OCULAR PHARMACOLOGY OF CHEMOTHERAPY FOR RETINOBLASTOMA

SCHAIQUEVICH, PAULA; FABIUS, ARMIDA W.; FRANCIS, JASMINE H.; CHANTADA, GUILLERMO L.; ABRAMSON, DAVID H.

RETINA

LIPPINCOTT WILLIAMS & WILKINS

Año: 2017 vol. 37 p. 1 - 10

0275-004X

PURPOSE: To review preclinical and clinical pharmacokinetic studies of the three most important chemotherapy drugs used for intraocular retinoblastoma and thecontribution of the reported results to optimize treatment.METHODS: Systemic review of pharmacokinetic studies identified by a literaturesearch at Pubmed using the keywords carboplatin, melphalan, topotecan,intravitreal, ophthalmic artery chemosurgery, pharmacokinetics, andretinoblastoma.RESULTS: A total of 21 studies were reviewed for assessing the preclinical andclinical pharmacokinetics of carboplatin, topotecan, and melphalan delivered byintravenous, periocular, ophthalmic artery, and intravitreal routes. Somepreclinical studies were done before translation to the clinics. Others, despite encouraging preclinical data as reported for periocular topotecan did notcorrelate with clinical use. In addition, as was the case for melphalan afterophthalmic artery chemosurgery and despite nonfavorable preclinical information, some routes of drug delivery are clinically effective. Besides topotecan,complete knowledge of the pharmacokinetics of melphalan and carboplatin is still lacking.CONCLUSION: Pharmacokinetic knowledge of chemotherapy may aid to guideretinoblastoma treatment in favor of safety and efficacy. Nonetheless, resultsobtained in preclinical models should be translated with care to the clinics.