***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose Sunitinib is an oral tyrosine kinase inhibitor of VEGF , PDGF , c-KIT , and flt-3 receptors . A pediatric phase I study of sunitinib capsules identified the maximum tolerated dose as 15 mg/m2/day . This study was conducted to evaluate sunitinib given as a powder formulation . Methods Sunitinib 15 mg/m2 was administered orally daily for 4 weeks on/2 weeks off to patients < 21 years old with refractory solid tumors .  Sunitinib capsules were opened , and the powder sprinkled onto applesauce or yogurt . Plasma levels of sunitinib  and an active metabolite , SU12662 , were measured , and pharmacokinetic parameters were estimated . Results 12 patients , median age 13 ( range 4–21 ) years , were treated . The most common first-cycle toxicities were leucopenia ( n = 6 ) , fatigue ( n = 5 ) , neutropenia ( n = 4 ) , and hypertension ( n = 4 ) . Three patients had dose-limiting toxicities ( DLTs ) in cycle 1 ( dizziness/back pain , h and –foot syndrome , and intratumoral hemorrhage/hypoxia ) . A median peak plasma sunitinib concentration of 21 ( range 6–36 ) ng/ml was reached at a median of 4 ( range 4–8 ) h after the first dose . The median exposure ( AUC0–48 ) was 585 ( range 196–1,059 ) h ng/l . The median half-life was 23 ( range 13–36 ) h. The median trough concentration measured before day 14 dosing was 32 ( range 12–58 ) ng/ml . Conclusions The pharmacokinetic profile of sunitinib appears similar between a powder formulation and published data using capsules . The powder formulation allows patients unable to swallow capsules to receive sunitinib ABSTRACT Two multicenter , open-label , single-arm , two-phase studies evaluated single-dose pharmacokinetics and single- and multiple-dose safety of a pediatric oral famciclovir formulation ( prodrug of penciclovir ) in children aged 1 to 12 years with suspicion or evidence of herpes simplex virus ( HSV ) or varicella-zoster virus ( VZV ) infection . Pooled pharmacokinetic data were generated after single doses in 51 participants ( ∼12.5 mg/kg of body weight [ BW ] for children weighing < 40 kg and 500 mg for children weighing ≥40 kg ) .  The average systemic exposure to penciclovir was similar ( 6- to 12-year-olds ) or slightly lower ( 1- to < 6-year-olds ) than that in adults receiving a 500-mg dose of famciclovir ( historical data ) . The apparent clearance of penciclovir increased with BW in a nonlinear manner , proportional to BW0.696 . An eight-step weight-based dosing regimen was developed to optimize exposure in smaller children and was used in the 7-day multiple-dose safety phases of both studies , which enrolled 100 patients with confirmed/suspected viral infections . Twenty-six of 47 ( 55.3 % ) HSV-infected patients who received famciclovir twice a day and 24 of 53 ( 45.3 % ) VZV-infected patients who received famciclovir three times a day experienced at least one adverse event . Most adverse events were gastrointestinal in nature . Exploratory analysis following 7-day famciclovir dosing regimen showed resolution of symptoms in most children with active HSV ( 19/21 [ 90.5 % ] ) or VZV disease ( 49/53 [ 92.5 % ] ) . Famciclovir formulation ( sprinkle capsules in OraSweet ) was acceptable to participants /caregivers . In summary , we present a weight-adjusted dosing schedule for children that achieves systemic exposures similar to those for adults given the 500-mg dose Background Efforts to ease administration and enhance acceptability of the oral anti-malarial artemether-lumefantrine ( A-L ) crushed tablet to infants and children triggered the development of a novel dispersible tablet of A-L. During early development of this new formulation , two studies were performed in healthy subjects , one to evaluate the palatability of three flavours of A-L , and a second one to compare the bioavailability of active principles between the dispersible tablet and the tablet ( administered crushed and intact ) . Methods Study 1 was performed in 48 healthy schoolchildren in Tanzania . Within 1 day , all subjects tasted a strawberry- , orange- and cherry-flavoured oral A-L suspension for 10 seconds ( without swallowing ) in a r and omized , single-blind , crossover fashion . The palatability