Therapeutic drug monitoring in oncology - What’s out there: A bibliometric evaluation on the topic

Abstract

Pharmacological therapy is the mainstay of treatment for cancer patients. Despite wide interpatient variability in systemic drug concentrations for numerous antineoplastics, dosing based on body size remains the predominant approach. Therapeutic drug monitoring (TDM) is used for few antineoplastics in specific scenarios. We conducted a rapid bibliometric evaluation of TDM in oncology to capture a snapshot of research in this area over time and explore topics that reflect development in the field. Reports with the composite, indexed term ‘therapeutic drug monitoring’ in the title and abstract were extracted from MEDLINE (inception to August 2021). Reports related to applications in cancer were selected for inclusion and were tagged by study design, antineoplastic drugs and concepts related to TDM. We present a timeline from 1980 to the present indicating the year of first report of antineoplastic agents and key terms. The reports in our sample primarily reflected development and validation of analytical methods with few relating to clinical outcomes to support implementation. Our work emphasises evidence gaps that may contribute to poor uptake of TDM in oncology.

Bariatric surgery and oral chemotherapy: Where is the dosing guidance?

“…TDM already provides valuable guidance for dose adjustment of antibiotics, immunosuppressives, antiepileptics, and other drugs, but its use in cancer therapy has been very limited. A recent literature review of nearly 9000 TDM articles noted that less than 8% involved antineoplastic medications 15 . The lack of research and availability of TDM in oncology is discouraging, given that pharmacokinetic variability (such as that exhibited with bariatric patients) and irregular oral chemotherapy adherence are both detectable via TDM.…”

“…A recent literature review of nearly 9000 TDM articles noted that less than 8% involved antineoplastic medications. 15 The lack of research and availability of TDM in oncology is discouraging, given that pharmacokinetic variability (such as that exhibited with bariatric patients) and irregular oral chemotherapy adherence are both detectable via TDM. Consequently, an opportunity to reduce modifiable cancer progression risk factors is being squandered.…”