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Introduction to the ESMO Handbook on Clinical Pharmacology of Anti-Cancer Agents

Clinical pharmacology is the science of drugs and their clinical use. It should connect the gap between medical practise and laboratory science.

Traditionally, medical oncologists have been skilled and deeply trained in this field, as the drugs they were using had a narrow therapeutic window, making it difficult to gamble between activity and toxicity. In the past, this task was simplified by the fact that the majority of anti-cancer agents were DNA-disrupting agents and had a similar toxicity profile despite different pharmacokinetics. Things became more complicated in the last two decades with the progressive appearance of drugs with completely different mechanisms of action: monoclonal antibodies, anti-angiogenic drugs, drugs targeting tyrosine kinases or intracellular pathways, or even other mechanisms involved in cell functioning such as the proteasome. A whole new spectrum of possible side effects, drug interactions, schedules, and combinations appeared.

We therefore considered it timely to produce a book and website section in which all of the important information is included, in a synthetic manner, to allow clinicians to make quick decisions on how to administer drugs to their cancer patients.

This section is small and informative, edited in such a way that it can be carried around and is easily available, and it contains the essential information: only anti-cancer agents are covered (supportive drugs such as antiemetics, growth factors, antibiotics, and so on have been excluded), divided into chapters according to their mechanism of action. Each chapter has a short introduction which is followed by the most important section: the tables summarising the pharmacological characteristics of each drug.

This handbook opens a new season in the strategy of the ESMO Publishing Working Group. We intend in the next years to edit a total of nine books (which will be called “Essentials for Clinicians”) covering the management of the most common tumours divided by organ of origin, while the general oncology topics will continue to be covered in the annual handbooks. These will be prepared in such a way that the two series will be complementary and will cover all the important domains of oncology for which practising physicians and juniors preparing their exams will need to have knowledge.

In the name of the ESMO Publishing Working Group, I want to thank all the authors, the editors, and particularly Cristiana Sessa, who has spent a lot of time and energy making this book and section a reality and a tool which is at once concise, useful, and precise.

Professor Michele Ghielmini
Oncology Institute of Southern Switzerland
Chairman of the ESMO Publishing Working Group

Chapter 1 - Preclinical Drug Development

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