Therapeutic drug monitoring (TDM) of 5-fluorouracil (5-FU): new preanalytic aspects
-
Sonani Mindt
,
Sihem Aida
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.
Acknowledgment
We are grateful to Saladax Biomedical for providing the test reagents.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: Ralf-Dieter Hofheinz: Consulting fee: Saladax.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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©2019 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
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Artikel in diesem Heft
- Frontmatter
- Editorial
- Epigenetics in cancer: a promising path to follow?
- Reviews
- The circulating miRNAs as diagnostic and prognostic markers
- Analytical barriers in clinical B-type natriuretic peptide measurement and the promising analytical methods based on mass spectrometry technology
- Mini Review
- Commutability of reference and control materials: an essential factor for assuring the quality of measurements in Laboratory Medicine
- EFLM Paper
- Preanalytical challenges – time for solutions
- General Clinical Chemistry and Laboratory Medicine
- Iron status determination in individuals with Helicobacter pylori infection: conventional vs. new laboratory biomarkers
- Harmonizing by reducing inter-run variability: performance evaluation of a quality assurance program for antinuclear antibody detection by indirect immunofluorescence
- Increased prevalence of anti-DFS70 antibodies in young females: experience from a large international multi-center study on blood donors
- Accuracy of determination of the glomerular filtration marker iohexol by European laboratories as monitored by external quality assessment
- Therapeutic drug monitoring (TDM) of 5-fluorouracil (5-FU): new preanalytic aspects
- Monitoring the effectiveness of hypothermia in perinatal asphyxia infants by urinary S100B levels
- Hematology and Coagulation
- Determination of haemoglobin derivatives in aged dried blood spot to estimate haematocrit
- Reference Values and Biological Variations
- A study of biological and lifestyle factors, including within-subject variation, affecting concentrations of growth differentiation factor 15 in serum
- Reference intervals for thyroid-stimulating hormone, free thyroxine, and free triiodothyronine in elderly Chinese persons
- Cancer Diagnostics
- Extracellular vesicle-associated miRNAs in ovarian cancer – design of an integrated NGS-based workflow for the identification of blood-based biomarkers for platinum-resistance
- Evaluating the diagnostic and prognostic value of serum long non-coding RNA CTC-497E21.4 in gastric cancer
- A pilot study of new promising non-coding RNA diagnostic biomarkers for early-stage colorectal cancers
- Cardiovascular Diseases
- Prognostic role of GDF-15 across the spectrum of clinical risk in patients with NSTE-ACS
- Acute-phase dynamics and prognostic value of growth differentiation factor-15 in ST-elevation myocardial infarction
- Diabetes
- Lipid profile and genetic status in a familial hypercholesterolemia pediatric population: exploring the LDL/HDL ratio
- Letters to the Editor
- The search for a new test of early cancer detection
- Need of a dedicated isotopic internal standard for accurate 3-epi-25(OH)D3 quantification by LC-MS/MS
- An unexpectedly prolonged severe hyperbilirubinemia in a patient with pre-existing hepatitis A: a role of genetic predisposition?
- Creatine kinase elevation: a neglected clue to the diagnosis of polymyositis. A case report
- Analytical performance of the new Siemens NT-proBNP assays on the Advia Centaur XPT compared to the NT-proBNP method on the Dimension Vista
- Free PAPP-A as a biomarker: heparin-induced release is not related to coronary atherosclerotic burden
- Anti-citrullinated protein antibodies are not associated with extent of disease or prognosis in patients with coronary artery disease
- A new preanalytical factor: conveyor transport influences residual platelet concentrations
- Stability of cannabinoids in cannabis FM1 flowering tops and oil preparation evaluated by ultra-high performance liquid chromatography tandem mass spectrometry
- Requirement of a reference measurement system for the tissue factor-induced coagulation time and the international normalized ratio
