Three cancer drugs linked by one withdrawn animal study. Afatinib is a long-established prescription medicine that delays tumor growth in lung cancers with particular receptor faults, at the cost of near-universal rash, diarrhea and nail inflammation. Daraxonrasib extended survival in previously treated pancreatic cancer on a single company-run study. SD-36 has never entered a human body. (Full Review)
| Marker | Target | Why |
|---|---|---|
| Alanine aminotransferase | 10–26 U/L | Detects drug-induced liver injury before symptoms |
| Aspartate aminotransferase | 10–26 U/L | Confirms and grades hepatocellular injury |
| Total bilirubin | 0.4–1.0 mg/dL | Separates reversible enzyme rise from real liver injury |
| Serum creatinine and eGFR | eGFR >90 mL/min/1.73 m² | Detects kidney injury after diarrhea-related dehydration |
| Serum potassium | 4.0–4.5 mmol/L | Depleted by diarrhea; low levels destabilise heart rhythm |
| Serum magnesium | 2.0–2.5 mg/dL | Depleted by diarrhea; low levels worsen cramps and fatigue |
| Serum albumin | 4.2–5.0 g/dL | Best marker of nutritional reserve and dose tolerance |
| Hemoglobin | 13.5–15.5 g/dL (men); 12.5–14.5 g/dL (women) | Anemia amplifies treatment fatigue and limits function |
| High-sensitivity C-reactive protein | <0.5 mg/L | Tracks inflammation, which predicts tolerance and prognosis |
| Carbohydrate antigen 19-9 | Falling ≥50% from baseline by week 8 | Earliest quantitative response signal in pancreatic cancer |
| Circulating tumor DNA mutation fraction | Undetectable, or falling from baseline | Detects response and resistance before imaging does |
| Left ventricular ejection fraction | ≥55% | Detects cardiac dysfunction from HER2 blockade |
Cadence: Baseline panel before starting. Laboratory review at weeks 2 and 4, every 4 weeks through month 3, then every 8 to 12 weeks. Imaging at 6 to 8 weeks, then every 8 to 12 weeks. Any new respiratory symptom triggers immediate imaging.