Pediatric pharmaceutical forms in oncology: A review of galenic challenges, difficulties encountered in hospital practice, and perspectives offered by new technologies

Abstract

ObjectiveTo review the pharmaceutical challenges associated with pediatric anticancer formulations and discuss current limitations, hospital practice difficulties, and emerging technological strategies to improve safety, accuracy, and acceptability of pediatric oncology treatments.Data SourcesRelevant literature on pediatric oncology formulations, compounding practices, and innovative drug-delivery technologies was analyzed using a narrative review approach.Data SummaryPediatric oncology presents unique pharmaceutical challenges due to the limited availability of age-appropriate anticancer formulations. Because most anticancer drugs are developed for adults, pediatric treatment frequently relies on off-label use and extemporaneous manipulation of dosage forms, raising concerns regarding dose accuracy, stability, excipient-related toxicity, and occupational safety in hospital settings. Extemporaneous compounding may lead to dosing variability, reduced stability, and healthcare professional exposure to hazardous drugs. Emerging approaches, including 3D-printed individualized mini-tablets, orodispersible films, nanocarrier-based delivery systems, physiologically based pharmacokinetic modeling, and therapeutic drug monitoring, show potential to improve dosing precision, safety, and treatment acceptability.ConclusionsThe lack of suitable pediatric anticancer formulations remains a major barrier to safe and effective therapy. Hospital pharmacists play a central role in mitigating formulation-related risks through controlled preparation and innovative practices. Integration of emerging pharmaceutical technologies into clinical practice may enable safer, more standardized, and individualized pediatric oncology treatments.