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 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 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.
Shares Regimen and cycles, Neutropenia.
Shares Regimen and cycles, Peripheral neuropathy (chemotherapy-induced).