On-Site Therapeutic Drug Monitoring

• Published in: Trends in biotechnology (Regular ed.) Vol. 38; no. 11; pp. 1262 - 1277
• Main Authors: Ates, H. Ceren, Roberts, Jason A., Lipman, Jeffrey, Cass, Anthony E.G., Urban, Gerald A., Dincer, Can
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-11-2020; Elsevier Limited
• Subjects: Antibiotics; Antibodies; Binding sites; Biosensors; Cancer; Chromatography; Clinical medicine; Competition; Dose-response effects; Drugs; Immunoassay; immunoassays; Laboratories; Methods; Monitoring; Nanoparticles; on-site drug monitoring; Onsite; pharmacokinetics; PK/PD models; Precision medicine; Sensors; Therapeutic drug monitoring; wearables; pharmacokinetics; immunoassays; biosensors; wearables; on-site drug monitoring; PK/PD models
• ISSN: 0167-7799; 1879-3096
• DOI: 10.1016/j.tibtech.2020.03.001

Recent technological advances have stimulated efforts to bring personalized medicine into practice. Yet, traditional application fields like therapeutic drug monitoring (TDM) have remained rather under-appreciated. Owing to clear dose-response relationships, TDM could improve patient outcomes and reduce healthcare costs. While chromatography-based routine practices are restricted due to high costs and turnaround times, biosensors overcome these limitations by offering on-site analysis. Nevertheless, sensor-based approaches have yet to break through for clinical TDM applications, due to the gap between scientific and clinical communities. We provide a critical overview of current TDM practices, followed by a TDM guideline to establish a common ground across disciplines. Finally, we discuss how the translation of sensor systems for TDM can be facilitated, by highlighting the challenges and opportunities.
On-site therapeutic drug monitoring has the potential to improve patient outcomes and drastically reduce healthcare costs.Despite being on the radar of the scientific community for almost two decades, sensor-based approaches have yet to break through and support the clinical application of therapeutic drug monitoring, potentially due to the gap between scientific and clinical communities.Chromatography as a routine practice is limited due to its lack of standardization, high turnaround-times and instrumentation costs, and labored sample preparation.Sensors offer a low-cost, easy-to-use, and on-site analysis method to explore the full potential of therapeutic drug monitoring, overcoming these limitations.The success of individualized dosing strongly relies on two factors: how PK/PD studies are integrated with therapeutic drug monitoring and how the measurement process is managed.