of each formulation was rated using a visual analogue scale ( VAS ) . Study 2 was an open , r and omized crossover trial in 48 healthy adults given single doses of A-L ( 80 mg artemether + 480 mg lumefantrine )  with food . The objectives were to compare the bioavailability of artemether , dihydroartemisinin ( DHA ) and lumefantrine  between the dispersible tablet and the tablet administered crushed ( primary objective ) and intact ( secondary objective ) . Results Study 1 showed no statistically significant difference in VAS scores between the three flavours but cherry had the highest score in several ratings ( particularly for overall liking ) . Study 2 demonstrated that the dispersible and crushed tablets delivered bioequivalent artemether , DHA and lumefantrine systemic exposure ( area under the curve [ AUC ] ) ; mean ± SD AUC0-tlast were 208 ± 113 vs 195 ± 93 h.ng/ml for artemether , 206 ± 81 vs 199 ± 84 h.ng/ml for DHA and 262 ± 107 vs 291 ± 106 h.μg/ml for lumefantrine . Bioequivalence was also shown for peak plasma concentrations ( Cmax ) of DHA and lumefantrine . Compared with the intact tablet , the dispersible tablet result ed in bioequivalent lumefantrine exposure , but AUC and Cmax values of artemether and DHA were 20 - 35 % lower . Conclusions Considering that cherry was the preferred flavour , and that the novel A-L dispersible tablet demonstrated similar pharmacokinetic performances to the tablet administered crushed , a cherry-flavoured A-L dispersible tablet formulation was selected for further development and testing in a large efficacy and safety study in African children with malaria The aim of this work was to develop indinavir pediatric anti-HIV/AIDS formulations enabling convenient dose adjustment , ease of oral administration , and improved organoleptic properties by means of the generation of drug-loaded microparticles made of a polymer that is insoluble under intake conditions and dissolves fast in the stomach in order to completely release the active agent . Indinavir-loaded microparticles made of a pH-dependent polymeric excipient soluble at pH < 5 , Eudragit E100 , were prepared using a double emulsion solvent diffusion technique and the in vitro release profiles characterized . Finally , taste masking properties were evaluated in blind r and omized sensory experiments by ten healthy human volunteers . The use of a w/o/o emulsion system result ed in  indinavir  loads around 90 % . Thermal analysis of the microparticles by differential scanning calorimetry revealed that indinavir appeared mainly dispersed at the molecular level . Concentrations of residual organic solvents as determined by gas chromatography were below the upper limits specified by the European Pharmacopeia for pharmaceutical oral formulations . Then , the behavior of drug-containing microparticles in aqueous media at different pH values was assessed . While they selectively dissolved in gastric-like medium , in tap water ( intake conditions ) , the matrix remained almost unchanged and efficiently prevented drug dissolution . Finally , sensoring taste tests performed by volunteers indicated that systems with indinavir loads ∼15 % displayed acceptable taste . This work explored the production of indinavir-containing microparticles based on a common pharmaceutical excipient as a means for the improvement of medicines of drugs involved in the treatment of HIV/AIDS . For systems containing about 15 % drug , taste studies confirmed the acceptability of the formulation . In pediatric regimes , this composition would require an acceptable amount of formulation ( 0.7–1.5 g ) Verrotti A , Nanni G , Agostinelli S , Tozzi Alleva E , Aloisi P , Franzoni E , Spalice A , Chiarelli F , Coppola G. Effects of the abrupt switch from solution to modified‐release granule formulation of valproate . Acta Neurol Sc and : 2012 : 125 : e14–e18 . © 2011 John Wiley & Sons Abstract Objectives : Traditional Chinese medicine ( TCM ) is popular as an alternative medicine in children with atopic dermatitis ( AD ) . A concoction of five herbs in a capsular preparation has been confirmed to be efficacious in improving the quality of life and sparing topical corticosteroid usage . We evaluated the clinical efficacy and