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TDM oncology

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https://www.readbyqxmd.com/read/27446421/therapeutic-drug-monitoring-and-tyrosine-kinase-inhibitors
#1
Pauline Herviou, Emilie Thivat, Damien Richard, Lucie Roche, Joyce Dohou, Mélanie Pouget, Alain Eschalier, Xavier Durando, Nicolas Authier
The therapeutic activity of drugs can be optimized by establishing an individualized dosage, based on the measurement of the drug concentration in the serum, particularly if the drugs are characterized by an inter-individual variation in pharmacokinetics that results in an under- or overexposure to treatment. In recent years, several tyrosine kinase inhibitors (TKIs) have been developed to block intracellular signaling pathways in tumor cells. These oral drugs are candidates for therapeutic drug monitoring (TDM) due to their high inter-individual variability for therapeutic and toxic effects...
August 2016: Oncology Letters
https://www.readbyqxmd.com/read/27270831/evaluation-of-clinical-pharmacists-interventions-in-the-czech-republic
#2
Jitka Rychlíčková, Jan Šaloun, Jana Gregorová
STUDY OBJECTIVES: To determine the frequency of interventions, categorized by type of intervention and therapeutic class, made by a team of four clinical pharmacists over a 1-year period, and to assess the potential economic impact of these interventions. DESIGN: Prospective analysis. SETTING: Large medical center in Prague, Czech Republic. PATIENTS: A total of 9153 adults who were admitted to the general surgery, infectious diseases, oncology, orthopedics, and thoracic surgery and respiratory medicine services between January 1, 2014, and December 31, 2014...
July 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27217046/therapeutic-drug-monitoring-of-5-fluorouracil
#3
REVIEW
James J Lee, Jan H Beumer, Edward Chu
PURPOSE: For over 50 years, 5-FU has played a critical role in the systemic chemotherapy of cancer patients. 5-FU serves as the main backbone of combination chemotherapy for patients with colorectal cancer in both the adjuvant and metastatic disease settings. Herein, we review the current status of 5-FU therapeutic drug monitoring (TDM) and discuss its potential role in the clinical practice setting. METHOD: PubMed and abstracts from the American Society of Clinical Oncology were searched up through September 2015 for clinical data relating to 5-FU TDM...
September 2016: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/27065859/design-and-testing-of-an-ehr-integrated-busulfan-pharmacokinetic-decision-support-tool-for-the-point-of-care-clinician
#4
Susan M Abdel-Rahman, Matthew L Breitkreutz, Charlie Bi, Brett J Matzuka, Jignesh Dalal, K Leigh Casey, Uttam Garg, Sara Winkle, J Steven Leeder, JeanAnn Breedlove, Brian Rivera
BACKGROUND: Busulfan demonstrates a narrow therapeutic index for which clinicians routinely employ therapeutic drug monitoring (TDM). However, operationalizing TDM can be fraught with inefficiency. We developed and tested software encoding a clinical decision support tool (DST) that is embedded into our electronic health record (EHR) and designed to streamline the TDM process for our oncology partners. METHODS: Our development strategy was modeled based on the features associated with successful DSTs...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27055173/toward-sers-based-point-of-care-approaches-for-therapeutic-drug-monitoring-the-case-of-methotrexate
#5
Stefano Fornasaro, Silvia Dalla Marta, Marco Rabusin, Alois Bonifacio, Valter Sergo
To date, in spite of their toxicity, the plasmatic concentration of most chemotherapeutic drugs is difficult to monitor in oncological patients, because their quantitative determination is expensive and time consuming. This contribution reports a first attempt for the direct quantitative determination of a chemotherapeutic drug in human serum samples by means of Surface Enhanced Raman Spectroscopy (SERS). In this study, SERS substrates constituted by Au nanoparticles deposited on paper by a simple dipping method have been used for rapid (few minutes) analysis of diluted human serum spiked with different concentrations of methotrexate, MTX...
