Potential applications of therapeutic drug monitoring in treatment of neoplastic disease by antineoplastic agents

Charles Erlichman

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Therapeutic drug monitoring of antineoplastic agents must be considered in terms of cytotoxicity to stem cells and toxicity of normal tissues. The dose-limiting toxicity which is myelosuppression is believed to be a necessary effect for maximal antitumour effect. The areas in which therapeutic drug monitoring can play a role include: 1) predicting patients at risk of toxicity, e.g. high dose methotrexate therapy; 2) low bioavailability, e.g. oral 6-mercaptopurine; 3) identifying patients at risk of treatment failure, e.g. methotrexate clearance in acute lymphoblastic leukemia. Although therapeutic drug monitoring is not clinically useful at present, the potential role it can play is illustrated for cytosine arabinoside, adriamycin and cyclophosphamide. Two problems encountered with drug monitoring of antineoplastic disease are tumour heterogeneity manifested by clonal, nutritional and physical characteristics and the common practice of combination chemotherapy. These problems must be addressed in order to make therapeutic drug monitoring a practical tool in cancer chemotherapy. Future applications of therapeutic drug monitoring will require more studies to define therapeutic ranges for single agents, patient-to-patient variation, course-to-course variation and the effects of drug combinations on pharmacokinetic profiles of the drugs used.

Original languageEnglish (US)
Pages (from-to)101-106
Number of pages6
JournalClinical Biochemistry
Volume19
Issue number2
DOIs
StatePublished - 1986
Externally publishedYes

Fingerprint

Drug Monitoring
Antineoplastic Agents
Monitoring
Pharmaceutical Preparations
Toxicity
Chemotherapy
Methotrexate
Therapeutics
6-Mercaptopurine
Pharmacokinetics
Cytarabine
Proxy
Drug Combinations
Cytotoxicity
Combination Drug Therapy
Stem cells
Treatment Failure
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Doxorubicin
Cyclophosphamide

Keywords

  • antineoplastic agents
  • cancer
  • drug therapy
  • therapeutic drug monitoring

ASJC Scopus subject areas

  • Clinical Biochemistry

Cite this

Potential applications of therapeutic drug monitoring in treatment of neoplastic disease by antineoplastic agents. / Erlichman, Charles.

In: Clinical Biochemistry, Vol. 19, No. 2, 1986, p. 101-106.

Research output: Contribution to journalArticle

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