Research hotspots and trends in therapeutic drug monitoring of anticancer drugs: a 1990–2024 bibliometric analysis

Objective: To explore the current status of therapeutic drug monitoring (TDM) research on anticancer drugs, analyze research hotspots and trends, and provide insights and references for future studies. Methods: Data were retrieved from the Web of Science Core Collection (1990-2024) using keywords related to "anticancer drugs" and "therapeutic drug monitoring." Bibliometric analyses were performed using VOSviewer, CiteSpace, R, and Scimago Graphica to visualize trends in publications, keywords, collaborations, and citation networks. Results: A total of 1474 articles were included. Global research output on TDM for anticancer drugs has grown steadily, with an accelerating trend in recent years. Key research themes include drug-specific monitoring, analytical methodologies, and clinical safety and efficacy. Busulfan remains the most studied agent in hematologic malignancies, while tyrosine kinase inhibitors, particularly crizotinib and nilotinib, along with monoclonal antibodies, have emerged as focal points of recent citation bursts. The keyword "pediatric patients" also shows a strong burst signal, reflecting growing attention to developmental pharmacokinetics and individualized dosing in vulnerable populations. The majority of influential studies were published in clinical oncology and pharmacology journals, with chemotherapy and targeted therapy dominating among the most cited papers. The United States, China, Japan, and Western European countries, notably the Netherlands and France, account for the majority of global publications. Among these, the Netherlands, Switzerland, and France demonstrate not only the highest research intensity, as measured by the Relative Importance Index (RII), but also a gradual increase in RII over time. Institutional-level RII analysis further highlights sustained contributions from leading European academic and clinical networks. International collaboration is highly concentrated among these high-output regions, forming a tightly interconnected research network. Conclusion: This study maps the evolving landscape of TDM in oncology. Accelerating research on tyrosine kinase inhibitors, monoclonal antibodies, and pediatric populations highlights TDM's clinical value in optimizing therapy for narrow-therapeutic-index drugs. Rising research intensity in Europe and strong international collaboration underscore a coordinated global effort, supporting TDM's integration into precision oncology, especially for vulnerable patients.