Volumetric absorptive microsampling as a suitable tool to monitor tyrosine kinase inhibitors

Verougstraete, Nick; Stove, Christophe

doi:10.1016/j.jpba.2021.114418

Cited by 14 publications

(34 citation statements)

References 32 publications

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“…Methods have been described for anticancer drugs [ 47 ], opioids [ 48 ], anti-epileptic drugs [ 21 , 49 , 50 ], anabolic steroids [ 51 ], and monoclonal antibodies [ 52 , 53 ]. Especially in the case of oral anti-cancer drugs, a very recent method paper evaluated the similarity between liquid venous blood and VAMS (sampled from liquid venous blood), indicating that VAMS samples corresponded well to a liquid sample [ 54 ]. This underlines the feasibility and appropriateness of using VAMS for cabozantinib and axitinib, especially considering the poor performance for this substance class using DBS [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

Developing a Nationwide Infrastructure for Therapeutic Drug Monitoring of Targeted Oral Anticancer Drugs: The ON-TARGET Study Protocol

Laughlin

Schmulenson

Teplytska

et al. 2021

Cancers

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Exposure-efficacy and/or exposure-toxicity relationships have been identified for up to 80% of oral anticancer drugs (OADs). Usually, OADs are administered at fixed doses despite their high interindividual pharmacokinetic variability resulting in large differences in drug exposure. Consequently, a substantial proportion of patients receive a suboptimal dose. Therapeutic Drug Monitoring (TDM), i.e., dosing based on measured drug concentrations, may be used to improve treatment outcomes. The prospective, multicenter, non-interventional ON-TARGET study (DRKS00025325) aims to investigate the potential of routine TDM to reduce adverse drug reactions in renal cell carcinoma patients receiving axitinib or cabozantinib. Furthermore, the feasibility of using volumetric absorptive microsampling (VAMS), a minimally invasive and easy to handle blood sampling technique, for sample collection is examined. During routine visits, blood samples are collected and sent to bioanalytical laboratories. Venous and VAMS blood samples are collected in the first study phase to facilitate home-based capillary blood sampling in the second study phase. Within one week, the drug plasma concentrations are measured, interpreted, and reported back to the physician. Patients report their drug intake and toxicity using PRO-CTCAE-based questionnaires in dedicated diaries. Ultimately, the ON-TARGET study aims to develop a nationwide infrastructure for TDM for oral anticancer drugs.

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Section: Discussionmentioning

confidence: 99%

Developing a Nationwide Infrastructure for Therapeutic Drug Monitoring of Targeted Oral Anticancer Drugs: The ON-TARGET Study Protocol

Laughlin

Schmulenson

Teplytska

et al. 2021

Cancers

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“…For example, the sample preparation of dried plasma spots (DPS) for the measurement of bosutinib, dasatinib, ibrutinib, imatinib, nilotinib and ponatinib consisted of a liquid extraction step followed by solid-phase extraction and subsequent drying ( 43 ). In two VAMS-based methods, VAMS samples were pre-wetted with an aqueous solution prior to the addition of an organic solvent for extraction ( 35 , 46 ). Overall, a robust extraction procedure is key to the reliability of a method using dried blood microsamples.…”

Section: Methodological Aspects Of Dried Blood Microsample Methods Fo...mentioning

confidence: 99%

“…Examples include dasatinib and talazoparib, with median reported trough levels of 2.61 ng/mL and 3.54 ng/mL, respectively ( 5 ). Published dried blood microsample-based methods for dasatinib had LLOQs of 2.5 ng/mL in 10-µL DBS (whole spot analysis) ( 41 ), 1 ng/mL in 40-µL DPS ( 43 ) and 0.5 ng/mL in 10-µL VAMS ( 35 ). Specificity is achieved by separation of the compounds on LC columns and detection in multiple reaction monitoring (MRM) mode.…”

Section: Methodological Aspects Of Dried Blood Microsample Methods Fo...mentioning

confidence: 99%

“…Specificity is achieved by separation of the compounds on LC columns and detection in multiple reaction monitoring (MRM) mode. Several multi-TKI LC-MS/MS methods have been developed ( 35 , 41 , 43 , 46 ), offering the advantage that one dedicated method can be applied for a variety of analytes (and, hence patient samples), which is especially relevant in routine clinical settings. Known disadvantages of LC-MS/MS are the high investment and maintenance cost, the high technical expertise that is required and the need for time-consuming sample preparation, which is typically more laborious for dried microsamples, when compared with plasma samples.…”

