Therapeutic Drug Monitoring of Everolimus in Oncology: Evidences and Perspectives

摘要

Everolimus is a mammalian target of rapamycin (mTOR) inhibitor that has been approved for the treatment of hormone receptor-positive advanced breast cancer, metastatic renal cancer, and neuroendocrine tumors. Although therapeutic drug monitoring (TDM) of everolimus is well established in the transplantation field, it is not currently performed in oncology. The last consensus conference about the TDM of everolimus states that for the use of everolimus in oncology, "further studies are required to determine the clinical utility of TDM for everolimus in oncology settings." In this review, the authors will discuss the current evidences and perspectives, based on observational studies available, in favor of the TDM of everolimus in oncology focusing on (1) the management of everolimus in routine practice, (2) the prerequisites for TDM of everolimus in oncology, (3) the pharmacodynamics (including a description of the biomarker of resistance and mutations in m-TOR), and (4) a general outlook.