Neonatal and infant cancer is a rare but challenging condition. Significant physiological changes in the infant's first year, elevated rates of toxicity, mortality, and late effects complicate treatment. Portion improvement of chemotherapeutics might be a significant stage to further developing results. The majority of infant-use anticancer medications are dosed based on body size. However, dosing strategies are frequently inconsistent between tumor types and treatment protocols, and dose regimens are generally not based on evidence. We have compiled the pharmacological evidence that supports infant dosing regimens for a wide range of cytotoxic drugs in this review. A systematic review was carried out, and the available data were ranked according to a level of evidence (1–5) and a recommendation grade (A–D) based on consensus, with the appropriate dosing strategies indicated. There was sufficient pharmacological evidence to recommend a dosing algorithm for infants for nine of the 29 drugs (busulfan, carboplatin, cyclophosphamide, daunorubicin, etoposide, fludarabine, isotretinoin, melphalan, and vincristine) that received grade scores. There was sufficient evidence to recommend therapeutic drug monitoring in infants for busulfan and carboplatin.
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