{"id":129051,"date":"2021-02-05T16:51:54","date_gmt":"2021-02-05T15:51:54","guid":{"rendered":"https:\/\/medios.uchceu.es\/actualidad-ceu\/?p=129051"},"modified":"2023-05-30T10:24:48","modified_gmt":"2023-05-30T08:24:48","slug":"the-challenges-of-drug-monitoring-in-oncology","status":"publish","type":"post","link":"https:\/\/medios.uchceu.es\/actualidad-ceu\/en\/the-challenges-of-drug-monitoring-in-oncology\/","title":{"rendered":"The challenges of drug monitoring in oncology"},"content":{"rendered":"<ul>\n<li>One of the most exciting areas in cancer research concerns patient-specific treatment with personalized drug dosages, according to Dr Vanesa Escudero, a CEU UCH researcher at the Elche campus<\/li>\n<li>Drug monitoring for oncology enables dosages to be adjusted and to identify the high number of patients in whom standard dosage regimens do not elicit a clinical response.<\/li>\n<\/ul>\n<p>Dr\u00a0<a href=\"https:\/\/www.uchceu.es\/directorio\/vanesa-escudero?_ga=2.47018471.1750761789.1613377151-1882249699.1588245643&amp;_gac=1.190346713.1613471226.cj0kcqia962bbhczarisaipwel10tunrtmtmao2lqwlzhco66yoeqlltund3fjuyp49vkymzmmbpo3kaamxmealw_wcb\" target=\"_blank\" rel=\"noopener\">Vanesa Escudero<\/a>\u00a0has been researching <a href=\"http:\/\/www.plataformadeoncologia.com\/webcms\/index.php?menu=176\" target=\"_blank\" rel=\"noopener\">quantitative pharmacology and personalized drug therapy<\/a> since 2005, focusing especially on cancer treatment. Personalized dosing regimens for classic chemotherapy treatment, small-molecule drugs, modelling techniques, pharmacokinetic simulation and oncological pharmacodynamics are just some of the areas she is active in. Although she also specializes in immunotherapy for cancer, she\u2019s currently working on the challenge of oncological drug monitoring.<\/p>\n<p>She is a lecturer on the <a href=\"https:\/\/www.uchceu.es\/estudios\/grado\/enfermeria?-ga=2.253736777.1750761789.1613377151-1882249699.1588245643&amp;-gac=1.93812463.1613471226.Cj0KCQiA962BBhCzARIsAIpWEL10tuNRtmtmAO2LQwlZhCo66YOeQLlTUND3fJuYP49vkYMzmMBPo3kaAmXMEALw-wcB\" target=\"_blank\" rel=\"noopener\">Nursing degree at CEU UCH\u2019s campus in Elche<\/a>\u00a0and she is currently coordinating two research projects funded by the Valencian regional government, the Generalitat Valenciana.<\/p>\n<p>One of these projects has led to the establishment of a monitoring system for theimatinib, dasatinib and nilotinib drugs in routine clinical practice, with the aim of increasing the efficacy and decreasing the toxicity of these treatments for haemato-oncology patients.<\/p>\n<figure id=\"attachment_128471\" aria-describedby=\"caption-attachment-128471\" style=\"width: 2177px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-128471\" src=\"https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/IMG_4745-scaled.jpg\" alt=\"\" width=\"2177\" height=\"2560\" srcset=\"https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/IMG_4745-scaled.jpg 2177w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/IMG_4745-255x300.jpg 255w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/IMG_4745-1060x1247.jpg 1060w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/IMG_4745-768x903.jpg 768w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/IMG_4745-1306x1536.jpg 1306w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/IMG_4745-1741x2048.jpg 1741w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/IMG_4745-1020x1200.jpg 1020w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/IMG_4745-150x176.jpg 150w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/IMG_4745-300x353.jpg 300w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/IMG_4745-696x819.jpg 696w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/IMG_4745-1068x1256.jpg 1068w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/IMG_4745-1920x2258.jpg 1920w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/IMG_4745-357x420.jpg 357w\" sizes=\"auto, (max-width: 2177px) 100vw, 2177px\" \/><figcaption id=\"caption-attachment-128471\" class=\"wp-caption-text\">Dr Vanesa Escudero, CEU researcher in drug monitoring for oncology<\/figcaption><\/figure>\n<p><strong><a href=\"https:\/\/www.cancer.gov\/espanol\/cancer\/tratamiento\/tipos\/pruebas-de-biomarcadores-tratamiento-cancer\" target=\"_blank\" rel=\"noopener\">Precision medicine in oncology<\/a> is a concept which is getting a lot of attention in the fight against cancer. But what does it mean?