The interest of therapeutic and pharmacological drug monitoring of methotrexate: A systematic review

IF 3 3区医学 Q2 ONCOLOGY

Seminars in oncology Pub Date : 2025-04-01 DOI:10.1016/j.seminoncol.2025.152342

Wissal Chellal , Youssra Metarfi , Zineb Ben khadda , Hasnae Hoummani , Rhizlane Berrady , Sanae Achour

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Abstract

Methotrexate (MTX) is largely prescribed for cancers, particularly hematological malignancies. To reduce its toxicity, therapeutic drug monitoring (TDM) is highly recommended. This review aimed to assess knowledge on methotrexate monitoring and compare strategies for managing its toxicities. We searched several databases for articles that met the selection criteria. All articles were screened and data on analytical methods, results, and toxicities were extracted. Thirty articles were included in this review, consisting mainly of single-center studies. MTX monitoring studies have been conducted in various countries. Patient demographics covered children and adults, with one study focusing on elderly patients. MTX doses varied primarily between high-dose regimens. Sample collection times were varied. Various techniques were used to quantify MTX levels. This review highlights the diversity of study designs, patient populations, dosing regimens, and analytical techniques, emphasizing the need for standardized protocols and further research to optimize MTX treatment, ensuring both efficacy and safety.

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甲氨蝶呤治疗和药物监测的意义：系统综述

甲氨蝶呤（MTX）主要用于治疗癌症，特别是血液系统恶性肿瘤。为了降低其毒性，强烈建议进行治疗性药物监测（TDM）。本综述旨在评估甲氨蝶呤监测方面的知识，并比较管理其毒性的策略。我们在几个数据库中搜索了符合选择标准的文章。对所有文章进行筛选，提取分析方法、结果和毒性的数据。本综述纳入了30篇文章，主要为单中心研究。在许多国家进行了MTX监测研究。患者人口统计包括儿童和成人，其中一项研究侧重于老年患者。甲氨蝶呤的剂量主要在高剂量方案之间变化。样品采集时间各不相同。各种技术用于量化MTX水平。这篇综述强调了研究设计、患者群体、给药方案和分析技术的多样性，强调需要标准化的方案和进一步的研究来优化MTX治疗，确保疗效和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in oncology 医学-肿瘤学

CiteScore

6.60

自引率

0.00%

发文量

审稿时长

104 days

期刊介绍： Seminars in Oncology brings you current, authoritative, and practical reviews of developments in the etiology, diagnosis and management of cancer. Each issue examines topics of clinical importance, with an emphasis on providing both the basic knowledge needed to better understand a topic as well as evidence-based opinions from leaders in the field. Seminars in Oncology also seeks to be a venue for sharing a diversity of opinions including those that might be considered "outside the box". We welcome a healthy and respectful exchange of opinions and urge you to approach us with your insights as well as suggestions of topics that you deem worthy of coverage. By helping the reader understand the basic biology and the therapy of cancer as they learn the nuances from experts, all in a journal that encourages the exchange of ideas we aim to help move the treatment of cancer forward.