Most anticancer agents exhibit a narrow therapeutic index, i.e., a small change in plasma\nconcentrations can lead to a less efficacious treatment or an unacceptable degree of toxicity. This study\naimed at providing health professionals with a feasible and time-saving tool to adapt the dose of\nanticancer agents for patients with renal or hepatic dysfunction. A guideline for anticancer agents\nwas developed based on a literature search. An algorithm was generated to enhance the efficiency\nof the dose adaptation process. Finally, the dosing guideline was converted into an easy-to-use\nExcelTM tool. The concept was applied to a total of 105 adult patients at the Centre for Integrated\nOncology, Bonn, Germany. In total, 392 recommendations for dose adaptation were made and\n320 (81.6%) recommendations were responded to by the oncologists. 98.4% of the recommendations\nwere accepted. The algorithm simplifies the decision and screening process for high-risk patients.\nMoreover, it provides the possibility to quickly decide which laboratory tests are required and\nwhether a dose adjustment for a particular anticancer drug is needed. The ExcelTM tool provides\na recommended individual dose for patients with renal or hepatic dysfunction. The effectiveness\nof this strategy to reduce toxicity should be investigated in further studies before being adopted for\nroutine use.
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