June 23, 2016: Faraday Discussions
https://www.readbyqxmd.com/read/26558811/the-clinical-significance-of-voriconazole-therapeutic-drug-monitoring-in-children-with-invasive-fungal-infections
#6
Hyun Mi Kang, Hoan Jong Lee, Eun Young Cho, Kyung-Sang Yu, Hyunju Lee, Ji Won Lee, Hyoung Jin Kang, Kyung Duk Park, Hee Young Shin, Eun Hwa Choi
Voriconazole is an antifungal drug used to treat fungal infections. This was a retrospective study of 61 children with hemato-oncologic diseases or solid organ transplantation who were administered voriconazole for invasive fungal infections. Of the 61 patients, 31 (50.8%) were in the therapeutic drug monitoring (TDM) group, and 30 (49.2%) were in the non-TDM group. At 12 weeks, treatment failure rate in the non-TDM group was higher than the TDM group (78.6% versus 40.0%, p = 0.038). Drug discontinuation due to adverse events was less frequent in the TDM group than the non-TDM group (26...
2015: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/26265133/therapeutic-drug-monitoring-of-monoclonal-antibodies-in-inflammatory-and-malignant-disease-translating-tnf-%C3%AE-experience-to-oncology
#7
REVIEW
T H Oude Munnink, M J Henstra, L I Segerink, K L L Movig, P Brummelhuis-Visser
Lack of response to monoclonal antibodies (mAbs) has been associated with inadequate mAb serum concentrations. Therapeutic drug monitoring (TDM) of mAbs has the potential to guide to more effective dosing in individual patients. This review discusses the mechanisms responsible for interpatient variability of mAb pharmacokinetics, summarizes exposure-response data of mAbs used in inflammatory and malignant disease, presents current evidence of mAb-TDM in inflammatory disease, and provides hurdles and required future steps for further implementing mAb-TDM...
April 2016: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/26164063/-interest-of-biological-documentation-on-brain-metastatic-disease-in-breast-cancer-a-case-report
#8
S Boissonneau, R Faguer, C Joubert, S Fuentes, P Metellus
Breast cancer, after lung cancer, is the second major cause of brain metastases. In breast cancer, the prognosis is closely linked to the molecular subtype of the primary tumor. Targeted therapies, with or without cytotoxic treatment, have significantly modified overall survival in these patients. We report, the case of a patient suffering from breast cancer with brain metastasis in whom the biological documentation of the metastatic disease permitted to tailor the systemic treatment. Analysis of the surgical specimen revealed an immunohistochemical HER2 positive staining, which was not found in the primary tumor and therefore warranted trastuzumab administration...
August 2015: Neuro-Chirurgie
https://www.readbyqxmd.com/read/25661259/clinical-comparison-of-weight-and-age-based-strategy-of-dose-administration-in-children-receiving-intravenous-busulfan-for-hematopoietic-stem-cell-transplantation
#9
COMPARATIVE STUDY
D Gürlek Gökçebay, F Azik, N Ozbek, P Isik, Z Avci, B Tavil, A Kara, B Tunc
Bu, combined with TDM-guided dosing, is associated with fewer graft failures/relapses and lower toxicity in pediatric HSCT. We aimed this retrospective study for comparison of weight- and age-based dosing in terms of clinical outcomes such as time to engraftment, early complications, EFS, OS, and toxicity profiles in children receiving iv Bu. Sixty-one children who underwent HSCT from April 2010 to February 2013 by means of a Bu-based conditioning regimen and completed 100 days after transplantation at Ankara Children?s Hematology and Oncology Hospital Bone Marrow Transplantation Unit were enrolled in this study...
May 2015: Pediatric Transplantation
https://www.readbyqxmd.com/read/25482740/survey-of-antifungal-prophylaxis-and-fungal-diagnostic-tests-employed-in-malignant-haematology-and-haemopoietic-stem-cell-transplantation-hsct-in-australia-and-new-zealand
#10
REVIEW
S J van Hal, N M Gilroy, C O Morrissey, L J Worth, J Szer, C S Tam, S C Chen, K A Thursky, M A Slavin
This article reports the findings of a survey developed to assess the current use of antifungal prophylaxis among haematology and infectious disease clinicians across Australia and New Zealand, and their alignment with existing consensus guidelines for the use of antifungal agents in the haematology/oncology setting (published 2008). Surveyed clinicians largely followed the current recommendations for prophylaxis in the setting of induction chemotherapy for acute myeloid leukaemia, as well as autologous and low-risk allogeneic haemopoietic stem cell transplantation (HSCT)...
