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Therapeutic drug monitoring in oncology: International Association of Therapeutic Drug Monitoring and Clinical Toxicology consensus guidelines for imatinib therapy

Journal

EUROPEAN JOURNAL OF CANCER
Volume 157, Issue -, Pages 428-440

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.ejca.2021.08.033

Keywords

Imatinib; Therapeutic drug monitoring; Precision medicine; Leukaemia; Gastrointestinal stromal tumour (GIST)

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Therapeutic drug monitoring (TDM) is not widely accepted in oncology but plays an important role in other medical fields. Imatinib and other oral chemotherapy drugs use a flat dosing approach, with numerous studies examining the correlation between blood concentrations and clinical effects. The International Association identified the need to develop consensus guidelines based on available data.
Although therapeutic drug monitoring (TDM) is an important tool in guiding drug dosing for other areas of medicine including infectious diseases, cardiology, psychiatry and transplant medicine, it has not gained wide acceptance in oncology. For imatinib and other tyrosine kinase inhibitors, a flat dosing approach is utilised for management of oral chemotherapy. There are many published studies examining the correlation of blood concentrations with clinical effects of imatinib. The International Association of Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT) determined that there was a need to examine the published literature regarding utility of TDM in imatinib therapy and to develop consensus guidelines for TDM based on the available data. This article summarises the scientific evidence regarding TDM of imatinib, as well as the consensus guidelines developed by the IATDMCT. (c) 2021 Published by Elsevier Ltd.

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