Correct drug dosing of anticancer agents is essential to obtain optimal outcomes. Overdosing will result in increased toxicity, treatment interruption and possible cessation of anticancer treatment. Underdosing may result in suboptimal anti-cancer effects and may increase the risk of cancer-related mortality. As it is practical nor feasible to perform therapeutic drug monitoring for all anti-cancer drugs, kidney function is used to guide drug dosing for those drugs whose primary mode of excretion is through the kidney. However, it is not well-established what method should be utilized to measure or estimate kidney function and the choice of method does influence treatment decisions regarding eligibility for anti-cancer drugs and their dose. In this review, we will provide an overview regarding the importance of drug dosing, the preferred method to determine kidney function and a practical approach to drug dosing of anticancer drugs.

Department of Microbiology Immunology and Transplantation Laboratory of Molecular Immunology Rega Institute for Medical Research KU Leuven and Division of Nephrology University Hospitals Leuven Both in Leuven Belgium

Department of Nephrology Dialysis and Internal Medicine Warsaw Medical University Warsaw Poland

Department of Oncology 1st Faculty of Medicine Charles University and General University Hospital Prague Czech Republic

Division of Nephrology University of Virginia Health System Charlottesville VA USA

eviQ Cancer Institute NSW Alexandria NSW Australia

Section of Hematology Oncology University of Chicago IL USA

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