Target concentration intervention in oncology: Where are we at?

Saleem, Mohamed, Dimeski, Goce, Kirkpatrick, Carl M., Taylor, Paul J. and Martin, Jennifer H. (2012) Target concentration intervention in oncology: Where are we at?. Therapeutic Drug Monitoring, 34 3: 257-265. doi:10.1097/FTD.0b013e3182557342

Author Saleem, Mohamed
Dimeski, Goce
Kirkpatrick, Carl M.
Taylor, Paul J.
Martin, Jennifer H.
Title Target concentration intervention in oncology: Where are we at?
Journal name Therapeutic Drug Monitoring   Check publisher's open access policy
ISSN 0163-4356
Publication date 2012-06
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1097/FTD.0b013e3182557342
Volume 34
Issue 3
Start page 257
End page 265
Total pages 9
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Collection year 2013
Language eng
Abstract Therapeutic drug monitoring (TDM) and more recently target concentration intervention (TCI) have been widely used in clinical practice for the optimization of drug treatment. TDM and TCI have been applied most frequently in the cardiovascular, respiratory, neurology, and infectious disease areas because the medications used here have both narrow therapeutic indices and a clear relationship between concentration and effect. However, apart from drugs such as methotrexate and 5-fluorouracil, the clinical application of TDM/TCI in oncology is minimal. An important reason for this is that a therapeutic index for most anticancer agents has not been established. However, in the last 20 years, relationships between plasma drug concentrations and clinical outcome have been defined for various chemotherapeutic agents. Defining concentration-effect relationships is also complicated by the fact that cancer is almost always treated with multiple drugs given in combination making the precise definition of the pharmacodynamics of individual agents difficult. The increase in patients with obesity and also those underweight adds to the complexity of effective oncology treatment. This review describes some of the evidence that supports the use of TDM/TCI in oncology. It is proposed that as more patients previously ineligible for chemotherapy become eligible, TDM/TCI may play a critical role in optimizing chemotherapy outcomes. However, pharmacokinetic-pharmacodynamic research to investigate both therapeutic benefit and feasibility in daily clinical practice is required.
Keyword Target concentration intervention
Therapeutic drug monitoring
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2013 Collection
School of Medicine Publications
School of Pharmacy Publications
UQ Diamantina Institute Publications
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Citation counts: TR Web of Science Citation Count  Cited 10 times in Thomson Reuters Web of Science Article | Citations
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