ArticleDaru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences2023
The use of therapeutic drug monitoring to highlight an over-looked drug-drug interaction leading to imatinib treatment failure.
Article in Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 4 citations in OpenAlex.
- Clinical Validity of Imatinib Therapeutic Drug Monitoring in a Real-World Italian Cohort of Gastrointestinal Stromal Tumors and the Role of Patients' Sex.Pharmaceutics · 2026Article
- Increased plasma imatinib exposure and toxicity in chronically treated GIST patients with SARS-CoV-2 infection: a case series.Frontiers in immunology · 2024Article
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11 authors at 1 institution in 1 country.
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Abstract
backgroundChronic oral anticancer therapies, are increasingly prescribed and present new challenges including the enhanced risk of overlooked drug-drug interactions (DDIs). Lengthy treatments and patients' management by different professionals can lead to serious prescribing errors that therapeutic drug monitoring (TDM) can help identifying thus allowing a more effective and safer treatment of patients with polypharmacy.
objectivesThis report aims to exemplify how an intensified pharmacological approach could help in the clinical monitoring of patients on chronic treatments.
methodsA patient with gastrointestinal stromal tumor was referred to our clinical pharmacology service due to tumor progression while on imatinib therapy. The investigation was based on TDM, pharmacogenetics, DDI evaluation and Circulating tumor DNA (ctDNA) analysis. The patient underwent repeated blood samplings to measure imatinib and norimatinib plasma concentrations through a validated LC-MS/MS method. Polymorphisms affecting genes involved in imatinib metabolism and transport were investigated using SNPline PCR Genotyping System. Drug-drug interactions were evaluated though Lexicomp. ctDNA analysis was performed on MiSeq platform.
resultsTDM analysis revealed that the patient was underexposed to imatinib (C
conclusionThe active pharmacological monitoring allowed the identification of a dangerous previously over-looked DDI leading to IMA under-exposure. The switch to a different antiepileptic treatment, reversed the effect of DDI, restoring therapeutic IMA plasmatic concentrations.
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