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

Ther Drug Monit. 2024 Jun 1;46(3):321-331. doi: 10.1097/FTD.0000000000001206. Epub 2024 Apr 30.

Abstract

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.

Publication types

  • Systematic Review

MeSH terms

  • Angiogenesis Inhibitors* / pharmacokinetics
  • Angiogenesis Inhibitors* / therapeutic use
  • Carcinoma, Renal Cell* / drug therapy
  • Drug Monitoring* / methods
  • Humans
  • Indazoles* / therapeutic use
  • Kidney Neoplasms* / drug therapy
  • Pyrimidines* / pharmacokinetics
  • Pyrimidines* / therapeutic use
  • Sarcoma* / drug therapy
  • Sulfonamides* / pharmacokinetics
  • Sulfonamides* / therapeutic use

Substances

  • pazopanib
  • Indazoles
  • Sulfonamides
  • Pyrimidines
  • Angiogenesis Inhibitors