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Therapeutic Drug Monitoring of Targeted Therapy in Metastatic Renal Cell Carcinoma.

Protein Pept Lett; 2018 05 30.
Artigo em Inglês | MEDLINE | ID: mdl-29848258
Targeted therapy has been widely used in the treatment of patients with metastatic renal cell carcinoma (mRCC). The current available therapies focus on the inhibition of angiogenesis through targeting the vascular endothelial growth factor receptor (VEGFR), and protein kinase such as the mammalian target of rapamycin (mTOR). Compared with other traditional chemotherapies and radiotherapies, targeted therapies dramatically improved progression-free survival (PFS). However, the microenvironment of patients' body, drug-drug interactions, as well as polymorphisms of metabolic enzymes and drug transporters ABC could influence pharmacokinetic characteristics. Therefore, targeted therapy has been shown to present a large interindividual variability. Therapeutic drug monitoring (TDM) in the clinical practice aims at improving efficacy and reducing toxicity by measuring drug concentration in biological samples and adjusting drug dose for each individual. TDM is widely employed under the situations such as lack of therapeutic response to other drugs, emerging of severe or unexpected toxicities, with narrow therapeutic windows or potential drug-drug interactions. The development of TDM in targeted therapy have been proposed in recent years, more and more targeted therapies have benefited from TDM. This review discusses the role of TDM in the individual targeted treatment of mRCC. It also depicts the molecular mechanism of mRCC targeted drugs, and the relationship between exposure and response.