OCT 30, 2014 10:30 AM PDT

Therapeutic Drug Monitoring (TDM) in Cancer Chemotherapy: A Tool for Optimizing Drug Management

  • Associate Professor of Pathology, Clinical Toxicology, Director, Point-of-Care Testing, Johns Hopkins University School of Medicine
      Dr. William Clarke is an associate professor of pathology at the Johns Hopkins University School of Medicine. His research focuses on the development of analytical methods for drug analysis, clinical mass spectrometry, and devices for point-of-care testing. Dr. Clarke serves as the director of Clinical Toxicology as well as Critical and Point-of-Care Testing Program at The Johns Hopkins Hospital.

      His team's current projects include qualitative screening for antiretroviral drugs and substances of abuse in various HIV- prevention clinical trials, development and validation of mass spectrometry methods for clinical analysis, and development of clinical assays for use on microfluidic platforms.

      Dr. Clarke received his B.S. in Chemistry from the University of Nebraska at Kearney and his Ph.D. in Analytical Chemistry from the University of Nebraska-Lincoln, as well as an M.B.A. from the Carey School of Business at Johns Hopkins University. He completed a post-doctoral fellowship in Clinical Chemistry at the Johns Hopkins School of Medicine.


    Many drugs currently used for anti-cancer therapy demonstrate significant inter-individual variability that cannot be normalized using body weight or body surface area. There is an increasing amount of evidence in the scientific literature describing the use of therapeutic drug monitoring (TDM) to inform dosing of these drugs can lead to more effective treatment. This presentation will discuss the scientific literature addressing inter-individual variability of these drugs, the concept of maximum tolerated dose (MTD), and why an approach using maximum tolerated exposure (MTE) might be a better way to manage some chemotherapeutic drugs. Specific examples of TDM in oncology will be discussed including 5-fluorouracil, taxanes, and tyrosine kinase inhibitors.

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