Terapijsko praćenje lijekova kao način poboljšanja ishoda onkološke terapije

Professional paper - Professional paper

• Author: Lu Turković
• Author: Zvonimir Mlinarić
• Author: Tajana Silovski
• Author: Mario Šekerija
• Author: Miranda Sertić
• Author's institution: University of Zagreb; Faculty of Pharmacy and Biochemistry
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Pharmacy

Abstract (english)

Cancer is currently one of the leading causes of death in the
world, and different classes of antitumor drugs are used for the
treatment. Traditional cytostatics act not only on tumor cells but also on some
healthy cells and thus show a toxic effect. Despite the development of new, targeted
drugs, the problem of ineffectiveness and toxicity of therapy is still present.
Due to large differences in efficacy and toxicity both in different patients and in
each individual patient, it is desirable to introduce therapeutic drug monitoring
(TDM). Already in early clinical trials, the therapeutic and toxic doses of a drug
is determined by pharmacokinetic and pharmacodynamic studies. However,
depending on the stage and type of the disease, as well as the characteristics of
the patient, it is possible that the effective doses will be significantly lower than
the maximum tolerated dose, or that even the doses above which significant
toxicity occurs will not lead to an adequate effect. Despite the fact that in most
cases the determination of the concentration of drugs in the body ends with
their registration, for some drugs patients could benefit from therapeutic monitoring.
Drugs that are good candidates for TDM must meet a number of pharmacokinetic
and pharmacodynamic conditions, and it is necessary to select an
optimal sample for analysis, which is currently plasma in most cases. The benefit
of therapeutic monitoring of a drug must also be proven by a randomised prospective
study. Therapeutic monitoring of antitumor drugs appears to be an
excellent way of individualising therapy in order to prolong and improve the
quality of life of oncology patients, but its introduction into clinical everyday life
is faced with numerous obstacles. Many see the future of antineoplastic TDM in
the development of simpler monitoring methods, with the relief of the health
system by developing sampling techniques that the patient can carry out at
home, or through different biosensors that would even enable continuous monitoring
of drug concentrations. Finally, the opening of medicine to new technologies
and the involvement of clinical pharmacists, as well as public pharmacists
in the multidisciplinary oncology team will surely ease the implementation of
therapeutic drug monitoring in the clinical practice, thereby improving the therapeutic
outcomes and increasing the therapeutic efficacy, while reducing the
number of adverse events related to antitumor therapy.

• Keywords (croatian): rak; tumor; antitumorski lijekovi; terapijsko praćenje
• Language: croatian
• Publication type: Professional paper - Professional paper
• Publication status: Published
• Peer review: Peer review - domestic
• Publication version: Published version
• Journal title: Farmaceutski glasnik
• Numbering: vol. 78, no. 11-12, pp. 551-565
• p-ISSN: 0014-8202
• URN:NBN: urn:nbn:hr:163:002852
• Publication: 2022
• Type of resource: Text
• Access conditions: Open access
• Created on: 2023-01-17 14:44:03