Evidence-based Pharmaceutical Study on Individualized Vincristine Dosing Based on Therapeutic Drug Monitoring

OBJECTIVE To investigate the evidence-based pharmaceutical research on therapeutic drug monitoring(TDM) and model-informed precision dosing(MIPD) in the individualized treatment of vincristine.

METHODS Literature searches were performed in the CNKI database using Chinese keywords and in the PubMed database using English keywords for the following terms: “vincristine” “therapeutic drug monitoring” “model-informed precision dosing” “physiologically based pharmacokinetic model” “pharmacokinetic/pharmacodynamic model” “population pharmacokinetics model” and “artificial intelligence”. The search covered the period from the inception of each database to June 2025. Relevant clinical studies were included. A technical framework was developed to address issues supporting the clinical implementation of individualized vincristine therapy. The latest advancements in TDM and MIPD for vincristine were systematically reviewed, and evidence-based pharmaceutical data were analyzed to address the framework questions.

RESULTS Current evidence indicates that there was considerable individual variability in the therapeutic response to vincristine, with significant interindividual differences in drug exposure. TDM and MIPD showed potential in optimizing individualized vincristine therapy; however, models guiding dose adjustment required further development.

CONCLUSION While current research on TDM and MIPD for vincristine remains limited, their potential for individualized therapy is increasingly evident. Further studies are urgently needed to justify the implementation of TDM and MIPD in clinical practice.