Therapeutic drug monitoring of imatinib in chronic myeloid leukemia: experience from 1216 patients at a centralized laboratory.

Bouchet S, Titier K, Moore N, et al. Fundam Clin Pharmacol. 2013;27:690-697.

This first very large scale analysis of the potential utility of TDM in real clinical practice demonstrated that the optimal response threshold of 1,000 ng/mL Cmin, was associated with major molecular response and complete molecular response independent of treatment duration.  In practice there was high interpatient variability (60%) and the majority of patients (61%) had Cmin levels below the therapeutic threshold.   The study demonstrated that TDM with a Cmin therapeutic threshold of 1,000 ng/mL  could be important  for dose optimization to achieve molecular responses.

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