On-Site Therapeutic Drug Monitoring

Recent technological advances have stimulated efforts to bring personalized medicine into practice. Yet, traditional application fields like therapeutic drug monitoring (TDM) have remained rather under-appreciated. Owing to clear dose-response relationships, TDM could improve patient outcomes and reduce healthcare costs. While chromatography-based routine practices are restricted due to high costs and turnaround times, biosensors overcome these limitations by offering on-site analysis. Nevertheless, sensor-based approaches have yet to break through for clinical TDM applications, due to the gap between scientific and clinical communities. We provide a critical overview of current TDM practices, followed by a TDM guideline to establish a common ground across disciplines. Finally, we discuss how the translation of sensor systems for TDM can be facilitated, by highlighting the challenges and opportunities. On-site therapeutic drug monitoring has the potential to improve patient outcomes and drastically reduce healthcare costs.Despite being on the radar of the scientific community for almost two decades, sensor-based approaches have yet to break through and support the clinical application of therapeutic drug monitoring, potentially due to the gap between scientific and clinical communities.Chromatography as a routine practice is limited due to its lack of standardization, high turnaround-times and instrumentation costs, and labored sample preparation.Sensors offer a low-cost, easy-to-use, and on-site analysis method to explore the full potential of therapeutic drug monitoring, overcoming these limitations.The success of individualized dosing strongly relies on two factors: how PK/PD studies are integrated with therapeutic drug monitoring and how the measurement process is managed.