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

Eur J Cancer. 2021 Nov:157:428-440. doi: 10.1016/j.ejca.2021.08.033. Epub 2021 Sep 28.

Abstract

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.

Keywords: Gastrointestinal stromal tumour (GIST); Imatinib; Precision medicine, Leukaemia; Therapeutic drug monitoring.

Publication types

  • Review

MeSH terms

  • Consensus
  • Dose-Response Relationship, Drug
  • Drug Monitoring / standards*
  • Humans
  • Imatinib Mesylate / administration & dosage
  • Imatinib Mesylate / adverse effects*
  • Medical Oncology / standards
  • Neoplasms / drug therapy*
  • Practice Guidelines as Topic*
  • Protein Kinase Inhibitors / administration & dosage
  • Protein Kinase Inhibitors / adverse effects*
  • Toxicology / standards
  • Voluntary Health Agencies / standards

Substances

  • Protein Kinase Inhibitors
  • Imatinib Mesylate