Therapeutic drug monitoring of imatinib: how far are we in the leukemia setting?
Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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Therapeutic drug monitoring of imatinib : how far are we in the leukemia setting? / Rasmussen, Anna Sofie Buhl; Andersen, Christen Lykkegaard; Weimann, Allan; Yang, Tianwu; Tron, Camille; Gandemer, Virginie; Dalhoff, Kim; Rank, Cecilie Utke; Schmiegelow, Kjeld.
I: Expert Review of Clinical Pharmacology, Bind 17, Nr. 3, 2024, s. 225-234.Publikation: Bidrag til tidsskrift › Review › Forskning › fagfællebedømt
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TY - JOUR
T1 - Therapeutic drug monitoring of imatinib
T2 - how far are we in the leukemia setting?
AU - Rasmussen, Anna Sofie Buhl
AU - Andersen, Christen Lykkegaard
AU - Weimann, Allan
AU - Yang, Tianwu
AU - Tron, Camille
AU - Gandemer, Virginie
AU - Dalhoff, Kim
AU - Rank, Cecilie Utke
AU - Schmiegelow, Kjeld
PY - 2024
Y1 - 2024
N2 - IntroductionTyrosine kinase inhibitors (TKIs) have revolutionized survival rates of chronic myeloid leukemia (CML) and Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL) and replaced hematopoietic stem cell transplantation (hSCT) as the key treatment option for these patients. More recently, the so-called Philadelphia chromosome-like (Ph-like) ALL has similarly benefitted from TKIs. However, many patients shift from the first generation TKI, imatinib, due to treatment-related toxicities or lack of treatment efficacy. A more personalized approach to TKI treatment could counteract these challenges and potentially be more cost-effective. Therapeutic drug monitoring (TDM) has led to higher response rates and less treatment-related toxicity in adult CML but is rarely used in ALL or in childhood CML.Areas coveredThis review summarizes different antileukemic treatment indications for TKIs with focus on imatinib and its pharmacokinetic/-dynamic properties as well as opportunities and pitfalls of TDM for imatinib treatment in relation to pharmacogenetics and co-medication for pediatric and adult Ph+/Ph-like leukemias.Expert opinionTDM of imatinib adds value to standard monitoring of ABL-class leukemia by uncovering non-adherence and potentially mitigating adverse effects. Clinically implementable pharmacokinetic/-dynamic models adjusted for relevant pharmacogenetics could improve individual dosing. Prospective trials of TDM-based treatments, including both children and adults, are needed.
AB - IntroductionTyrosine kinase inhibitors (TKIs) have revolutionized survival rates of chronic myeloid leukemia (CML) and Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL) and replaced hematopoietic stem cell transplantation (hSCT) as the key treatment option for these patients. More recently, the so-called Philadelphia chromosome-like (Ph-like) ALL has similarly benefitted from TKIs. However, many patients shift from the first generation TKI, imatinib, due to treatment-related toxicities or lack of treatment efficacy. A more personalized approach to TKI treatment could counteract these challenges and potentially be more cost-effective. Therapeutic drug monitoring (TDM) has led to higher response rates and less treatment-related toxicity in adult CML but is rarely used in ALL or in childhood CML.Areas coveredThis review summarizes different antileukemic treatment indications for TKIs with focus on imatinib and its pharmacokinetic/-dynamic properties as well as opportunities and pitfalls of TDM for imatinib treatment in relation to pharmacogenetics and co-medication for pediatric and adult Ph+/Ph-like leukemias.Expert opinionTDM of imatinib adds value to standard monitoring of ABL-class leukemia by uncovering non-adherence and potentially mitigating adverse effects. Clinically implementable pharmacokinetic/-dynamic models adjusted for relevant pharmacogenetics could improve individual dosing. Prospective trials of TDM-based treatments, including both children and adults, are needed.
U2 - 10.1080/17512433.2024.2312256
DO - 10.1080/17512433.2024.2312256
M3 - Review
C2 - 38345044
VL - 17
SP - 225
EP - 234
JO - Expert Review of Clinical Pharmacology
JF - Expert Review of Clinical Pharmacology
SN - 1751-2433
IS - 3
ER -
ID: 381559239