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Targeted drug monitoring in oncology for personalized treatment with use of next generation analytics
Wei Li1, Chaoling Wen2, Bin Ye3
1Second People's Hospital of Wuhu, Wuhu, Anhui, China.
Abstract:
Therapeutic drug monitoring (TDM) is a clinical procedure aimed at maintaining plasma drug concentrations within a specific therapeutic range, thereby maximizing the safety and efficacy of pharmacological therapy. Conventional oncology strategies face challenges like non-specific toxicity, drug resistance, incomplete tumor eradication, high costs, and significant side effects that impact quality of life. Moreover, conventional therapy offers limited benefits in advanced stages, pose risks of secondary cancers and immune suppression, and lack personalization, highlighting the need for targeted, innovative approaches. In modern oncology, TDM has gained significant interest due to narrow therapeutic windows, significant inter-individual variability in pharmacokinetics, and the complexity of cancer pharmacotherapy. This study reviews the role of TDM in oncology with more emphasis on pharmacogenetic testing, immunoassays, and liquid-chromatography-mass spectroscopy (LC-MS/MS) techniques, highlighting its applications in optimizing the dose during immunotherapies, targeted therapies, and chemotherapeutics. Moreover, the review discusses the challenges and limitations associated with TDM in oncology, such as the requirement of robust clinical evidence, standardized practices, and integration with personalized medicine approaches. Emerging technologies, including AI and machine learning, are also considered for their potential to enhance TDM in oncology.
Insights
Therapeutic drug monitoring (TDM) optimizes cancer treatment by ensuring drug levels are safe and effective. This review explores TDM
Area of Science:
- Oncology
- Pharmacology
- Clinical Chemistry
Background:
- Conventional cancer treatments face challenges including toxicity, resistance, and lack of personalization.
- Advanced cancer stages and side effects limit conventional therapy efficacy and patient quality of life.
- There is a need for targeted, innovative approaches in modern oncology.
Purpose of the Study:
- To review the role of therapeutic drug monitoring (TDM) in optimizing cancer pharmacotherapy.
- To highlight TDM applications in immunotherapies, targeted therapies, and chemotherapeutics.
- To discuss challenges, limitations, and emerging technologies in TDM for oncology.
Main Methods:
- Review of literature on TDM in oncology.
- Emphasis on pharmacogenetic testing, immunoassays, and liquid-chromatography-mass spectroscopy (LC-MS/MS).
- Discussion of TDM's role in dose optimization for various cancer drug classes.
Main Results:
- TDM is crucial in oncology due to narrow therapeutic windows and inter-individual pharmacokinetic variability.
- TDM techniques like LC-MS/MS aid in optimizing drug doses for better efficacy and safety.
- Pharmacogenetic testing and immunoassays are key components of TDM in cancer care.
Conclusions:
- TDM enhances the safety and efficacy of cancer pharmacotherapy, addressing limitations of conventional treatments.
- Integrating TDM with personalized medicine approaches is essential for optimal patient outcomes.
- Emerging technologies like AI and machine learning hold promise for advancing TDM in oncology.
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