title: Therapeutic drug monitoring for imatinib: Current status and Indian experience.
abstract: Imatinib is the current gold standard for treatment of chronic myeloid leukemia (CML). Recent pharmacokinetic studies have shown considerable variability in trough concentrations of imatinib due to variations in its metabolism, poor compliance, or drug-drug interactions and highlighted its impact on clinical response. A trough level close to 1000 ng/mL, appears to be correlated with better cytogenetic and molecular responses. Therapeutic Drug Monitoring (TDM) for imatinib may provide useful added information on efficacy, safety and compliance than clinical assessment alone and help in clinical decision making. It may be particularly helpful in patients with suboptimal response to treatment or treatment failure, severe or rare adverse events, possible drug interactions, or suspected nonadherence. Further prospective studies are needed to confirm relationship between imatinib plasma concentrations with response, and to define effective plasma concentrations in different patient populations.
authors: Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
authors: Brijesh
authors: B
authors: Arora
authors: Department of Clinical Pharmacology, Tata Memorial Centre, Mumbai, Maharashtra, India.
authors: Vikram
authors: V
authors: Gota
authors: Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
authors: Hari
authors: H
authors: Menon
authors: Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
authors: Manju
authors: M
authors: Sengar
authors: Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
authors: Reena
authors: R
authors: Nair
authors: Department of Clinical Pharmacology, Tata Memorial Centre, Mumbai, Maharashtra, India.
authors: Pankaj
authors: P
authors: Patial
authors: Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India.
authors: S D
authors: SD
authors: Banavali
keywords: Blood-level testing; chronic myeloid leukemia; imatinib; pharmacodynamics; pharmacokinetics; tyrosine kinase inhibitors