Overview of the changing paradigm in cancer treatment: Oral chemotherapy
Overview of the changing paradigm in cancer treatment: Oral chemotherapy
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DOI：
10.2146/ajhp070035
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发表时间：
2007-05-01
影响因子：
2.7
通讯作者：
Aisner, Joseph
中科院分区：
文献类型：
--
作者：
Aisner, Joseph
目的.最近引进了几种新的口服化疗药物。许多药物具有新的作用机制和特定靶点，导致与传统化疗和激素治疗相关的不良反应特征不同。口服化疗的潜在优势和挑战进行了讨论。口服途径的使用是方便的，并且允许在家或在非传统环境中进行给药。然而，恶心、吞咽困难、患者不依从、与药物和食物的相互作用、其他药代动力学因素以及治疗的高成本可能在通过口服途径使用这些药剂时存在问题。临床医生对口服化疗潜在问题的认识有助于避免或减少可能影响患者预后的问题。虽然生物利用度研究通常是开发口服制剂的一个组成部分，但其与胃肠外制剂的比较记录较少。然而，比较静脉注射5-氟尿嘧啶（5-FU）与口服5-FU前药的研究表明，口服治疗的疗效、安全性和生活质量不会受到影响。最后，这些研究以及其他研究表明，患者更喜欢口服给药途径。
Purpose. Several new oral chemotherapeutic agents have recently been introduced. Many possess novel mechanisms of action and specific targets that result in different adverse effect profiles from those associated with traditional chemotherapies and hormonal therapies. The potential advantages and challenges associated with oral chemotherapy are discussed.Summary. Use of the oral route is convenient and allows administration to take place at home or in non-traditional settings. However, nausea, difficulty swallowing, patient nonadherence, interactions with drugs and food, other pharmacokinetic factors, and the high cost of treatment can present problems in using these agents by the oral route. Awareness by clinicians of the potential problems with oral chemotherapy can help to avoid or minimize problems that might affect patient outcomes.Conclusion. While bioavailability studies are often an integral part of developing oral agents, their comparisons with parenteral forms are less well documented. However, studies comparing intravenous 5-fluorouracil (5-FU) with oral 5-FU prodrugs have demonstrated that efficacy, safety, and quality of life are not compromised by the use of oral therapy. Finally, these studies, as well as others, reveal patients prefer the oral route of administration.