Clinical Pharmacology of Anti-Cancer Drugs

Abstract

The pharmacological principles determining the effectiveness of drugs in the treatment of malignant and non-malignant diseases are similar. Thus, drug absorption, binding, distribution, metabolism and excretion determine the concentration of drug at the target site and the duration and intensity of action. However, with anti-cancer drugs, there are frequently extra factors, not commonly encountered with other drugs, which influence the efficacy of treatment. Such special factors are that many anti-cancer drugs:

• (a) have a very narrow therapeutic index, i.e. a narrow margin between effective dose and lethal dose;

• (b) are highly unstable;

• (c) are effective at very low concentrations; and

• (d) have unusual metabolic pathways.