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Dennis Dionne

Another addition to your definition of Personalized Medicine should include "Therapeutic Drug Monitoring".
Case in point;
Chemotherapy drugs,ie. 5-fluorouracil (5-FU) are dosed by BSA. In the May 2008 issue of the Journal of Clinical Oncology, Dr E Gamelin reported a randomized multi-center study among metastatic CRC patients treated with continuous infusion 5-FU whose drug blood levels were monitored and dosing adjusted to achieve target concentrations. Gamelin demonstrated that patients were over-dosed and only 25% were actually in the optimal range. By practicing therapeutic dose management (TDM) to maintain the plasma level of 5-FU within the therapeutic window, patients did much better. They experienced significantly better objective tumor response and doubling of survival at two years, while experiencing significantly less toxicity.
Therefore, once the right patient is placed on the right therapy (genetic testing), therapeutic drug monitoring can make sure the right dose correlates with the right plasma level exposure to achieve optimal value.

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