Cancer Institute

Research project  |  Therapeutic drug monitoring for oral anti-cancer drugs

DPOG TDM

Status: Ongoing project

During this project we will implement therapeutic drug monitoring of oral targeted anti-cancer drugs to personalize the given treatment for each individual

What we do

About our project

Aim of the project

During the treatment with oral anticancer drugs individuals have a high risk to be underdosed (>30% of the patients), which could lead to a decrease in anti-tumor efficacy, or overdosed (>15% of the patients), which could lead to increase in side effects.1-5 By implementing Therapeutic Drug Monitoring we try to personalize the dosing of the anti-cancer treatment to reach to most optimal dose for each individual. 

Therapeutic drug monitoring

Therapeutic drug monitoring (TDM) is a well-established way of personalizing the dose of a drug based on measured drug levels in blood.6 Blood is collected during treatment, drug levels are determined and are used to guide further dosing. The aim of TDM is to establish the optimal dose for each individual patient taking into account important patient and treatment characteristics, as co-medication, co-morbidity and measured drug concentrations. TDM is a well-established method for personalized dosing of drugs and is broadly used in the field of transplantation medicine or treatment of micro-organisms. 

Execution of the project

For most oral anticancer drugs, blood samples will be taken at 4, 8 and 12 weeks after start of treatment to measure the concentration of the drug in the blood of the patient. Based on this concentration and patient characteristics an advise on the dosing of the treatment will be given to the treating physician. Together with the patient the treating physician will discuss the recommendation and possibly implement it. After 4 weeks the intervention will be evaluated and if necessary further improved. After 12 weeks the aim is to reach the most optimal dose for the individual patient. Every 12 weeks there after the dose will be monitored and if necessary improved.

Our research focus

The aim of this project is to perform a prospective study implementing TDM of oral targeted anti-cancer drugs in multiple large hospitals in the Netherlands and to build a prospective registry to structurally collect data on the patients’ clinical outcome and the effectiveness of the interventions.

Funds & Grants

This project is partly funded by unrestricted grants by Novartis, Roche and Pfizer.

Collaborations

Collaboration within Erasmus MC:

This project is performed by the department of Medical Oncology in collaboration with the department of Pharmacy.

Collaboration outside Erasmus MC:

This project is an initiative of the Dutch Pharmacology Oncology Group (DPOG) which is a collaboration between the following institutions:

Publications

Our team

Contact us:

r.vaneerden@erasmusmc.nl