| Abstract | Cilj istraživanja: Cilj ovog rada je napraviti pregled dosadašnjih uspjeha u razvoju metoda u
terapijskom praćenju lijekova (engl. Therapeutic Drug Monitoring, TDM) kod raka dojke. Komentirat
će se i izazovi koji preostaju kako bi upotreba TDM-a postala standardni pristup u liječenju raka
dojke.
Materijal i metode: Istraživanje se provelo pregledom znanstvene literature i uvidom u trenutnu
kliničku praksu pretraživanjem baza podataka “Scopus”, “Web of Science”, “PubMed”,
“ScienceDirect” i “Directory of Open Access Journals” s ključnim riječima therapeutic drug
monitoring, TDM, breast cancer treatment, analytical methods, chemotherapy individualization, genetic
polymorphism in chemotherapy, bioanalytical methods, recommendations for therapeutic drug monitoring i njihovim
kombinacijama.
Rezultati: Kod velikog broja lijekova proračunavanje doza na temelju površine tijela nije
primjereno. Jedan od problema uvođenja TDM-a u terapiju raka dojke u tim slučajevima je i
nedostatak prikladnih analitičkih metoda. Isto tako, za starije lijekove i lijekove namijenjene za veći
broj indikacija je uspostavljen veći broj metoda i više se zna o njihovoj farmakokinetici pa se za
njih češće provodi TDM, za razliku od novijih lijekova i lijekova koji se koriste u ograničenom
broju indikacija.
Zaključak: TDM je i dalje slabo istraženo i iskorišteno područje te postoji puno prostora za
napredak. Potrebno je razviti brze, jednostavne, robusne i jeftine metode da se osigura racionalna
i učinkovitija terapija, ali i ovdje ima prostora za daljnji razvoj. Međutim, može se očekivati da će
uz razvoj sve većeg broj dostupnih metoda i poboljšanja njihovih performansi, rasti i njihova
popularnost, a samim time će porasti i njihova dostupnost. |
| Abstract (english) | Objectives: The objective of this thesis is to provide an overview of the previous successes in the
method development for therapeutic drug monitoring (TDM) in breast cancer treatment. The
remaining challenges to make TDM a standard approach in breast cancer treatment will also be
discussed.
Materials and Methods: The research was conducted by reviewing scientific literature and
examining current clinical practice by searching databases "Scopus", "Web of Science", "PubMed",
"ScienceDirect", and "Directory of Open Access Journals" using keywords therapeutic drug
monitoring, TDM, breast cancer treatment, analytical methods, chemotherapy individualization, genetic
polymorphism in chemotherapy, bioanalytical methods, recommendations for therapeutic drug monitoring and their
combinations.
Results: For many drugs, body surface area-based dose calculation is not appropriate. One
problem with introducing TDM into breast cancer therapy in these cases is the lack of suitable
analytical methods. Additionally, for older drugs and drugs with more indications, more methods
have been established and more is known about their pharmacokinetics, so TDM is more
frequently performed, unlike newer drugs and drugs used in a limited number of indications.
Conclusion: TDM is still poorly researched and underutilized, and there is plenty of room for
improvement. It is necessary to develop fast, simple, robust, and inexpensive methods to ensure
rational and more effective therapy, but there is still room for improvement. However, with the
increased number of available methods and improvements in their performance, it can be expected
that their popularity will grow, as their availability. |
