Paclitaxel and Therapeutic Drug Monitoring with Microsampling in Clinical Practice
Radovanovic et al.
The finding, in our words
Capillary blood collected with the Mitra® device showed correlation with venous samples for paclitaxel therapeutic drug monitoring, but wide confidence intervals suggest the methods may not be interchangeable. While plasma and whole blood concentrations were more closely aligned, the variability raises questions about using self-collected capillary samples for dose individualisation without further validation.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
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.
The authors validated an LC-MS and LC-MS/MS method for quantifying axitinib from 10 microlitre capillary blood collected by VAMS, demonstrating within- and between-run precision within 14% CV and accuracy between 81 and 116% against plasma as the gold standard, making the approach suitable for therapeutic drug monitoring in ambulatory and clinical care.
Volumetric absorptive microsampling (VAMS) using the Neoteryx Mitra device was validated for mitotane therapeutic drug monitoring across 1–50 mg/L, with acceptable haematocrit bias and one-week stability at room temperature. However, comparison with venous plasma showed poor correlation, suggesting home-based VAMS is of limited clinical value for mitotane unless a method-specific target range is established.
The validated LC-MS/MS method showed similar pharmacokinetic profiles for albendazole and its metabolites across plasma, whole blood, dried blood spots and Mitra microsamples from hookworm-infected adolescents, supporting microsampling for paediatric pharmacokinetic studies. Mitra extraction proved more robust than dried blood spots during validation and is recommended for future albendazole pharmacokinetic work, despite higher albendazole sulfone concentrations observed in both microsampling devices compared with wet matrices.
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.