Eberhard Schleyer, Markus Metzler |
---|---|
Rok vydání: | 2017 |
Předmět: |
0301 basic medicine
medicine.medical_specialty Adolescent medicine.drug_class Fusion Proteins bcr-abl Antineoplastic Agents Pharmacology Tyrosine-kinase inhibitor Medication Adherence Food-Drug Interactions 03 medical and health sciences 0302 clinical medicine Leukemia Myelogenous Chronic BCR-ABL Positive hemic and lymphatic diseases Internal medicine Animals Humans Medicine Pharmacology (medical) General Pharmacology Toxicology and Pharmaceutics Child Protein Kinase Inhibitors neoplasms Hematology Glycoprotein binding business.industry Myeloid leukemia Imatinib General Medicine 030104 developmental biology Imatinib mesylate 030220 oncology & carcinogenesis Imatinib Mesylate Trough level Drug Monitoring business Pharmacogenetics medicine.drug |
Zdroj: | Expert Review of Clinical Pharmacology. 11:219-231 |
ISSN: | 1751-2441 1751-2433 |
Popis: | The tyrosine kinase inhibitor (TKI) imatinib was rationally designed to target BCR-ABL1 which is constitutively activated in chronic myeloid leukemia (CML). Following the tremendous success in adults, imatinib also became licensed for treatment of CML in minors. The rarity of pediatric CML hampers the conduction of formal trials. Thus, imatinib is still the single TKI approved for CML treatment in childhood. Areas covered: This review attempts to provide an overview of the literature on pharmacology, pharmacokinetic, and pharmacogenetic of imatinib concerning pediatric CML treatment. Articles were identified through a PubMed search and by reviewing abstracts from relevant hematology congresses. Additional information was provided from the authors' libraries and expertise and from our own measurements of imatinib trough plasma levels in children. Pharmacokinetic variables (e.g. alpha 1-acid glycoprotein binding, drug-drug/food-drug interactions via cytochrome P450 3A4/5, cellular uptake mediated via OCT-1-influx variations and P-glycoprotein-mediated drug efflux) still await to be addressed in pediatric patients systematically. Expert commentary: TKI response rates vary among different individuals and pharmacokinetic variables all can influence CML treatment success. Adherence to imatinib intake may be the most prominent factor influencing treatment outcome in teenagers thus pointing towards the potential benefits of regular drug monitoring. |
Databáze: | OpenAIRE |
Externí odkaz: |