Therapeutic Drug Monitoring in Oncology: IATDMCT Recommendations for 5-Fluorouracil Therapy

Beumer JH, Chu E, Allegra C, et al. Clin Pharmacol Ther. 2018 Jun 20. [Epub ahead of print] Review.

Patient care evolves around evidence based guidelines. An expert working committee of clinician-scientists tasked by the International Association of Therapeutic Drug Monitoring and Clinical Toxicology reviewed the available peer-reviewed literature.

TDM of 5-FU was strongly recommended for dose titration. The required evidence is: established therapeutic ranges, demonstrated improved action and/or lower toxicity in controlled TDM clinical trials. The clinical outcome is: therapeutic blood levels give the highest probability of response, “subtherapeutic” levels have the risk of lower response rates, “supratherapeutic” levels increase the risk of toxicity.

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