From the Research
Introduction to Febuxostat in Cancer Patients
Febuxostat, a xanthine oxidase inhibitor, is used to control serum uric acid (sUA) levels in patients with cancer and hyperuricemia, particularly those at risk of tumor lysis syndrome (TLS) [ 1, 2,3,4,5 ].
Indications for Febuxostat Initiation
Febuxostat can be initiated in patients with cancer and hyperuricemia who are at intermediate to high risk of TLS, particularly those receiving chemotherapy [ 1, 2 ].
- Patients with hematologic malignancies, such as leukemia or lymphoma, may benefit from febuxostat initiation 3, 4
- Those with solid tumors may also be considered for febuxostat therapy, especially if they have a high risk of TLS 1
Timing of Febuxostat Initiation
Febuxostat can be started 24-48 hours before chemotherapy initiation 1, 3, 4
- The goal is to reduce sUA levels before chemotherapy-induced TLS occurs
- Early initiation of febuxostat may help prevent TLS and its associated complications
Dosage and Administration
The recommended dosage of febuxostat varies, but common doses include:
- 60 mg/day 1
- 40-60 mg/day, depending on renal function 4
- 120 mg/day, as a fixed dose 2
- Treatment duration is typically 7-9 days, but may vary depending on the patient's risk of TLS and chemotherapy regimen 1, 2
Efficacy and Safety
Febuxostat has been shown to be effective in reducing sUA levels and preventing TLS in patients with cancer 1, 2, 3, 4, 5
- The medication has a similar safety profile to allopurinol, with common adverse effects including elevation of liver function tests 5
- Febuxostat may be a useful alternative to allopurinol in patients who are intolerant or have contraindications to allopurinol 5
Caveats and Considerations
- Patients with renal impairment may require dose adjustments 4
- Monitoring of sUA levels, renal function, and liver function tests is recommended during febuxostat therapy 1, 2, 3, 4, 5
- Further studies are needed to define the optimal dosage and safety profile of febuxostat in patients with cancer and hyperuricemia 5