Advancing Therapeutic Drug Monitoring for Oral Targeted Anticancer Drugs: From Hospital-Based Towards Home-Sampling

Abstract

Home-sampling for therapeutic drug monitoring (TDM) for oral targeted anticancer drugs offers a promising alternative to traditional hospital-based sampling methods, though it presents challenges. This review aims to summarize the state-of-the-art of home-sampling methods for TDM and evaluates the analytical and clinical validation challenges. A comprehensive search was conducted across Embase, Medline, and Scopus. Eligible articles described analytical and/or clinical validation of home-sampling methods for oral targeted anticancer drugs. ASReview was used to process unique references and to identify relevant studies. Of the 39 included articles, 32 detailed on analytical validation experiments, while 27 covered clinical validation experiments. Dried blood spot and volumetric absorptive microsampling were the primary sampling methods. Key challenges were ensuring robust sample collection, sample pretreatment, hematocrit effects, and sample stability, which were generally thoroughly investigated. Clinical validation yielded promising results for most analytes, although external validation remains crucial for confirming reliability. Home-sampling methods for TDM of oral targeted anticancer drugs show promising results for clinical implementation. Methods for well-studied drugs may be clinically implemented immediately, while others require further external validation. Future research should address device-specific challenges and assess patient feasibility to facilitate the routine use of home-sampling in clinical practice.