Evaluación de la relación exposición-respuesta de bevacizumab y de cetuximab en cáncer colorrectal metastásico y de cetuximab en cáncer de cabeza y cuello

Résumé

Dosing of mAbs is often based on body surface area or weight, because of the general perception that dosing based on patients’ body size reduces inter-subject variability in distribution and elimination. However, this has recently been challenged. Furthermore, it is suggested that the current dos-ing of cancer mAbs may not be optimal from an efficacy-cost perspective. This is explained, considering no impact in efficacy, when dose reductions would sub-stantially decrease the cost of treatment or in patients with very high drug con-centrations. Moreover, in oncology dose modifications are usually reductions due to toxicity, but rarely is the dose increased in the absence of efficacy or toxicity. Therapeutic drug monitoring (TDM) has the potential in oncology to opti-mize drug use in clinical practice. However, TDM in oncology is less developed than in other areas. Despite the fact that mAbs have many of the requisites for TDM there is a limited number of studies in oncology supporting TDM of mAbs. One of the reasons is the lack of a target concentration to be effective in each disease, information which is necessary for pharmacokinetic (PK)-pharmacody-namic studies...