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Therapeutic Drug Monitoring and Clinical Toxicology
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Interview with Bianca Maria Goffredo

This month we hear from Bianca Maria Goffredo from the Laboratory of Metabolic Pathology at Bambino Gesù Children's Hospital in Rome. Bianca shares about her experience in developing drug assays and applying them to personalize therapy, especially for pediatric patients.

 

Bianca Maria Goffredo
Laboratory of Metabolic Pathology
Bambino Gesù Children's Hospital, Rome, Italy

 

Can you tell us a little bit about your respective roles? What is a typical day like for you?

I am a biologist and my work involves determining drug concentrations for the purposes of optimizing dosing. I work with a group of collaborators, pharmacists, biologists and technicians.

On a typical day, we start by calibrating our HPLC and MS instruments, then we perform the analyses for the day, and I put together the report for clinicians. There are also meetings and online calls. I also develop protocols to carry out research. Often, clinician colleagues ask to determine concentrations where we need to develop an assay, primarily for one-off plasma samples. However, in some situations we determine a concentration-time curve to better understand the drug response for a particular patient and personalize treatment.

Is there anything that your laboratory does, or that is done at your centre, that you would consider innovative?

Yes, our job can be considered innovative especially when it comes to controlling and personalizing therapies.

What technological innovations have entered into use during your career that have permitted a change, or evolution, in practice?

HPLC has been innovative for dosing many drugs in the last 10 years. MS has revealed to be very innovative and made a significant contribution to clinical practice.

How did you become interested in your area of expertise?

My interest in TDM began 15 years ago when Prof. Locatelli arrived at our hospital and specifically asked me for a specific assay. My area of expertise was determinations based on HPLC, and this is how I became interested in TDM and PK. In recent years, I have also become more involved in clinical toxicology.

Is there anything that you’ve seen or heard about recently and thought “I’d like to incorporate that idea at my center”?

When I began TDM, I thought “I’d like to incorporate the idea at my centre” because personalized therapy was lacking at my hospital, especially for the pediatric population, which are a very vulnerable population.

What sort of research do you have on the horizon that you think might influence clinical practice in the future?

My idea is to put into practice the evaluation of antibiotic levels with MIC. Precise use of antibiotic therapy is very important to avoid severe complications for patients in intensive care. In this way the therapy is shorter, but more efficacious.

What do you consider is the future for TDM and CT? What are you excited about? What are the challenges we face?

The future for TDM and CT is to organize very technological laboratories and increase the culture of TDM and CT among doctors, health operators and hospital directors. The challenges are to improve a culture of drug use and to raise awareness among hospital directors in hospitals.

How has COVID-19 affected your professional life?

I worked during the lockdown due to Covid-19 and TDM continued in hospitalized patients. Unfortunately, there were no scientific meetings during this period, which I missed a lot.

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