Medical Oncologist
Before you start
Baseline Tests Done Before — Starting a TKI
Before your first dose of a tyrosine kinase inhibitor, your oncology team will run a set of standard checks. These are not a formality — they set the reference point your team uses to tell whether any change during treatment is caused by the medicine.
Medically reviewed by Dr. T. Raghavender Reddy, Medical Oncologist, MBBS · DM (Medical Oncology) · MD (Radiation Oncology) · Last reviewed August 2026
- Sets your personal baseline — These tests show what is normal for you before treatment, so any change caused by the TKI stands out clearly.
- One visit covers most tests — Blood draw, ECG and blood pressure recording can usually all be done in a single morning appointment.
- Abnormal does not mean cancelled — A borderline result usually leads to closer monitoring, not to treatment being stopped before it starts.
- The specific TKI shapes the list — Some medicines need thyroid or urine tests that others do not — your team will tell you exactly which apply to you.
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Before starting a tyrosine kinase inhibitor (TKI), your team will check your blood counts, liver function, kidney function, heart rhythm, and blood pressure. These tests set a personal baseline so any change caused by treatment can be spotted early. Most can be completed in a single morning visit.
What does your team check, and in what order?
Biomarker result confirmed
Your oncologist checks that the mutation or marker making you eligible for this specific TKI is documented before your first dose. If the result is not yet in hand, your start date is moved rather than the medicine given without confirmation.
Blood draw for three panels
A single blood sample checks your complete blood count (red cells, white cells, and platelets), your liver function, and your kidney function. Together these tell your team how each organ is working before any medicine is added.
Heart tracing (ECG)
A resting ECG measures your QT interval — the part of your heart rhythm that some TKIs can prolong. It takes only a few minutes, requires no preparation, and the result is usually available before you leave.
Blood pressure recording
Several TKIs are associated with raised blood pressure during treatment. A resting reading taken before your first dose gives your team a personal starting point to compare against at every follow-up.
TKI-specific extras
Depending on which medicine has been chosen, your team may also check your thyroid function, request a urine protein test, or arrange an eye assessment. Your oncologist will tell you which of these apply before the visit.
Oncologist reviews all results
Once every result is back, your oncologist confirms your start date. A borderline finding does not always delay treatment — it more often means that organ will be watched more closely during the first weeks.
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Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Interventional Radiologist
Dr. Mohammed Imran
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Why does your team need these results before treatment starts?
These tests give your team a personal reference point — what is normal for you, not for a textbook average. When a blood marker shifts during treatment, your team needs to know whether it was already moving beforehand or changed because of the TKI.
Liver and kidney tests matter because most TKIs are processed through the liver or cleared by the kidneys. An organ that is already under pressure may need a dose adjustment from the outset, and the baseline result is what makes that judgement possible.
The ECG specifically checks the QT interval, which reflects how the heart recovers between beats. NCCN and ESMO guidance includes a baseline ECG as standard for TKIs known to affect this interval.
What should you know about the day of testing?
Most people have all their baseline tests done in a single morning visit. The blood draw, ECG, and blood pressure recording together are usually completed well within a morning.
Ask your team the evening before whether you need to fast. Not all TKI baseline blood tests require an empty stomach, but if a glucose or lipid level is being checked at the same visit, avoiding food for a few hours beforehand may be needed.
You should receive your results and a confirmed start date within a few days. If you have not heard back within a week of the testing visit, contact your team directly rather than waiting.
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Common questions
Frequently asked questions
Do I need a new biopsy before starting a TKI?
Not usually. The mutation or biomarker result that makes you eligible is typically drawn from tissue collected during your original biopsy. If that sample was too small, degraded, or the result was inconclusive, a repeat biopsy or a liquid biopsy may be needed before the baseline visit. Ask your oncologist which result is currently on file and whether it is sufficient to proceed.
What happens if my liver tests come back slightly abnormal?
A mildly raised liver result does not automatically delay or cancel treatment. Your oncologist will look at how far the value sits outside the normal range and what is most likely causing it. If the change is small and not a sign of active liver strain, treatment can often start as planned, with more frequent liver tests in the first weeks to track whether the value settles or climbs.
How long do the baseline test results take?
Most blood results come back within a day or two. The ECG result is usually available before you leave the clinic. If your workup includes a specialised test such as thyroid function or urine protein, the timeline may be slightly longer. Your team will tell you when to expect everything and will contact you once a start date is confirmed.
Will I need the same tests repeated during treatment?
Yes. The panels checked at baseline are repeated at regular intervals throughout treatment — usually before each follow-up visit. This is how your team tracks whether a change is new, worsening, or stabilising. How often the tests repeat depends on which TKI you are taking and how your results look in the first weeks.
Do I need to fast before these blood tests?
It depends on what your oncologist has ordered. A standard blood count and liver or kidney panel usually does not require fasting. If a fasting glucose or lipid panel is being checked at the same visit, you may need to avoid food for a few hours beforehand. Ask your team the evening before your appointment so you arrive prepared.