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

Sarah A Purcell; Dieuwertje E Kok; Tyler Ketterl; Miriam B Garcia; Lenat Joffe; Justin C Brown; Christina M Dieli-Conwright; Grant R Williams

doi:10.1093/jncimonographs/lgad010

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

J Natl Cancer Inst Monogr. 2023 May 4;2023(61):3-11. doi: 10.1093/jncimonographs/lgad010.

Authors

Sarah A Purcell^{1

2}, Dieuwertje E Kok³, Tyler Ketterl^{4

5}, Miriam B Garcia⁶, Lenat Joffe⁷, Justin C Brown⁸, Christina M Dieli-Conwright^{9

10}, Grant R Williams¹¹

Affiliations

¹ Department of Medicine, Division of Endocrinology, University of British Columbia, Vancouver, Canada.
² Irving K. Barber Faculty of Science, Department of Biology, University of British Columbia Okanagan, Kelowna, Canada.
³ Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, the Netherlands.
⁴ Division of Pediatric Hematology/Oncology and Bone Marrow Transplant, Department of Pediatrics, University of Washington, Seattle, WA, USA.
⁵ Cancer and Blood Disorders Center, Seattle Children's Hospital, Seattle, WA, USA.
⁶ Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
⁷ Division of Pediatric Hematology, Oncology, and Stem Cell Transplantation, Cohen Children's Medical Center, Donald and Barbara Zucker School of Medicine at Hofstra, Northwell Health, New Hyde Park, NY, USA.
⁸ Pennington Biomedical Research Center, Baton Rouge, LA, USA.
⁹ Division of Population Sciences, Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
¹⁰ Harvard Medical School, Boston, MA, USA.
¹¹ Institute for Cancer Outcomes and Survivorship, Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.

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.

Publication types

Review
Research Support, N.I.H., Extramural

MeSH terms

Aged
Body Composition
Child
Diet
Eating*
Energy Intake
Energy Metabolism
Humans
Neoplasms* / drug therapy

Grants and funding

R25CA203650/CA/NCI NIH HHS/United States