治疗药物监测（TDM）——根据测量的药物水平和既定的药代动力学（PK）目标进行剂量调整——可以优化患者间暴露量差异较大的药物的治疗。我们评估了 TDM 用于多种口服靶向治疗的可行性。在这里，我们报告常规 TDM 不可行的药物。我们评估了荷兰药理学肿瘤学组 - TDM 研究的药物队列。根据预先指定时间点的 PK 水平，进行 PK 指导的干预措施。评估了 TDM 的可行性，并根据 TDM 的成功和实用性，可以关闭队列。24 个队列中有 10 个队列 TDM 不可行，因此关闭了纳入。不良事件的高发生率导致卡博替尼、达拉非尼/曲美替尼、依维莫司、瑞戈非尼和维莫德吉队列被关闭。恩杂鲁胺和厄洛替尼队列被关闭，因为几乎所有 PK 水平都高于目标。其他非药理学原因导致终止了哌柏西利、奥拉帕尼和他莫昔芬队列。尽管 TDM 有助于许多药物的个体化治疗，但上述原因可能会影响其可行性、有用性和临床适用性。因此，不建议对卡博替尼、达拉非尼/曲美替尼、恩杂鲁胺、厄洛替尼、依维莫司、瑞戈非尼和维莫德吉进行常规 TDM。尽管如此，TDM 对于个人临床决策仍然有价值。© 2024。作者。

Therapeutic drug monitoring (TDM) - performing dose adjustments based on measured drug levels and established pharmacokinetic (PK) targets - could optimise treatment with drugs that show large interpatient variability in exposure. We evaluated the feasibility of TDM for multiple oral targeted therapies. Here we report on drugs for which routine TDM is not feasible.We evaluated drug cohorts from the Dutch Pharmacology Oncology Group - TDM study. Based on PK levels taken at pre-specified time points, PK-guided interventions were performed. Feasibility of TDM was evaluated, and based on the success and practicability of TDM, cohorts could be closed.For 10 out of 24 cohorts TDM was not feasible and inclusion was closed. A high incidence of adverse events resulted in closing the cabozantinib, dabrafenib/trametinib, everolimus, regorafenib and vismodegib cohort. The enzalutamide and erlotinib cohorts were closed because almost all PK levels were above target. Other, non-pharmacological reasons led to closing the palbociclib, olaparib and tamoxifen cohort.Although TDM could help personalising treatment for many drugs, the above-mentioned reasons can influence its feasibility, usefulness and clinical applicability. Therefore, routine TDM is not advised for cabozantinib, dabrafenib/trametinib, enzalutamide, erlotinib, everolimus, regorafenib and vismodegib. Nonetheless, TDM remains valuable for individual clinical decisions.© 2024. The Author(s).