Comparative efficacy and safety of pharmacokinetically guided and body surface area-based 5-fluorouracil dosing in colorectal cancer: a systematic review and meta-analysis.
Maryam Saqib, Wajahat Mirza, Syeda Tahira Zaidi et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy and safety of pharmacokinetically guided versus body surface area (BSA)-based dosing of 5-fluorouracil (5-FU) in colorectal cancer. Analyzing five studies with 809 patients, the results indicated that PK-guided dosing significantly reduced severe toxicity (RR 0.50) and improved objective response rates (RR 1.50) compared to BSA-based dosing.
Key findings
- PK-guided dosing reduced severe or grade ≥3 toxicity (RR 0.50, 95% CI 0.33-0.76; P=0.001).
- Objective response rate was higher with PK-guided dosing (RR 1.50, 95% CI 1.24-1.80; P<0.0001).
- Disease control rate improved with PK-guided dosing (RR 1.18, 95% CI 1.07-1.30; P=0.001).
- Severe diarrhea was reduced with PK-guided dosing (RR 0.33, 95% CI 0.18-0.62; P=0.0006).
Why it matters
The findings suggest that pharmacokinetically guided dosing of 5-FU may enhance treatment outcomes and reduce severe side effects in colorectal cancer patients, potentially leading to better management strategies in clinical practice.
What to keep in mind
The evidence was derived from a small and clinically heterogeneous group of studies, limiting generalizability.