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.

Impact statement
Therapeutic Drug Monitoring (TDM) has gained popularity over the years in the light of its value in improving the efficacy and safety of cancer treatment with traditional cytotoxics; however, broader applications of TDM to targeted drugs and mAbs are now available as are novel and easier-to-do methods of blood sampling. The importance of combining TDM with patient genotyping can revolutionize therapeutic strategies in many settings.
It is the time for pharmacologists, clinicians and expert groups of scientific societies to cooperate and foster the widest possible exploitation of TDM in oncologic settings.

Table of Content: Vol. 3 (No. 3) 2021 September