Section: Methodological Aspects Of Dried Blood Microsample Methods Fo...mentioning

confidence: 99%

“…Apart from conventional DBS, other microsampling devices are also being explored for TKI monitoring. E.g., we recently reported on the determination of a TKI panel in samples collected via volumetric absorptive microsampling (VAMS) ( 35 ). Briefly, VAMS is a sampling technique in which a fixed volume of blood is wicked up by an absorbent tip attached to a plastic handler, used as an alternative to classical DBS sampling.…”

Section: Introduction: Tdm Of Tkismentioning

confidence: 99%

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Therapeutic Drug Monitoring of Tyrosine Kinase Inhibitors Using Dried Blood Microsamples

et al. 2022

Self Cite

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Therapeutic drug monitoring (TDM) of tyrosine kinase inhibitors (TKIs) is not yet performed routinely in the standard care of oncology patients, although it offers a high potential to improve treatment outcome and minimize toxicity. TKIs are perfect candidates for TDM as they show a relatively small therapeutic window, a wide inter-patient variability in pharmacokinetics and a correlation between drug concentration and effect. Moreover, most of the available TKIs are susceptible to various drug-drug interactions and medication adherence can be checked by performing TDM. Plasma, obtained via traditional venous blood sampling, is the standard matrix for TDM of TKIs. However, the use of plasma poses some challenges related to sampling and stability. The use of dried blood microsamples can overcome these limitations. Collection of samples via finger-prick is minimally invasive and considered convenient and simple, enabling sampling by the patients themselves in their home-setting. The collection of small sample volumes is especially relevant for use in pediatric populations or in pharmacokinetic studies. Additionally, working with dried matrices improves compound stability, resulting in convenient and cost-effective transport and storage of the samples. In this review we focus on the different dried blood microsample-based methods that were used for the quantification of TKIs. Despite the many advantages associated with dried blood microsampling, quantitative analyses are also associated with some specific difficulties. Different methodological aspects of microsampling-based methods are discussed and applied to TDM of TKIs. We focus on sample preparation, analytics, internal standards, dilution of samples, external quality controls, dried blood spot specific validation parameters, stability and blood-to-plasma conversion methods. The various impacts of deviating hematocrit values on quantitative results are discussed in a separate section as this is a key issue and undoubtedly the most widely discussed issue in the analysis of dried blood microsamples. Lastly, the applicability and feasibility of performing TDM using microsamples in a real-life home-sampling context is discussed.

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Blood microsampling technologies: Innovations and applications in 2022

Thangavelu

Wouters

Kindt

et al. 2023

Analytical Science Advances

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With the development of highly sensitive bioanalytical techniques, the volume of samples necessary for accurate analysis has reduced. Microsampling, the process of obtaining small amounts of blood, has thus gained popularity as it offers minimal‐invasiveness, reduced logistical costs and biohazard risks while simultaneously showing increased sample stability and a potential for the decentralization of the approach and at‐home self‐sampling. Although the benefits of microsampling have been recognised, its adoption in clinical practice has been slow. Several microsampling technologies and devices are currently available and employed in research studies for various biomedical applications. This review provides an overview of the state‐of‐the‐art in microsampling technology with a focus on the latest developments and advancements in the field of microsampling. Research published in the year 2022, including studies (i) developing strategies for the quantitation of analytes in microsamples and (ii) bridging and comparing the interchangeability between matrices and choice of technology for a given application, is reviewed to assess the advantages, challenges and limitations of the current state of microsampling. Successful implementation of microsampling in routine clinical care requires continued efforts for standardization and harmonization. Microsampling has been shown to facilitate data‐rich studies and a patient‐centric approach to healthcare and is foreseen to play a central role in the future digital revolution of healthcare through continuous monitoring to improve the quality of life.

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Volumetric absorptive microsampling as a suitable tool to monitor tyrosine kinase inhibitors

Cited by 14 publications

References 32 publications

Developing a Nationwide Infrastructure for Therapeutic Drug Monitoring of Targeted Oral Anticancer Drugs: The ON-TARGET Study Protocol

Developing a Nationwide Infrastructure for Therapeutic Drug Monitoring of Targeted Oral Anticancer Drugs: The ON-TARGET Study Protocol

Therapeutic Drug Monitoring of Tyrosine Kinase Inhibitors Using Dried Blood Microsamples

Blood microsampling technologies: Innovations and applications in 2022

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