LC-MS/MS in Therapeutic Drug Monitoring: Current Status and Future Directions

This review assesses the growing role of liquid chromatography-tandem mass spectrometry in therapeutic drug monitoring (TDM), where it offers superior specificity and multiplexing capability over traditional immunoassays. LC-MS/MS eliminates antibody cross-reactivity issues that plague immunoassay-based TDM platforms, particularly for immunosuppressants, antifungals, and antiretrovirals. The authors discuss remaining barriers to wider adoption, including method standardisation, throughput limitations, and the need for specialised operator expertise.