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- Title
Therapeutic drug monitoring (TDM) of 5-fluorouracil (5-FU): new preanalytic aspects.
- Authors
Mindt, Sonani; Aida, Sihem; Merx, Kirsten; Müller, Annette; Gutting, Tobias; Hedtke, Maren; Neumaier, Michael; Hofheinz, Ralf-Dieter
- Abstract
Background: 5-Fluorouracil (5-FU) is frequently used for the treatment of gastrointestinal tumors. The pharmacological effect of 5-FU is influenced by genetic polymorphisms as well as differently dosed regimens. Currently, 5-FU is generally administered as a continuous infusion via an implanted port system using a body surface area (BSA)-based dose calculation. In order to optimize treatment, the area under the curve (AUC) can be estimated to allow for individual dose adjustment. A 5-FU AUC range between 20 and 30 [mg×h×L] is recommended. The aim of the current study was to assess if blood for AUC analysis could also be drawn at the side where the port system had been placed. Methods: We collected EDTA blood samples of patients receiving infusional 5-FU simultaneously from different sampling points (right/left cubital vein). 5-FU concentrations were measured in a steady-state equilibrium based on nanoparticle immunoassay (My5-FU; Saladax). Results: A total of 39 patients took part in this study. About half of the patients did not reach the target 5-FU concentration window (37% were under- and 16% of the patients were overdosed). Calculated median AUC was 23.3 for the right arm (range 5.8–59.4) and a median of 23.4 for the left arm (range 5.3–61.0). AUC values showed no difference between right compared to left arms (p=0.99). Conclusions: In all, these results confirm that a high percentage of patients are not treated with 5-FU doses reaching suggested AUC levels of 20–30. The location of venepuncture, however, had no impact on the results of plasma 5-FU concentration.
- Subjects
DRUG monitoring; FLUOROURACIL; GASTROINTESTINAL tumors; GENETIC polymorphisms; IMMUNOASSAY
- Publication
Clinical Chemistry & Laboratory Medicine, 2019, Vol 57, Issue 7, p1012
- ISSN
1434-6621
- Publication type
Article
- DOI
10.1515/cclm-2018-1177