caa a22 4500 465752357 CHVBK 20180323111837.0 cr unu---uuuuu 170327e19900301xx s 000 0 eng 10.1007/BF01576271 doi (NATIONALLICENCE)springer-10.1007/BF01576271 Pharmacologic management of drug-resistant genitourinary tumors [Elektronische Daten] [Michael DeGregorio, Valerie Wiebe] Summary: The purpose of this article is to examine potentially useful treatment strategies for drug-resistant genitourinary (GU) tumors. To achieve the desired pharmacologic effect, adequate concentration vs time (C×T) drug kinetic profiles must be achieved at the target tissues. Inadequate C×T drug profiles can result from low vascular tissues, rapid drug metabolism, and insufficient dosing schedules. These factors may also contribute to the development of acquired drug resistance by enabling tumor cells to repair sublethal damage caused by cytotoxic drugs. Although the development of acquired drug resistance may represent a normal response to foreign agents and hence be inevitable in many tumors, dose-intensive regimens as first-line treatment may delay the clinical onset of resistance. Once acquired drug resistance does develop, several investigational treatment strategies aimed at biochemical mechanisms of resistance may further circumvent treatment failures. Finally, intrinsic drug resistance represents an additional problem in certain GU tumors, particularly renal cell carcinoma. In this case, dose-intensive treatment regimens that incorporate a chemosensitizing agent may prove to the useful as firstline therapy. Tumor-specific treatment regimens need to be developed based on many factors, including degree of intrinsic resistance, past chemotherapy, stage and site of disease, and patient tolerance to aggressive treatment regimens. Springer-Verlag, 1990 DeGregorio Michael Section of Medical Oncology, Department of Internal Medicine, School of Medicine, Yale University, 333 Cedar Street, P.O. Box 3333, 06510, New Haven, CT, USA aut Wiebe Valerie Section of Medical Oncology, Department of Internal Medicine, School of Medicine, Yale University, 333 Cedar Street, P.O. Box 3333, 06510, New Haven, CT, USA aut World Journal of Urology Springer-Verlag 8/1(1990-03-01), 6-12 0724-4983 8:1<6 1990 8 345 https://doi.org/10.1007/BF01576271 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01576271 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- DeGregorio Michael Section of Medical Oncology, Department of Internal Medicine, School of Medicine, Yale University, 333 Cedar Street, P.O. Box 3333, 06510, New Haven, CT, USA aut NATIONALLICENCE 700 1- Wiebe Valerie Section of Medical Oncology, Department of Internal Medicine, School of Medicine, Yale University, 333 Cedar Street, P.O. Box 3333, 06510, New Haven, CT, USA aut NATIONALLICENCE 773 0- World Journal of Urology Springer-Verlag 8/1(1990-03-01), 6-12 0724-4983 8:1<6 1990 8 345 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer