Framework for Implementing Individualised Dosing of Anti-Cancer Drugs in Routine Care: Overcoming the Logistical...

Area of Science:

• Oncology
• Pharmacology
• Precision Medicine

Background:

• Standard fixed dosing for oral anti-cancer drugs, especially kinase inhibitors (KIs), presents challenges in achieving optimal patient outcomes.
• Individualized dosing is crucial for the safe and efficient use of anti-cancer therapies.

Purpose of the Study:

• To outline a 6-step framework for implementing the Accurate Dosing of Anti-cancer Patient-centred Therapies (ADAPT) program.
• To facilitate the individualised dosing of orally administered anti-cancer drugs in routine clinical care.

Main Methods:

• The study adapted the Medical Research Council (MRC) framework into a 6-step process for ADAPT program implementation.
• Key strategies from the Expert Recommendations for Implementing Change (ERIC) study were integrated into the framework.
• The framework includes steps for evidence evaluation, analytical setup, clinical education, sample analysis, results interpretation, and clinical application.

Main Results:

• The ADAPT program has been successfully implemented in South Australia.
• The program currently provides routine plasma drug concentration monitoring for patients on oral anti-cancer medications.
• The program's evaluation phase is nearing completion.

Conclusions:

• The developed 6-step framework offers a viable model for advancing individualized dosing of oral anti-cancer drugs.
• This approach has the potential to significantly improve the safety and efficacy of cancer treatment through precision dosing.