On precision dosing of oral small molecule drugs in oncology.
On precision dosing of oral small molecule drugs in oncology.
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DOI：
10.1111/bcp.14454
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发表时间：
2021-03
影响因子：
3.4
通讯作者：
Cremers S
中科院分区：
文献类型：
--
作者：
Lyashchenko AK;Cremers S
基于个体患者血液药物水平的口服小分子抗癌药物剂量的个性化，也称为治疗药物监测（TDM），具有通过最大化药物功效和最小化毒性来显著改善治疗有效性的潜力。然而，这种选择尚未被肿瘤学界广泛接受。其原因包括剂量个体化的后勤复杂性增加，缺乏测量小分子药物浓度以支持患者护理的临床实验室，以及缺乏费用报销。然而，主要障碍可能是缺乏明确证明监测口服小分子抗癌药物水平实际上改善临床结果的研究。如果没有明确的证据支持TDM指导的剂量个体化，特别是在随机对照试验中证明TDM可以提高生存率，肿瘤学家不太可能广泛接受这种方法，保险公司也不太可能报销，患者可能会继续因接受不正确的药物剂量而遭受痛苦。本文综述了肿瘤学中口服小分子药物的TDM的现状，并旨在为评估TDM在此临床背景下的效用的研究设计提供战略性见解。
Personalization of oral small molecule anticancer drug doses based on individual patient blood drug levels, also known as therapeutic drug monitoring (TDM), has the potential to significantly improve the effectiveness of treatment by maximizing drug efficacy and minimize toxicity. However, this option has not yet been widely embraced by the oncology community. Some reasons for this include increased logistical complexity of dose individualization, the lack of clinical laboratories that measure small molecule drug concentrations in support of patient care, and the lack of reimbursement of costs. However, the main obstacle may be the lack of studies clearly demonstrating that monitoring of oral small molecule anticancer drug levels actually improves clinical outcomes. Without unequivocal evidence in support of TDM-guided dose individualization, especially demonstration of improved survival with TDM in randomized controlled trials, wide acceptance of this approach by oncologists and reimbursement by insurance companies is unlikely, and patients may continue to suffer as a result of receiving incorrect drug doses. This article reviews the current status of TDM of oral small molecule drugs in oncology and intends to provide strategic insights into the design of studies for evaluating the utility of TDM in this clinical context.
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
4.5
作者：
Kloprogge, Frank;Simpson, Julie A.;Tarning, Joel
通讯作者：
Tarning, Joel
影响因子：
3.4
作者：
Holford, NHG
通讯作者：
Holford, NHG
DOI：
10.1158/1078-0432.ccr-14-3068
发表时间：
2015-10-15
期刊：
Clinical cancer research : an official journal of the American Association for Cancer Research
影响因子：
--
作者：
Amengual JE;Johannet P;Lombardo M;Zullo K;Hoehn D;Bhagat G;Scotto L;Jirau-Serrano X;Radeski D;Heinen J;Jiang H;Cremers S;Zhang Y;Jones S;O'Connor OA
通讯作者：
O'Connor OA
影响因子：
3.4
作者：
Lankheet, Nienke A. G.;Desar, Ingrid M. E.;van Erp, Nielka P.
通讯作者：
van Erp, Nielka P.