<\/strong><\/p>\n<p>One of the main new developments in cancer treatment and research is the ability to tailor treatment decisions to suit each patient. And not just on the basis of the genetic characteristics of the tumour, but also the patient\u2019s own characteristics, which may influence factors such as their metabolism and drug clearance. This is the context in which you hear people talk about precision medicine.<\/p>\n<p>Precision medicine in oncology has two objectives. First, it aims to ensure that cancer patients receive \u201cguided\u201d or \u201cdirected\u201d treatment which is specific to the genetic profile of their tumour. And it also seeks to personalize the patient\u2019s dosing regimen, minimizing toxicity while maximizing the treatment\u2019s effectiveness.<\/p>\n<p>This objective of personalizing dosing regimens in oncology is achieved via therapeutic drug monitoring. This is a key tool for precision medicine and it\u2019s the focus of the Clinical Pharmacy and Nutrition Research Group at the CEU Cardenal Herrera University.<\/p>\n<p><strong>Given your experience in bioanalysis and monitoring of cancer drugs and antidepressants in clinical practice, what does personalization really mean for cancer treatment?<\/strong><\/p>\n<p>The genetic analysis of the tumour itself enables us to determine the nature of each tumour, for each patient, in a personalized way. Once that has been done, a more specific pharmacological treatment, one that is more beneficial for the patient can be put in place. Under a conventional approach, fixed or standard doses would be used based on the patient\u2019s weight or body surface size.<\/p>\n<p>These parameters are often not a good reflection of the patient\u2019s real metabolism. In other words, different people taking the same doses may suffer different levels of toxicity and require a higher or lower dose of the drug. That\u2019s why finding the right balance between toxicity and efficacy continues to be a challenge for health professionals treating these patients.<\/p>\n<p>Thanks to the advances made in precision medicine, the drugs selected can then be monitored to adjust the dosing regimen to suit each patient. You do that by taking into account factors which are inherent to the patient (nutrition, other medication, other pathologies, individual pharmacokinetic factors, etc.). In other words, you provide treatment which is tailored to the needs of each patient. Can you imagine a shoe shop that only provides one size for all customers?<\/p>\n<p>There are numerous studies in the literature concerning dosage personalization. And they show that personalizing the dosage of antineoplastic drugs, on the basis of pharmacokinetic monitoring, can significantly improve target responses, improve average cancer-free survival and reduce toxicity.<\/p>\n<h3>Advantage of personalized dosing regimens<\/h3>\n<p><strong>How is this personalization of cancer treatment carried out?<\/strong><\/p>\n<p>The patient monitoring process is straightforward. To personalize the drug dose, we need certain data which can be taken from the patient\u2019s medical records. Once the drug has been administered for the first time (either orally or intravenously), a series of blood tests are carried out to determine the behaviour of the drug in the patient. You take those data and estimate the pharmacokinetic parameters of the drug for that patient. Then, you can make a recommendation for dosage adjustments, if necessary.<\/p>\n<p><strong>What benefits does the patient get from having the dosage personalized?<\/strong><\/p>\n<p>Therapeutic drug monitoring in cancer patients provides numerous benefits. By knowing the quantity of medication in the patient\u2019s blood after administration, we can adjust the dose provided and identify those patients who are not getting the right clinical response due to the dosage being too low, and we can lower the dose for those who are seeing excessive side effects. Preventing unwanted side effects improves patient safety and that translates into an increase in quality of life.<\/p>\n<figure id=\"attachment_128506\" aria-describedby=\"caption-attachment-128506\" style=\"width: 2027px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-128506\" src=\"https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/Vanesa-Escudero-dirige-dos-proyectos-de-investigacion-oncologica-scaled.jpg\" alt=\"\" width=\"2027\" height=\"2560\" srcset=\"https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/Vanesa-Escudero-dirige-dos-proyectos-de-investigacion-oncologica-scaled.jpg 2027w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/Vanesa-Escudero-dirige-dos-proyectos-de-investigacion-oncologica-238x300.jpg 238w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/Vanesa-Escudero-dirige-dos-proyectos-de-investigacion-oncologica-1060x1339.jpg 