tolerability of the same concoction in syrup form . Methods : This was a prospect i ve self-controlled trial set in the pediatric dermatology clinic of a teaching hospital . Children aged 4–7 years with moderate-to-severe AD received 20 ml of TCM syrup daily . Clinical parameters and laboratory markers were measured before and at 2 weeks , 7 weeks and 12 weeks of treatment , and at 4 weeks after completion . Disease severity was evaluated by the SCORing Atopic Dermatitis ( SCORAD ) index and quality of life by the Children 's Dermatology Life Quality Index ( CDLQI ) . Blood was obtained for a complete blood count , total IgE , eosinophil count , and biochemical studies prior to and after 3 months of TCM usage . Results : Twenty-two patients participated in the study . There were significant improvements in the objective SCORAD , pruritus and CDLQI scores 4 weeks after study completion . There was no change in sleep score or amount of topical steroid consumption . No biochemical evidence of any adverse drug reaction was observed during the study period . The TCM syrup was generally palatable and well tolerated by the children . Adverse effects were generally mild but two patients with rash withdrew during the study . Conclusion : The palatability means that further evaluations and dosage studies of the concoction will be possible in young children BACKGROUND Palatability is an important factor in medication compliance for children where the acceptability of a liquid medication and its ease of administration will be greatly affected by its taste . OBJECTIVES The objective of this study was to determine which , if any of two steroid preparations , oral dexamethasone or oral prednisolone , was more palatable to children requiring steroid treatment for asthma . METHODS A single-blind taste test of 2 different steroid suspensions , liquid prednisolone ( 1mg/ml ) versus liquid dexamethasone ( 1mg/ml ) , was conducted in children aged 5 - 12 years , presenting to the pediatric emergency department with an exacerbation of asthma requiring steroid treatment . Children received 2.5mls of either prednisolone or dexamethasone and were asked to score their impression of taste on a 10 cm visual analog scale . After cleansing of the palate they were given the other steroid and scored its taste . RESULTS Thirty-nine children ( 54 % male ) were enrolled in the study . The mean age was 7.1 years ( SD=2.0 ) . The median visual analog scale measurement for dexamethasone was 8.2 cm ( IQR= 5.2 ) whilst the median measurement for prednisolone was 5.0 cm ( IQR= 7.3 ) , p=0.03 . Male children were more likely to prefer  dexamethasone than females with a median score of 9.9 cm ( IQR=3.8 ) for males vs. 5.9 cm ( IQR=9.3 ) for females , p=0.005 . There was no gender preference for prednisolone . CONCLUSIONS There was a statistically significant difference between the taste of dexamethasone  and prednisolone , with dexamethasone being the preferred steroid among pediatric patients with asthma . Males were much more likely to prefer dexamethasone than females BACKGROUND Deferasirox is a once-daily , oral iron chelator that was developed out of a need for a long-acting , conveniently-administered chelator for patients with transfusional hemosiderosis . The approved mode of administration requires taking deferasirox on an empty stomach with water , apple juice , or orange juice to limit variation in bioavailability . This required administration schedule might not be palatable for patients . Additionally , approximately one-quarter of patients experience mild to moderate gastrointestinal ( GI ) symptoms , which may pose additional challenges , particularly in the younger and older age ranges . We present a trial to assess the palatability and safety of various administration modes of deferasirox in pediatric and adult patients . PROCEDURES Participants rated palatability in a 4-week run-in phase , where deferasirox was administered per label . Subsequently , patients rated several administration modes during a 3-month assessment phase . RESULTS Palatability was more favorable during the 
    Output:
    
Limited evidence regarding a correlation between palatability and treatment adherence in pediatric patients was identified