Clinical Pharmacology In Pediatrics

Pediatric cancer patients differ from adults both in the spectra of their malignancies and in their response to drugs. Our knowledge of the developmental pharmacology of anticancer drugs has increased, and yet we often do not have sufficient understanding to optimally treat pediatric cancer patients, particularly infants and young children. Well-designed clinical pharmacology studies in this group of patients are necessary for the development of novel dosing strategies tailored to children of different ages. The first section of this chapter reviews the basic principles of drug absorption, distribution, metabolism, and elimination in infants, children, and adolescents. Subsequent sections address the appropriate methods to select drug dosages in children, practical issues associated with clinical pharmacokinetic studies in children with cancer, and the pharmacokinetics of specific anticancer drugs in children. We then review the pharmacokinetics of selected anticancer drugs used in children with cancer.