The relevance of therapeutic drug monitoring in plasma and erythrocytes in anti-cancer drug treatment

Clin Chem Lab Med. 2004;42(11):1219-27. doi: 10.1515/CCLM.2004.244.

Abstract

Therapeutic drug monitoring generally focuses on the plasma compartment only. Differentiation between the total plasma concentration and the free fraction (plasma water) has been described for a number of limited drugs. Besides the plasma compartment, blood has also a cellular fraction which has by far the largest theoretical surface and volume for drug transport. It is with anti-cancer drugs that major progress has been made in the study of partition between the largest cellular blood compartment, i.e., erythrocytes, and the plasma compartment. The aim of the present review is to detail the progress made in predicting what a drug does in the body, i.e., pharmacodynamics including toxicity and plasma and/or red blood cell concentration monitoring. Furthermore, techniques generally used in anti-cancer drug monitoring are highlighted. Data for complex Bayesian statistical approaches and population kinetics studies are beyond the scope of this review, since this is generally limited to the plasma compartment only.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / blood
  • Antineoplastic Agents / pharmacology*
  • Area Under Curve
  • Chromatography, Liquid
  • Clinical Trials as Topic
  • Drug Monitoring / methods*
  • Erythrocytes / drug effects*
  • Erythrocytes / metabolism
  • Humans
  • Mass Spectrometry
  • Monitoring, Physiologic / methods
  • Neoplasms / drug therapy*
  • Pharmaceutical Preparations

Substances

  • Antineoplastic Agents
  • Pharmaceutical Preparations