[Personalized medicine for oral molecular-targeted anticancer drugs]

Area of Science:

• Pharmacology
• Oncology
• Clinical Chemistry

Background:

• Therapeutic drug monitoring (TDM) involves measuring drug plasma concentrations to optimize individual patient treatment.
• Molecular-targeted anticancer drugs often exhibit clear exposure-efficacy and exposure-toxicity relationships, making plasma concentrations valuable biomarkers.
• Establishing therapeutic target ranges is crucial for implementing TDM effectively.

Purpose of the Study:

• To highlight the importance of therapeutic drug monitoring (TDM) for molecular-targeted anticancer drugs.
• To discuss the current status and necessity of TDM in clinical practice.
• To emphasize the role of TDM in achieving precision medicine for cancer patients.

Main Methods:

• Review of existing literature and clinical practices regarding TDM for anticancer drugs.
• Discussion of the need for determining target plasma concentrations through clinical trials.
• Emphasis on the requirement for high-precision analytical methods in TDM.

Main Results:

• TDM for imatinib and sunitinib in Japan has shown reduced toxicity, discontinuation rates, and costs, alongside improved clinical efficacy.
• Plasma drug concentrations can serve as biomarkers for molecular-targeted therapies.
• TDM facilitates personalized dose adjustments to enhance treatment outcomes.

Conclusions:

• TDM is essential for optimizing molecular-targeted anticancer drug therapy, leading to improved patient outcomes and precision medicine.
• Further clinical trials are necessary to establish target plasma concentrations for a wider range of anticancer drugs.
• Implementing TDM requires robust analytical methods and defined therapeutic ranges to guide clinical decisions.