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A General Network Pharmacodynamic Model-Based Design Pipeline for Customized Cancer Therapy Applied to the VEGFR
X-Y Zhang1, M R Birtwistle1, J M Gallo1
1Department of Pharmacology and Systems Therapeutics, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Abstract:
A unified approach to optimize multidrug chemotherapy using a pharmacokinetic (PK)/enhanced pharmacodynamic model was developed using the vascular endothelial growth factor receptor (VEGFR) signaling system. The base VEGFR network model, characterized by ligand-receptor interactions, enzyme recruitment (Grb2-Sos, phospholipase C γ (PLCγ), and phosphoinositide-3 kinase (PI3K)), and downstream mitogen-activated protein kinase and Akt cascade activation, was linked to a sunitinib (VEGFR inhibitor) PK model and underwent Sobol sensitivity analysis that revealed potential sunitinib-enhancing mechanisms. Drugs targeting these mechanisms (a VEGF inhibitor, a PI3K inhibitor, a PLCγ inhibitor, and a mitogen-activated protein kinase inhibitor) and sunitinib were input to optimization-based control analyses to design multidrug regimens that maintained 80% pERK and pAkt inhibition for 28 days while minimizing drug dose. The resultant combination regimens contained both continuous and discontinuous schedules, mostly at low doses, and were altered by oncogenic mutations. This pipeline of computational analyses demonstrates how model-based methods can capture the complexities of drug action, tailor cancer chemotherapy, and empower personalized medicine.
Insights
This study developed a computational model to optimize cancer chemotherapy by combining drugs targeting the vascular endothelial growth factor receptor (VEGFR) pathway. The model suggests personalized, low-dose multidrug regimens can effectively inhibit cancer signaling.
Area of Science:
- Computational Biology and Bioinformatics
- Pharmacology and Pharmaceutical Sciences
- Oncology and Cancer Research
Background:
- Optimizing multidrug chemotherapy requires understanding complex drug interactions within signaling pathways.
- The vascular endothelial growth factor receptor (VEGFR) signaling system is a key target in cancer therapy.
- Existing models often lack the integration of pharmacokinetic and pharmacodynamic properties for comprehensive drug optimization.
Purpose of the Study:
- To develop a unified pharmacokinetic/pharmacodynamic (PK/PD) model for optimizing multidrug chemotherapy targeting the VEGFR signaling system.
- To identify potential drug combinations and schedules that maximize target inhibition while minimizing dosage.
- To explore the impact of oncogenic mutations on optimal therapeutic strategies.
Main Methods:
- Developed a detailed VEGFR signaling network model incorporating ligand-receptor interactions and downstream enzyme cascades.
- Integrated a sunitinib (VEGFR inhibitor) PK model with the VEGFR network model.
- Performed Sobol sensitivity analysis to identify key drug targets and employed optimization-based control analyses for regimen design.
Main Results:
- Sensitivity analysis revealed potential mechanisms to enhance sunitinib efficacy.
- Designed multidrug regimens (including VEGF, PI3K, PLCγ, and MAPK inhibitors) that maintained 80% pERK and pAkt inhibition for 28 days.
- Optimal regimens often involved low doses and varied continuous/discontinuous schedules, influenced by specific oncogenic mutations.
Conclusions:
- Model-based approaches can effectively capture the complexity of drug actions in cancer chemotherapy.
- This computational pipeline demonstrates a powerful tool for tailoring cancer treatment strategies.
- The findings support the advancement of personalized medicine through in silico drug regimen optimization.
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