December 2014: Internal Medicine Journal
https://www.readbyqxmd.com/read/25336126/-clinical-application-limits-and-perspectives-of-pharmacogenetic-and-pharmacokinetic-analysis-of-anticancer-drugs
#11
REVIEW
Anne-Sophie Chantry, Sylvie Quaranta, Joseph Ciccolini, Bruno Lacarelle
Despite significant progress in the discovery and design of drugs, the interindividual variability to the standard dose of a given drug remains a serious problem in clinical practice. In the future, the aim of pharmacogenetic is to provide new strategies for optimizing drug therapy, both in terms of efficacy and safety. The clinical validation of an increasing number of pharmacogenetic tests, as well as the development of new highly efficient technologies should further promote pharmacogenetics in clinical practice and lead to the optimization and individualization, before treatment, of drug therapy...
September 2014: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/24889915/review-of-therapeutic-drug-monitoring-of-anticancer-drugs-part-1-cytotoxics
#12
REVIEW
Angelo Paci, Gareth Veal, Christophe Bardin, Dominique Levêque, Nicolas Widmer, Jos Beijnen, Alain Astier, Etienne Chatelut
Most anticancer drugs are characterised by a steep dose-response relationship and narrow therapeutic window. Inter-individual pharmacokinetic (PK) variability is often substantial. The most relevant PK parameter for cytotoxic drugs is the area under the plasma concentration versus time curve (AUC). Thus it is somewhat surprising that therapeutic drug monitoring (TDM) is still uncommon for the majority of agents. Goals of the review were to assess the rationale for more widely used TDM of cytotoxics in oncology...
August 2014: European Journal of Cancer
https://www.readbyqxmd.com/read/24878063/therapeutic-drug-monitoring-in-cancer-are-we-missing-a-trick
#13
Christophe Bardin, Gareth Veal, Angelo Paci, Etienne Chatelut, Alain Astier, Dominique Levêque, Nicolas Widmer, Jos Beijnen
Therapeutic drug monitoring (TDM) can be defined as the measurement of drug in biological samples to individualise treatment by adapting drug dose to improve efficacy and/or reduce toxicity. The cytotoxic drugs are characterised by steep dose-response relationships and narrow therapeutic windows. Inter-individual pharmacokinetic (PK) variability is often substantial. There are, however, a multitude of reasons why TDM has never been fully implemented in daily oncology practice. These include difficulties in establishing appropriate concentration target, common use of combination chemotherapies and the paucity of published data from pharmacological trials...
August 2014: European Journal of Cancer
https://www.readbyqxmd.com/read/23183914/should-therapeutic-drug-monitoring-of-the-unbound-fraction-of-imatinib-and-its-main-active-metabolite-n-desmethyl-imatinib-be-developed
#14
Peggy Gandia, Cécile Arellano, Thierry Lafont, Françoise Huguet, Laurence Malard, Etienne Chatelut
PURPOSE: The European Society for Medical Oncology recommends therapeutic drug monitoring (TDM) for imatinib, based on total plasma concentrations in cases of sub-optimal response, failure, or adverse events. Imatinib is highly bound to alpha-1 acid glycoprotein (AGP) in the plasma. We determined the unbound plasma fraction of both imatinib and its main active metabolite (N-desmethyl-imatinib) in plasma from 44 patients. The objective was to quantify the inter-individual variability of the protein binding of imatinib in order to discuss the potential benefits and limits of TDM of free plasma concentrations...
February 2013: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/22585183/target-concentration-intervention-in-oncology-where-are-we-at
#15
REVIEW
Mohamed Saleem, Goce Dimeski, Carl M Kirkpatrick, Paul J Taylor, Jennifer H Martin
Therapeutic drug monitoring (TDM) and more recently target concentration intervention (TCI) have been widely used in clinical practice for the optimization of drug treatment. TDM and TCI have been applied most frequently in the cardiovascular, respiratory, neurology, and infectious disease areas because the medications used here have both narrow therapeutic indices and a clear relationship between concentration and effect. However, apart from drugs such as methotrexate and 5-fluorouracil, the clinical application of TDM/TCI in oncology is minimal...
