小分子靶向抗肿瘤药物的治疗药物浓度监测研究进展

蒋熠明; 张道明; 章欢琪; 林能明; 李杨玲

引用本文:	蒋熠明,张道明,章欢琪,林能明,李杨玲.小分子靶向抗肿瘤药物的治疗药物浓度监测研究进展[J].中国现代应用药学,2025,42(9):122-131.
	Jiang Yiming,Zhang Daoming,Zhang Huanqi,Lin Nengming,Li Yangling.A Review on Therapeutic Drug Monitoring of Small Molecule Targeted Anti-tumor Drugs[J].Chin J Mod Appl Pharm(中国现代应用药学),2025,42(9):122-131.

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小分子靶向抗肿瘤药物的治疗药物浓度监测研究进展
蒋熠明,张道明,章欢琪,林能明,李杨玲
1.浙江大学药学院/临床药学研究中心;2.杭州市第一人民医院临床药理研究室/浙江省临床肿瘤药理与毒理学研究重点实验室

摘要:

治疗药物监测(Therapeutic Drug Monitoring,TDM)在抗肿瘤药物的临床治疗过程中是一种非常重要的手段。但目前,多种小分子靶向抗肿瘤药物的TDM尚未完全应用到临床中,并且治疗药物监测指南仍存在较多不完善之处,其原因主要在于小分子靶向抗肿瘤药物在治疗过程中存在药动学/药效学个体间差异大、药动学参数受到多种因素影响、患者体内药物浓度测定困难等问题。除此之外,不同的小分子靶向抗肿瘤药物进行TDM采用不同的监测指标,采用的定量分析方法也有所不同。因此,进行个体化治疗药物监测有利于将用药的合理性最大化。本综述对已有的小分子靶向抗肿瘤药物TDM进行综述,对部分国内自主研发的口服靶向抗肿瘤药物TDM研究现状进行简述,以期完善靶向抗肿瘤药物的治疗药物监测方案,促进药物的临床合理用药。

关键词: 小分子靶向抗肿瘤药物治疗药物监测药物浓度

DOI：

分类号:

基金项目:浙江省临床肿瘤药理与毒理学研究重点实验室（NO.2020E10021);浙江省卫生高层次创新人才培养基金(ZWB-2020-18, 林能明) ；浙江省医学重点学科(ZWB-2018-02-03);杭州市医学重点学科(HWF-2021-21-16)

A Review on Therapeutic Drug Monitoring of Small Molecule Targeted Anti-tumor Drugs

Jiang Yiming¹, Zhang Daoming², Zhang Huanqi², Lin Nengming³, Li Yangling³

1.Research Center for Clinical Pharmacy，College of Pharmaceutical Sciences， Zhejiang University;2.College of Pharmaceutical Sciences/Research Center for Clinical Pharmacy， Zhejiang University;3.Dept. of Clinical Pharmacology/Zhejiang Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research，Hangzhou First People’s Hospital

Abstract:

ABSTRACT: Therapeutic Drug Monitoring (TDM) is a very important tool in the clinical treatment of antitumor drugs. However, TDM of various small molecule targeted anti-tumor drugs has not been fully applied in clinical practice, and there are still many imperfections in the guidelines for therapeutic drug monitoring, mainly due to the large interindividual differences in pharmacokinetics/pharmacodynamics of small molecule targeted anti-tumor drugs, the influence of various factors on pharmacokinetic parameters, and difficulties in determining drug concentrations in patients. In addition, different small molecule targeted anti-tumor drugs may differ in monitoring indicators for TDM, and the quantitative analysis methods used are also different. Therefore, individualized therapeutic drug monitoring is beneficial for maximizing the rationality of medication. This review provides an overview of the existing small molecule targeted anti-tumor drug TDM, and briefly summarizes the current research status of orally targeted anti-tumor drug TDM developed domestically, in order to improve the monitoring and treatment plans for targeted anti-tumor drugs and promote their clinical rational use.

Key words: small molecule targeted anti-tumor drugs therapeutic drug monitoring drug concentration