Therapeutic drug monitoring in anticancer agents: perspectives of Australian medical oncologists
Details
Publication Year 2024-09,Volume 54,Issue #9,Page 1458-1464
Journal Title
Internal Medicine Journal
Publication Type
Research article
Abstract
BACKGROUND: In the development of anticancer agents for solid tumours, body surface area continues to be used to personalise dosing despite minimal evidence for its use over other dosing strategies. With the development of tyrosine kinase inhibitors and other oral targeted anticancer agents, dosing using therapeutic drug monitoring (TDM) is now utilised in many health systems but has had limited uptake in Australia. AIM: To determine attitudes and barriers to the implementation of TDM among Australian oncologists. METHODS: A comprehensive questionnaire was developed by the Dutch Pharmacology Oncology Group from semistructured interviews of stakeholders. Seventy-nine questions across seven domains were developed with three free-text responses. This was rationalised to 17 questions with three free-text responses for Australian medical oncologists who identified limited experience with TDM. RESULTS: Fifty-seven responses were received, with 49 clinicians (86%) identifying limited experience of performing TDM in daily practice. Clinicians were positive (62-91% agree/strongly agree across seven questions) about the advantages of TDM. There was a mixed response for cost-effectiveness and scientific evidence being a barrier to implementation, but strong agreement that prospective studies were needed (75% agreed or strongly agreed); that national treatment guidelines would enable practice (80%) and that a 'pharmacology of oncolytics' education programme would be useful (96%) to provide knowledge for dose individualisation. CONCLUSION: Despite the limited experience of TDM in oncology in Australia, medical oncologists appear positive about the potential benefit to their patients. We have identified three barriers to implementation that could be targeted for increased adoption of TDM in oncology in Australia.
Publisher
Wiley
Keywords
Humans; *Drug Monitoring/methods; Australia; *Antineoplastic Agents/therapeutic use; Surveys and Questionnaires; *Oncologists; Attitude of Health Personnel; Neoplasms/drug therapy; Medical Oncology; clinical pharmacology; implementation tools; therapeutic drug monitoring
Department(s)
Medical Oncology
Open Access at Publisher's Site
https://doi.org/10.1111/imj.16415
Terms of Use/Rights Notice
Refer to copyright notice on published article.


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