Pharmacokinetic and Pharmacodynamic Considerations in the Treatment of Chronic Lymphocytic Leukemia: Ibrutinib, Idelalisib, and Venetoclax
| Autor: | Allison M. Winter, Madeline Waldron, Brian T. Hill |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Chronic lymphocytic leukemia
Antineoplastic Agents Pharmacology 030226 pharmacology & pharmacy 03 medical and health sciences chemistry.chemical_compound Food-Drug Interactions 0302 clinical medicine Pharmacotherapy Piperidines medicine Humans Pharmacology (medical) Drug Interactions Adverse effect Quinazolinones Sulfonamides Venetoclax business.industry Adenine medicine.disease Bridged Bicyclo Compounds Heterocyclic Leukemia Lymphocytic Chronic B-Cell Tumor lysis syndrome Leukemia Pyrimidines chemistry Purines 030220 oncology & carcinogenesis Ibrutinib Pyrazoles business Idelalisib |
| Zdroj: | Clinical pharmacokinetics. 56(11) |
| ISSN: | 1179-1926 |
| Popis: | Management of chronic lymphocytic leukemia has changed markedly over the last several years with the emergence of several novel oral agents targeting B-cell receptor and Bcl-2 signaling pathways. For patients requiring treatment, ibrutinib, idelalisib, and venetoclax offer unique clinical benefits with a different set of therapeutic considerations compared with traditional parenteral therapy. Despite the conveniences afforded by oral therapy, these agents also carry unique logistical obstacles. Drug interactions with agents that are metabolized via the cytochrome P450 3A4 pathway are possible with all three agents. Unique treatment-related adverse events including bleeding and atrial fibrillation with ibrutinib, hepatotoxicity with idelalisib, and tumor lysis syndrome with venetoclax can be severe and dose limiting. Furthermore, dose adjustments for organ dysfunction may also be warranted. Here, we review the available literature on the pharmacokinetic and pharmacodynamic properties of these novel agents to guide the reader in the appropriate use of ibrutinib, idelalisib, and venetoclax. |
| Databáze: | OpenAIRE |
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