1060w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/Vanesa-Escudero-dirige-dos-proyectos-de-investigacion-oncologica-768x970.jpg 768w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/Vanesa-Escudero-dirige-dos-proyectos-de-investigacion-oncologica-1216x1536.jpg 1216w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/Vanesa-Escudero-dirige-dos-proyectos-de-investigacion-oncologica-1622x2048.jpg 1622w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/Vanesa-Escudero-dirige-dos-proyectos-de-investigacion-oncologica-950x1200.jpg 950w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/Vanesa-Escudero-dirige-dos-proyectos-de-investigacion-oncologica-150x189.jpg 150w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/Vanesa-Escudero-dirige-dos-proyectos-de-investigacion-oncologica-300x379.jpg 300w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/Vanesa-Escudero-dirige-dos-proyectos-de-investigacion-oncologica-696x879.jpg 696w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/Vanesa-Escudero-dirige-dos-proyectos-de-investigacion-oncologica-1068x1349.jpg 1068w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/Vanesa-Escudero-dirige-dos-proyectos-de-investigacion-oncologica-1920x2425.jpg 1920w, https:\/\/medios.uchceu.es\/actualidad-ceu\/wp-content\/uploads\/sites\/2\/2021\/02\/Vanesa-Escudero-dirige-dos-proyectos-de-investigacion-oncologica-333x420.jpg 333w\" sizes=\"auto, (max-width: 2027px) 100vw, 2027px\" \/><figcaption id=\"caption-attachment-128506\" class=\"wp-caption-text\">Vanesa Escudero coordinates two cancer research projects<\/figcaption><\/figure>\n<h3><span style=\"color: #111111;font-family: Roboto, sans-serif;font-size: 22px\">Current challenges<\/span><\/h3>\n<p><strong>What are the challenges ahead for cancer drug monitoring?<\/strong><\/p>\n<p>The challenge for therapeutic drug monitoring is to work towards maximum coverage across all cancer treatment. Incorporating this tool into routine clinical practice benefits patients and it also means that you\u2019re using cutting edge research.<\/p>\n<p>And its implementation should be accompanied by research projects that enable new information to be generated and shared. In this way, we can foster new knowledge in the field and achieve the aim of providing better care to cancer patients.<\/p>\n<p><strong>You\u2019re the lead researcher for <a href=\"https:\/\/www.uchceu.es\/grupos-lineas-investigacion\/grupo-de-investigacion-en-farmacia-y-nutricion-clinica-clinicpharma?_ga=2.244693701.1750761789.1613377151-1882249699.1588245643&amp;_gac=1.150976708.1613471226.Cj0KCQiA962BBhCzARIsAIpWEL10tuNRtmtmAO2LQwlZhCo66YOeQLlTUND3fJuYP49vkYMzmMBPo3kaAmXMEALw_wcB\" target=\"_blank\" rel=\"noopener\">CEU\u2019s Clinical Pharmacy and Nutrition Research Group<\/a>. What\u2019s the group working on?<\/strong><\/p>\n<p>We\u2019re working on the development of new bioanalysis techniques for the quantification of drugs in cancer patients. And on the development of the pharmacokinetic models we need for treatment personalization. We have<a href=\"https:\/\/medios.uchceu.es\/actualidad-ceu\/la-ceu-uch-y-la-fundacion-fisabio-pondran-en-marcha-un-grupo-mixto-de-investigacion-en-farmacia-y-nutricion-clinica\/\" target=\"_blank\" rel=\"noopener\"> active research collaborations<\/a> with the <a href=\"http:\/\/fisabio.san.gva.es\/documents\/10157\/7d367c40-16b0-404b-8438-eb273853b6a1\" target=\"_blank\" rel=\"noopener\">Hospital General Universitario in Elche<\/a>, the\u00a0Hospital Vega Baja, the\u00a0<a href=\"http:\/\/fisabio.san.gva.es\/hospital-general-universitario-de-alicante1\" target=\"_blank\" rel=\"noopener\">Hospital General Universitario in Alicante\u00a0<\/a>and the\u00a0<a href=\"https:\/\/www.quironsalud.es\/torrevieja\" target=\"_blank\" rel=\"noopener\">Hospital Quir\u00f3nsalud in Torrevieja<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>One of the most exciting areas in cancer research concerns patient-specific treatment with personalized drug dosages, according to Dr Vanesa Escudero, a CEU UCH researcher at the Elche campus Drug monitoring for oncology enables dosages to be adjusted and to identify the high number of patients in whom standard dosage regimens do not elicit a [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":128467,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-129051","post","type-post","status-publish","format-standard","has-post-thumbnail","category-sin-categorizar"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The challenges of drug monitoring in oncology<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" 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