Therapeutic Drug Monitoring of Pazopanib in Renal Cell Carcinoma and Soft Tissue Sarcoma: A Systematic Review

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Authors	TURJAP Miroslav PELCOVÁ Marta GREGOROVÁ Jana ŠMAK Pavel MARTIN Hiroko ŠTINGL Jan PEŠ Ondřej JUŘICA Jan
Year of publication	2024
Type	Article in Periodical
Magazine / Source	THERAPEUTIC DRUG MONITORING
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://journals.lww.com/drug-monitoring/abstract/2024/06000/therapeutic_drug_monitoring_of_pazopanib_in_renal.7.aspx
Doi	http://dx.doi.org/10.1097/FTD.0000000000001206
Keywords	pazopanib; renal cell carcinoma; soft tissue sarcoma; therapeutic drug monitoring; toxicity-adjusted dosing
Attached files	Therapeutic_Drug_Monitoring_of_Pazopanib_in_Renal_Cell_Carcinoma_and_Soft_Tissue_Sarcoma_A_Systematic_Review.pdf
Description	Background: Pazopanib, an anti-angiogenic multitarget tyrosine kinase inhibitor, has been approved for the treatment of metastatic renal cell carcinoma and soft tissue sarcoma. However, its recommended dose does not always produce consistent outcomes, with some patients experiencing adverse effects or toxicity. This variability is due to differences in the systemic exposure to pazopanib. This review aimed to establish whether sufficient evidence exists for the routine or selective therapeutic drug monitoring of pazopanib in adult patients with approved indications. Methods: A systematic search of the PubMed and Web of Science databases using search terms related to pazopanib and therapeutic drug monitoring yielded 186 and 275 articles, respectively. Ten articles associated with treatment outcomes or toxicity due to drug exposure were selected for review. Results: The included studies were evaluated to determine the significance of the relationship between drug exposure/Ctrough and treatment outcomes and between drug exposure and toxicity. A relationship between exposure and treatment outcomes was observed in 5 studies, whereas the trend was nonsignificant in 4 studies. A relationship between exposure and toxicity was observed in 6 studies, whereas 2 studies did not find a significant relationship; significance was not reported in 3 studies. Conclusions: Sufficient evidence supports the therapeutic drug monitoring of pazopanib in adult patients to improve its efficacy and/or safety in the approved indications.