Therapeutic Drug Monitoring of Tyrosine Kinase Inhibitors Using Dried Blood Microsamples
Verougstraete et al.
The finding, in our words
A review of dried blood microsampling for tyrosine kinase inhibitor monitoring, covering the analytical and clinical requirements for moving oral cancer-drug TDM out of hospital.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
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.
A review of 39 studies found that dried blood spot and volumetric absorptive microsampling show promising results for therapeutic drug monitoring of oral targeted anticancer drugs. The authors state that external validation remains crucial to confirm reliability, citing haematocrit effects and sample stability as key challenges.
A UHPLC-MS/MS assay for risperidone, aripiprazole, pipamperone and their metabolites in dried blood spots was validated for therapeutic drug monitoring. The method proved accurate across haematocrit values of 30-45 percent, remained stable for ten days at room temperature, and was successfully applied to patient samples, enabling decentralised monitoring in children with autism spectrum disorders.
Dried blood spot microsampling provides a patient-centric alternative to venous sampling for therapeutic drug monitoring, with advantages of home self-collection, small sample volumes suitable for children, and analyte stability, though accuracy is affected by haematocrit and requires patient correlation studies to validate clinical equivalence.
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.