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治疗药物监测与酪氨酸激酶抑制剂

Therapeutic drug monitoring and tyrosine kinase inhibitors.

作者信息

Herviou Pauline, Thivat Emilie, Richard Damien, Roche Lucie, Dohou Joyce, Pouget Mélanie, Eschalier Alain, Durando Xavier, Authier Nicolas

机构信息

Department of Pharmacology, CHU Clermont-Ferrand, Clermont-Ferrand F-63003, France; INSERM U 1107, Neuro-Dol, Clermont-Ferrand F-63000, France; Centre Jean Perrin, Clermont-Ferrand F-63011, France.

Centre Jean Perrin, Clermont-Ferrand F-63011, France; ERTICa EA 4677, Research Team on Individualized Treatment of Cancers in Auvergne, Auvergne University and Centre Jean Perrin, Clermont-Ferrand F-63011, France; INSERM UMR 990, Auvergne University, Clermont-Ferrand F-63000, France.

出版信息

Oncol Lett. 2016 Aug;12(2):1223-1232. doi: 10.3892/ol.2016.4780. Epub 2016 Jun 24.

Abstract

The therapeutic activity of drugs can be optimized by establishing an individualized dosage, based on the measurement of the drug concentration in the serum, particularly if the drugs are characterized by an inter-individual variation in pharmacokinetics that results in an under- or overexposure to treatment. In recent years, several tyrosine kinase inhibitors (TKIs) have been developed to block intracellular signaling pathways in tumor cells. These oral drugs are candidates for therapeutic drug monitoring (TDM) due to their high inter-individual variability for therapeutic and toxic effects. Following a literature search on PubMed, studies on TKIs and their pharmacokinetic characteristics, plasma quantification and inter-individual variability was studied. TDM is commonly used in various medical fields, including cardiology and psychiatry, but is not often applied in oncology. Plasma concentration monitoring has been thoroughly studied for imatinib, in order to evaluate the usefulness of TDM. The measurement of plasma concentration can be performed by various analytical techniques, with liquid chromatography-mass spectrometry being the reference method. This method is currently used to monitor the efficacy and tolerability of imatinib treatments. Although TDM is already being used for imatinib, additional studies are required in order to improve this practice with the inclusion of other TKIs.

摘要

通过基于血清中药物浓度的测量来确定个体化剂量,可以优化药物的治疗活性,特别是当药物的特点是药代动力学存在个体间差异,从而导致治疗时暴露不足或过度暴露时。近年来,已经开发了几种酪氨酸激酶抑制剂(TKIs)来阻断肿瘤细胞中的细胞内信号通路。由于这些口服药物在治疗和毒性作用方面存在高度个体间变异性,因此它们是治疗药物监测(TDM)的候选药物。在PubMed上进行文献检索后,对TKIs及其药代动力学特征、血浆定量和个体间变异性进行了研究。TDM常用于包括心脏病学和精神病学在内的各种医学领域,但在肿瘤学中并不常用。为了评估TDM的有用性,已经对伊马替尼的血浆浓度监测进行了深入研究。血浆浓度的测量可以通过各种分析技术进行,液相色谱 - 质谱法是参考方法。该方法目前用于监测伊马替尼治疗的疗效和耐受性。尽管TDM已经用于伊马替尼,但为了将其他TKIs纳入其中以改进这种做法,还需要进行更多研究。

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