biostudies-literatureNijstad ALCancer Research UKNational Institute for Health Research (NIHR)137-154https://www.ebi.ac.uk/biostudies/studies/S-EPMC8914347biostudies-literatureUnknown164Cancer in neonates and infants is a rare but challenging entity. Treatment is complicated by marked physiological changes during the first year of life, excess rates of toxicity, mortality, and late effects. Dose optimisation of chemotherapeutics may be an important step to improving outcomes. Body size-based dosing is used for most anticancer drugs used in infants. However, dose regimens are generally not evidence based, and dosing strategies are frequently inconsistent between tumour types and treatment protocols. In this review, we collate available pharmacological evidence supporting dosing regimens in infants for a wide range of cytotoxic drugs. A systematic review was conducted, and available data ranked by a level of evidence (1-5) and a grade of recommendation (A-D) provided on a cEuropean journal of cancer (Oxford, England : 1990)Clinical pharmacology of cytotoxic drugs in neonates and infants: Providing evidence-based dosing guidance.PMC8914347PB-PG-1216-20032C9380/A25138C9380/A25169Veal GJParke ETweddle DAZwaan CMLalmohamed ABerenos IMHuitema ADRNijstad ALBarnett SKong JCarruthers VfalseClinical pharmacology of cytotoxic drugs in neonates and infants: Providing evidence-based dosing guidance.Cancer in neonates and infants is a rare but challenging entity. Treatment is complicated by marked physiological changes during the first year of life, excess rates of toxicity, mortality, and late effects. Dose optimisation of chemotherapeutics may be an important step to improving outcomes. Body size-based dosing is used for most anticancer drugs used in infants. However, dose regimens are generally not evidence based, and dosing strategies are frequently inconsistent between tumour types and treatment protocols. In this review, we collate available pharmacological evidence supporting dosing regimens in infants for a wide range of cytotoxic drugs. A systematic review was conducted, and available data ranked by a level of evidence (1-5) and a grade of recommendation (A-D) provided on a c2022-01-01T00:00:00Z2022 Mar2025-04-29T11:00:14.185Z2025-04-06T19:50:07.369ZS-EPMC89143473486594510.1016/j.ejca.2021.11.001