Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 May 4;2023(61):3-11.
doi: 10.1093/jncimonographs/lgad010.

Pharmacokinetics of cancer therapeutics and energy balance: the role of diet intake, energy expenditure, and body composition

Sarah A Purcell  1   2 , Dieuwertje E Kok  3 , Tyler Ketterl  4   5 , Miriam B Garcia  6 , Lenat Joffe  7 , Justin C Brown  8 , Christina M Dieli-Conwright  9   10 , Grant R Williams  11
Affiliations
Review

Pharmacokinetics of cancer therapeutics and energy balance: the role of diet intake, energy expenditure, and body composition

Sarah A Purcell et al. J Natl Cancer Inst Monogr. .

Abstract

Energy balance accounts for an individual's energy intake, expenditure, and storage. Each aspect of energy balance has implications for the pharmacokinetics of cancer treatments and may impact an individual's drug exposure and subsequently its tolerance and efficacy. However, the integrated effects of diet, physical activity, and body composition on drug absorption, metabolism, distribution, and excretion are not yet fully understood. This review examines the existing literature on energy balance, specifically the role of dietary intake and nutritional status, physical activity and energy expenditure, and body composition on the pharmacokinetics of cancer therapeutics. As energy balance and pharmacokinetic factors can be influenced by age-related states of metabolism and comorbidities, this review also explores the age-related impact of body composition and physiologic changes on pharmacokinetics among pediatric and older adult populations with cancer.

PubMed Disclaimer

Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Impact of energy balance on pharmacokinetics of cancer therapeutics.
Figure 2.
Figure 2.
Relationship between total short-form Patient-generated Subjective Global Assessment (PG-SGA) score and volume of distribution (A) and clearance (B) of oxaliplatin. Participants were n = 25 patients with gastrointestinal cancer (n = 12 colon, n = 7 pancreatic, n = 3 esophageal, n = 1 appendix, n = 1 rectal), with a median age of 69 years and predominantly male (68%).
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Fuchs HE, et al.Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7-33. - PubMed
    1. Williams GR, Al-Obaidi M, Rower J, et al.Does oxaliplatin pharmacokinetics (PKs) explain associations between body composition and chemotherapy toxicity risk in older adults with gastrointestinal (GI) cancers? J Clin Oncol. 2021;39(suppl 15):3095.
    1. Williams GR, Outlaw D, Harvey RD, Lichtman SM, Zamboni WC, Giri S.. Chemotherapy dosing in older adults with cancer: One size does NOT fit all. J Geriatr Oncol. 2023;14(1):101363. - PubMed
    1. Brown JC, Cespedes Feliciano EM, Caan BJ.. The evolution of body composition in oncology-epidemiology, clinical trials, and the future of patient care: facts and numbers. J Cachexia Sarcopenia Muscle. 2018;9(7):1200-1208. - PMC - PubMed
    1. Shachar SS, Williams GR, Muss HB, et al.Prognostic value of sarcopenia in adults with solid tumours: a meta-analysis and systematic review. Eur J Cancer. 2016;57:58-67. - PubMed

Publication types