Therapeutic drug monitoring for the cancer patient: challenges and opportunities
Therapeutic Drug Monitoring (TDM) is a valuable option to improve the efficacy and safety of cancer drugs. Here, members of the Cancer Pharmacology Working Group of the Italian Society of Pharmacology describe and discuss some paradigms of TDM, moving from best known examples (TDM for fluoropyrimidines) to new opportunities as applied to last generation targeted drugs (TDM for tyrosine kinase inhibitors and monoclonal antibodies). Advances in sampling and TDM-oriented genotyping are also discussed. Based on these paradigms, this Working Group concludes that TDM should be widely exploited in both investigational and real world settings, contributing to the optimal usage of drugs.