For patients undergoing cancer treatment, getting the right dose of chemotherapy is critical and can mean the difference between effective treatment, manageable side effects, and overall quality of life. This is where therapeutic drug monitoring (TDM) plays a vital role. By measuring drug concentrations in the bloodstream, TDM helps tailor treatment to individuals, ensuring the safest and most effective outcomes. However, for patients in regional, rural, and remote areas accessing standard TDM methods isn’t always easy. Traditional approaches rely on venous blood draws and specialist lab facilities, resources that aren’t always close to home. These barriers can delay or limit access to personalised cancer care, simply because of where someone lives.
Associate Professor Jennifer Schneider, a pharmacist, academic, and researcher at the University of Newcastle and Hunter Medical Research Institute (HMRI) is tackling this challenge head-on. “This research is about removing unnecessary hurdles so that patients in regional areas can access the same precision care as anyone else.” Jennifer highlights.
As a NSW Regional Cancer Research Network (NSWRCRN) Clinician Fellow, Jennifer set out to reconsider therapeutic drug monitoring (TDM) for patients outside major centres . Her research focuses on making TDM more accessible using dried blood spot sampling, an innovative approach for regional and remote communities. By developing advanced techniques to measure chemotherapy drug levels, including 5-fluorouracil and tyrosine kinase inhibitors, in ultra-small plasma volumes (as little as 0.003 millilitres), her work opens the door to easier, more patient-friendly testing. Instead of needing a full blood draw, patients could one day use a simple fingerprick and a card-based device to collect a drop of blood in their home. This could dramatically reduce the need for hospital visits, making personalised cancer treatment more convenient, timely, and equitable.
Developing the ability to measure these small plasma volumes with precision was a crucial first step, and it enables the use of specialised plasma collection cards. These innovative devices separate plasma from whole blood using just a single drop from a fingerprick, making at-home sampling a real possibility. During her NSWRCRN Clinician Fellowship, Jennifer put these cards to the test. Her lab studies compared the accuracy of plasma card samples with traditional blood draws and assessed how well drug concentrations held up under conditions that mimic postal transport across Australia's diverse conditions . The goal is to build a robust system where patients in rural and remote communities can access the same precision oncology services as those in urban centres, without the burden of travel or the tyranny of distance.
“By demonstrating stability and accuracy of testing, we’re paving the way for home-based drug monitoring that supports equitable cancer care.” Jennifer explains.
Prior to her academic career, Jennifer spent over a decade on the frontlines of care as a specialist palliative care pharmacist at Newcastle’s Calvary Mater Hospital. Her PhD research explored the use of opioids in palliative care, but her scope has now expanded into the broader field of anticancer therapies – in particular, personalising chemotherapy dosing to improve outcomes and reduce side effects.
Now, as an Associate Investigator on the Cancer Council NSW–funded PREDICT program, Jennifer is also contributing to the development of personalised chemotherapy dosing strategies to improve outcomes and reduce toxicity for cancer patients.
At the heart of her work is a commitment to equity. “I want to see a future where geography isn’t a barrier to safe and effective cancer treatment,” she says. With this latest work, she’s bringing that future one step closer—not just for regional patients in NSW, but potentially for communities across Australia.
“The NSWRCRN Clinician Fellowship enabled me to focus on developing easier ways to monitor chemotherapy dosing using just a drop of blood, making it safer and more accessible.”
These promising developments lay the groundwork for a practical, patient-friendly approach to TDM—one that could remove geographical barriers and bring precision oncology into the homes of patients across rural Australia.