现实生活中的人群比前瞻性临床研究中的人群更具异质性。在癌症患者中，合并症和联合用药有利于出现严重的不良反应，从而显着影响生活质量和治疗效果。大多数酪氨酸激酶抑制剂 (TKI) 都是采用固定口服剂量开发的，使患者面临因副作用而导致依从性差的风险。此外，遗传或生理因素、饮食差异以及药物间相互作用可能导致个体间差异，影响治疗结果并增加不良事件的风险。了解不同的变异因素可以实现个性化的患者管理。本综述探讨了依从性、食物摄入和药物剂型对口服 TKI 药代动力学的影响，并评估了改善 TKI 管理的药代动力学考虑因素。提供了所选 TKI 的浓度-有效性和浓度-毒性数据，并概述了一个简单的治疗药物监测方案，以帮助个体化口服 TKI 剂量。版权所有 © 2024。由 Elsevier B.V 出版。

Real-life populations are more heterogeneous than those included in prospective clinical studies. In cancer patients, comorbidities and co-medications favor the appearance of severe adverse effects which can significantly impact quality of life and treatment effectiveness. Most of tyrosine kinase inhibitors (TKI) have been developed with flat oral dosing exposing patients to the risk of poor adherence due to side effects. Additionally, genetic or physiological factors, differences in diet, and drug-drug interactions can lead to inter-individual variability affecting treatment outcomes and increasing the risk of adverse events. Knowledge of the different factors of variability allows individualized patient management. This review examines the effects of adherence, food intake, and pharmaceutical form on the pharmacokinetics of oral TKI, as well as evaluating pharmacokinetics considerations improving TKI management. Concentration-effectiveness and concentration-toxicity data are presented for the selected TKI, and a simple therapeutic drug monitoring schema is outlined to help individualize dosing of oral TKI.Copyright © 2024. Published by Elsevier B.V.