June 2012: Therapeutic Drug Monitoring
https://www.readbyqxmd.com/read/21083218/therapeutic-drug-monitoring-in-cancer-chemotherapy
#16
REVIEW
Dylan M Bach, Joely A Straseski, William Clarke
For a select number of drugs, proper management of patients includes monitoring serum or plasma concentrations of the drugs and adjusting the doses accordingly - this practice is referred to as therapeutic drug monitoring (TDM). The need for TDM arises when pharmacokinetic variability of drugs is not easily accounted for by common clinical parameters. Many chemotherapeutic drugs have large interindividual variability, yet TDM is not commonplace in chemotherapy management. This review will discuss pharmacokinetics in the context of chemotherapeutic drugs, examine the few instances where TDM is currently used in the field of oncology and propose other drugs where TDM might be useful for dose adjustments in the management of chemotherapy...
May 2010: Bioanalysis
https://www.readbyqxmd.com/read/20699073/-therapeutic-drug-monitoring-of-tyrosine-kinase-inhibitors-in-the-treatment-of-chronic-myelogenous-leukaemia-interests-and-limits
#17
REVIEW
Stéphane Bouchet, Bernard Royer, Chantal Le Guellec, Karine Titier et al.
During the last decade, imatinib was current gold standard treatment of chronic myelogenous leukemia (CML), showing a great effectiveness. Thus, the Therapeutic Drug Monitoring (TDM), rarely applied in clinical oncology practice, did not appear necessary at the moment. However, the absence of response among patients and the metabolic profile of imatinib (involving the CYP3A4) suggested the existence of a great interindividual variability. During the last 4 years, studies about the pharmacokinetic/pharmacodynamic relationship have confirmed this variability and highlighted a relation between the trough concentrations of imatinib and the clinical response...
May 2010: Thérapie
https://www.readbyqxmd.com/read/19854694/-imaging-in-oncology-and-international-rules-for-evaluation-the-nuclear-medicine
#18
REVIEW
Jean-Cyril Bourre, Jean-Philippe Vuillez
The growing success of isotopic explorations in oncology is related to the number of growing radiotracers and progress in the methods for detection and imaging. Today, the nuclear medicine is able to answer important questions raised by biology and therapeutic progress results from this. The new radiopharmaceutical compounds are able to explore in vivo the metabolism, the proliferation, the hypoxia and the expression of some receptors or antigens in tumor cells. This progress in radiopharmaceuticals design can be combined with the new tools for detection, such as the cameras coupled to a tomodensitometer (TEMP-TDM and TEP-TDM), the new gamma cameras with semiconductors, and the peroperative gamma probes...
November 2009: Bulletin du Cancer
https://www.readbyqxmd.com/read/19004719/-pharmacokinetics-and-therapeutic-drug-monitoring-of-anticancer-agents
#19
Pierre Marquet, Annick Rousseau
Treatment individualisation, an old concept renovated by the progress of analytical techniques and the advent of pharmacogenetics, aims at optimizing the usage of existing drugs by adjusting the nature and dose of anticancer agents to each patient, based on genetic, physiological and pathological criteria, on tumour nature, on associated drugs or previous treatment lines, on treatment efficacy and toxicity or on patient's exposure to the active drug form. This article exposes the pre-requisites and clinical trials necessary to demonstrate the usefulness of therapeutic drug monitoring (TDM) for drugs in general and anticancer agents in particular...
October 2008: Bulletin du Cancer
https://www.readbyqxmd.com/read/18755565/women-s-perceptions-of-their-treatment-decision-making-about-breast-cancer-treatment
#20
Mary Ann O'Brien, Timothy J Whelan, Cathy Charles, Peter M Ellis, Amiram Gafni, Peter Lovrics, Adrianne Hasler, Susan Dimitry
OBJECTIVE: There is limited understanding about what treatment decision making (TDM) means to patients. The study objective was to identify any processes or stages of TDM as perceived by women with early stage breast cancer (ESBC). METHODS: Initial consultations with a surgeon or medical oncologist were videotaped. Subsequently, women viewed their consultation using a qualitative approach with video-stimulated recall (VSR) interviews. Interviews were taped, transcribed, and analyzed...
December 2008: Patient Education and Counseling
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