Adverse drug reactions impose a huge burden not only on the patient but also on the health-care system. With the narrow therapeutic index of most agents used to treat cancer and the marked heterogeneity observed across cancer patient populations, adverse drug reactions are a reality that must be dealt with. A better understanding of the clinical and genetic factors that influence the pharmacokinetic profile of a chemotherapeutic agent is needed to optimize drug-dosing regimens to obtain maximal efficacy with minimal toxicity. Moreover, promising advancements in the field of pharmacogenetics will enable the development of effective agents that will make their way to the clinic in a timely manner. With the remarkable rate of progress seen in the field of cancer therapeutics, the application of "personalized cancer chemotherapy" to routine clinical practice will be a reality in the not too distant future.


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