Clinical Application of Volumetric Absorptive Microsampling for Therapeutic Drug Monitoring of Oral Targeted Anticancer Drugs
Meertens et al.
The finding, in our words
This study established conversion methods for estimating plasma concentrations from whole blood VAMS samples for seven out of ten oral anticancer drugs, finding good agreement between capillary and venous samples. Patients reported a positive experience with home sampling using this microsampling technique.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
VAMS matched serum for the kinase inhibitors nilotinib, cabozantinib, dabrafenib and ruxolitinib, r 0.94–0.97, with serum reliably predictable for the first three, and 93% of at-home samples were collected correctly: at-home VAMS shown feasible for routine cancer-drug monitoring.
In AML and CLL, 91% of VAMS venetoclax results fell within 20% of plasma after individualised haematocrit correction; in home sampling, 18 of 21 patients self-sampled independently and 76% of returned samples were analysable, which shows home microsampling is workable, though the authors ask for multicentre validation.
This review found that volumetric microsampling devices, such as Mitra, HemaPEN, HemaXis DB10, and Tasso-M20, overcome haematocrit bias, whilst Telimmune plasma separation cards enable direct plasma collection without centrifugation. These technologies support patient-centric, decentralised sampling, though the authors note that clinical validation remains limited across different drugs and patient populations.
Volumetric microsampling can enable patient-centred therapeutic drug monitoring with high patient preference and acceptable method validation for many drugs, but conversion from capillary to plasma and agreement with venous sampling varies by analyte and requires careful validation.
Microsampling with Mitra® devices correlated strongly with venous plasma for capecitabine therapeutic drug monitoring (r=0.97), but yielded consistently lower concentrations. Patients preferred this method and reported minimal pain, suggesting it is suitable for patient-centric oncology drug monitoring in decentralised settings.