Application of therapeutic drug monitoring of imatinib for individual treatment of gastrointestinal stromal tumor

Koji Fukuda,Shimazu Shimazu,Taichi Yoshida

doi:10.14319/ijcto.42.11

Koji Fukuda, Shimazu Shimazu + Show 1 more

Open Access

https://doi.org/10.14319/ijcto.42.11

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Abstract

Many molecular target agents are continuously administered at fixed dosages. Imatinib, which can control the growth of a gastrointestinal stromal tumor, is administrated at 400 mg/day. However, many patients cannot continue treatment because of adverse events, such as neutropenia. To obtain the best therapeutic response while maintaining quality of life, individualization should be considered. Study participants were gastrointestinal stromal tumor patients who required treatment with imatinib. Therapeutic drug monitoring was conducted using high-performance liquid chromatography. In our study, the trough (lowest) concentration that a drug reaches before the next dose is administered differed among patients. The grades of adverse events also differed individually. Moreover, the dosage that was necessary to shrink gastrointestinal stromal tumor differed in cases by cases. Dosage was modified according to the balance between blood concentration and therapeutic responses in order to minimize adverse events for individual patients, and to maximize the effect as the responses differed among patients. It was shown that based on therapeutic drug monitoring, individualization enabled the patients who may not normally continue the typical treatment to tolerate imatinib. According to the therapeutic drug monitoring, individualization of dosage of imatinib could improve the patients’ outcomes in both ends, therapeutic and adeverse responses.

Highlights

Individualization of cancer chemotherapy with cytotoxic patients’ weight, but many of them are given at a fixed agents for solid tumors is a very important issue
The evaluation of therapeutic outcome and the grading of A gastrointestinal stromal tumor (GIST) is derived from adverse events according to Response Evaluation the intestinal smooth muscle pacemaker cell, known as Criteria in Solid Tumors (RECIST) and Common the Cajal cell; typically, it results from gain-of-function
Imatinib is a tyrosine offer helpful information related to cancer kinase inhibitor targeting KIT and PDGFRA proteins and chemotherapy as well as the anti-microbial efficacy of is approved for advanced and post-operative patients, a antibiotics such as vancomycin[1] or lithium salts[2] for high-risk group of GIST.[7]

Summary

Introduction

Individualization of cancer chemotherapy with cytotoxic patients’ weight, but many of them are given at a fixed agents for solid tumors is a very important issue. 2 Fukuda et al.: Therapeutic drug monitoring of imatinib for GIST The purpose of TDM is to adjust the blood concentration of imatinib within the therapeutic window (TW). The therapeutic effects and adverse events associated with imatinib differ among patients, and TW ought to be determined individually.

Results

Conclusion