phgenomicsФармакогенетика и фармакогеномикаPharmacogenetics and Pharmacogenomics2588-05272686-8849LLC "Izdatelstvo OKI"phgenomics-163Research ArticleАКТУАЛЬНЫЕ ОБЗОРЫCURRENT REVIEWПерспективы разработки фармакогенетических и фармакокинетических подходов к персонализации применения таргетных препаратов при хроническом миелолейкозеThe perspectives of development for pharmacogenetic and pharmacokinetic approaches to personalized use of target therapy in chronic myeloid leukemiaСавельеваМ. И.SavelyevaM. I.

Савельева Марина Ивановна — д.м.н., профессор кафедры клинической фармакологии и терапии, ведущий научный сотрудник группы клинико-фармакологических технологий НИЦ.

г. Москва

Moscow

marinasavelyeva@mail.ruГБОУ ДПО «Российская медицинская академия последипломного образования» Минздрава РоссииРоссияRussian Medical Academy of Postgraduate StudyRussian Federation20162503202001912Copyright © Савельева М.И., 20202020Савельева М.И.Savelyeva M.I.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.pharmacogenetics-pharmacogenomics.ru/jour/article/view/163

Цель терапии хронического миелолейкоза (ХМЛ) на современном этапе — достижение цитогенетических и молекулярных ремиссий. Основная проблема, возникающая в процессе терапии ХМЛ — развитие фармакологической резистентности при применении ингибиторов тирозинкиназ (ИТК). Пероральный приём обуславливает целый комплекс последовательных фармакокинетических процессов, влияющих на судьбу ИТК в организме пациента. Очень выраженная индивидуальная фармакокинетическая вариабельность ИТК и вариабельность в ответе на терапию обуславливаются не только генетической гетерогенностью мишеней для действия лекарств, но также фармакогенетическими характеристиками пациента, приверженностью пациента к лечению и влиянием межлекарственных взаимодействий. Поэтому выбор лечения онкологических пациентов требует тщательного мониторинга новых видов таргетной терапии и развития инновационных (фармакогенетических и фармакокинетических) подходов к индивиуализации лечения.

The objective of chronic myeloid leukemia therapy today is the achievement of cytogenetic and molecular remissions. The main problem of the CML therapy is the development of pharmacological resistance on tyrosine kinase inhibitors (TKI). Oraladministration generates a complex step in the pharmacokinetics (PK) of these drugs. Interindividual PK variability is often large and variability observed in response is influencednot only by the genetic heterogeneity of drug targets, but also by the pharmacogenetic backgroundof the patient (e.g. cytochome P450 and ABC transporter polymorphisms), patient characteristics such as adherence to treatment and environmental factors (drug—drug interactions).The appropriate management of oncology patients thus requires careful monitoring of newer targeted therapies and the development of innovative pharmacokinetic and pharmacogenetic approaches to treatment individualization.

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The authors declare that there are no conflicts of interest present.