Loading
The everyday tools for living with side effects: pausing a drug until a problem settles (interruption), restarting at a lower dose (reduction), or stopping it for good (discontinuation). Between 30 and 60% of patients on oral targeted drugs need a reduction, so these rates are the clearest test of whether a dose was set right.
Labels specify dose modification rules by toxicity grade; in practice 30-60% of patients on oral targeted drugs need a reduction, and discontinuation for adverse events (typically 5-20% in trials, higher in real-world older populations) directly reduces benefit. Relative dose intensity below 85% is associated with worse outcomes for curative chemotherapy, whereas for targeted drugs lower doses often work as well (Project Optimus's rationale). Adherence to daily pills over years (endocrine therapy, imatinib) is a hidden determinant of efficacy. Trials report dose reductions and discontinuations alongside grade 3-4 events as the clearest summary of tolerability.
Shares CTCAE toxicity grading (grade 3-4 adverse events), Maximum tolerated dose (MTD), Therapeutic index (therapeutic window), Project Optimus.
Shares Fluorouracil dosing by measured blood level, Full weight-based chemotherapy dosing for people with obesity, Carboplatin dosing by kidney function: the Calvert formula and how kidney function is measured, CT body composition and sarcopenia measurement.
Shares Rash and skin toxicity (acneiform rash, paronychia), Hand-foot syndrome and hand-foot skin reaction, Peripheral neuropathy (chemotherapy-induced), Febrile neutropenia.
Shares Maximum tolerated dose (MTD), Pharmacokinetics (PK), half-life and exposure, Project Optimus.
Shares Hand-foot syndrome and hand-foot skin reaction, Peripheral neuropathy (chemotherapy-induced), Febrile neutropenia, Neutropenia.
Shares Fluorouracil dosing by measured blood level, Therapeutic index (therapeutic window), Pharmacokinetics (PK), half-life and exposure.
Shares Maximum tolerated dose (MTD), Pharmacokinetics (PK), half-life and exposure, Project Optimus.
Shares TPMT and NUDT15 genotyping before thiopurines, UGT1A1 genotyping before irinotecan, DPYD genotyping and DPD phenotyping before fluoropyrimidines.