Infant Chemotherapy Dosing Guidance

Pharmacological evidence based dosing guidance for the treatment of neonates and infants

The treatment of cancer in neonates and infants is complicated by marked physiological changes during the first year of life. Optimal dosing in this population is uncertain as dose regimens are commonly not evidence based and dosing strategies are frequently inconsistent between tumour types and treatment protocols. As part of a recent review published in the European Journal of Cancer, we have collated available published pharmacological evidence supporting dosing regimens in neonates and infants for a wide range of cytotoxic drugs.

This systematic review, a collaboration between Newcastle University and colleagues at the University Medical Center Utrecht and Princess Máxima Center for Pediatric Oncology, involved ranking the available data by a defined level of evidence (1-5). Evidence was awarded the highest level (Level 1) if population based pharmacokinetic modelling was conducted including infants in the population. The lowest level of evidence (Level 5) was awarded to findings derived from mechanism based reasoning or expert opinion. For further details on these evidence rankings please refer to the published article (Nijstad et al., Eur J Cancer 2022).