Loading
Chronic Myeloid Leukemia Treatments / Lung Cancer Treatments and Mutations / HER2/EGFR in Cancer Research · Journal article
Clinical Pharmacokinetics · September 4, 2026
Early or partial results. Treat as a signal, not a conclusion.
This single-centre retrospective analysis of 1237 therapeutic drug monitoring samples from 309 cancer patients receiving 12 different tyrosine kinase inhibitors identified suboptimal target attainment for most drugs and associations between TKI plasma concentrations and specific renal, hepatic, and haematological parameters. The findings suggest potential candidates for personalised dosing optimisation but lack prospective validation or clinical outcome correlation.
Single-centre retrospective observational study. Cancer patients treated with TKIs; data collected January 2020 to August 2024.. Intervention: Therapeutic drug monitoring of 12 tyrosine kinase inhibitors (alectinib, bosutinib, dasatinib, imatinib, ibrutinib, lenvatinib, nilotinib, pazopanib, ponatinib, regorafenib, sunitinib, trametinib). n = 309. Single centre (not specified).
Target attainment percentages varied widely: 74.6% for alectinib, 70% for bosutinib, 49.9–61.9% for imatinib (indication-dependent), 88.9% for nilotinib, 50% for pazopanib, 50% for ponatinib, 89.5% for regorafenib, 26.6% for sunitinib, and 40–87.5% for dasatinib (indication and parameter-dependent) Glomerular filtration rate correlated with alectinib, imatinib, and sunitinib concentrations Alkaline phosphatase, bilirubin, and Gamma-GT correlated with alectinib; alkaline phosphatase with imatinib
No clinical outcomes (response, toxicity, survival) reported; only surrogate pharmacokinetic targets assessed.
These findings support consideration of therapeutic drug monitoring and individualised dosing strategies for TKI therapy, but the retrospective, single-centre design and lack of prospective validation or clinical outcome data mean that changes to practice should await confirmation in prospective studies.
Single-centre retrospective observational study of TDM data identifying associations between TKI concentrations and biochemical parameters, without clinical outcome validation or prospective intervention testing.
As stated by the source record.
Quoted from the source exactly as published.
These findings support consideration of therapeutic drug monitoring and individualised dosing strategies for TKI therapy, but the retrospective, single-centre design and lack of prospective validation or clinical outcome data mean that changes to practice should await confirmation in prospective studies.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Tyrosine kinase inhibitors (TKIs) are targeted cancer therapies. However, TKIs are still limited due to their high inter-individual variability. This study evaluated target attainment using therapeutic drug monitoring (TDM) data from 12 TKIs, and investigated biochemical and patient-related characteristics influencing TKI pharmacokinetics (PK) This single-centre retrospective study included cancer patients treated with TKIs between January 2020 and August 2024. Demographic, clinical, and biochemical data were extracted from electronic health records. Univariate and multivariate linear mixed models were used to identify factors associated with TKI PK. A total of 1237 TKI concentrations from 309 patients were included. Target attainment percentages were: 74.6% for alectinib; 70% for bosutinib; 49.9–61.9% for imatinib depending on the indication; 88.9% for nilotinib; 50% for pazopanib; 50% for ponatinib; 89.5% for regorafenib; 26.6% for sunitinib; ibrutinib, lenvatinib and trametinib had too few data for formal assessment; 40–87.5% for dasatinib, depending on indication and parameter ( C max or C min ). A mixed linear model analysis identified key parameters correlated with TKI concentrations. Glomerular filtration rate was correlated with alectinib, imatinib, and sunitinib. Alkaline phosphatase (ALP), bilirubin, and Gamma-GT correlated with alectinib and ALP with imatinib. Albumin and thrombocytes correlated with imatinib, thrombocytes with pazopanib, absolute neutrophiles count (ANC) with ponatinib, and haematocrit with regorafenib. Target attainment was suboptimal for most TKIs, supporting the need for TDM-guided optimisation and individualised dosing. Associations between TKI exposure and renal, hepatic, and haematological parameters further support personalised treatment strategies.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.