TY - JOUR
T1 - Evidence for therapeutic drug monitoring of targeted anticancer therapies
AU - Gao, Bo
AU - Yeap, Shang
AU - Clements, Arthur
AU - Balakrishnar, Bavanthi
AU - Wong, Mark
AU - Gurney, Howard
PY - 2012/11/10
Y1 - 2012/11/10
N2 - Therapeutic drug monitoring (TDM) provides valuable guidance for dose adjustment of antibiotics, immunosuppressives, antiepileptics, and other drugs, but its use for traditional anticancer therapies has been limited. Perhaps the most important obstacle is the impractical requirement of multiple blood samples to adequately define systemic exposure of drugs that have a short elimination half-life and are given by intermittent intravenous injections. However, the newer targeted anticancer therapies have different pharmacokinetic (PK) and dosing characteristics compared with traditional cytotoxic drugs, making it possible to estimate the steady-state drug exposure with a single trough-level measurement. Recent evidence indicates that certain PK parameters, including trough levels, are correlated with clinical outcomes for many of these agents, including imatinib, sunitinib, rituximab, and cetuximab. Although the current evidence is insufficient to mandate TDM in routine practice, a concerted investigation should be encouraged to determine whether the steady-state trough measurements of targeted agents will have a practical place in the clinical care of patients with cancer.
AB - Therapeutic drug monitoring (TDM) provides valuable guidance for dose adjustment of antibiotics, immunosuppressives, antiepileptics, and other drugs, but its use for traditional anticancer therapies has been limited. Perhaps the most important obstacle is the impractical requirement of multiple blood samples to adequately define systemic exposure of drugs that have a short elimination half-life and are given by intermittent intravenous injections. However, the newer targeted anticancer therapies have different pharmacokinetic (PK) and dosing characteristics compared with traditional cytotoxic drugs, making it possible to estimate the steady-state drug exposure with a single trough-level measurement. Recent evidence indicates that certain PK parameters, including trough levels, are correlated with clinical outcomes for many of these agents, including imatinib, sunitinib, rituximab, and cetuximab. Although the current evidence is insufficient to mandate TDM in routine practice, a concerted investigation should be encouraged to determine whether the steady-state trough measurements of targeted agents will have a practical place in the clinical care of patients with cancer.
UR - http://www.scopus.com/inward/record.url?scp=84869381780&partnerID=8YFLogxK
U2 - 10.1200/JCO.2012.43.5362
DO - 10.1200/JCO.2012.43.5362
M3 - Review article
C2 - 22927532
AN - SCOPUS:84869381780
SN - 0732-183X
VL - 30
SP - 4017
EP - 4025
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 32
ER -