Related Experiment Video
Updated: Jul 13, 2025
Profiling Sensitivity to Targeted Therapies in EGFR-Mutant NSCLC Patient-Derived Organoids
Published on: November 22, 2021
At the right dose: personalised (N-of-1) dosing for precision oncology
Mina Nikanjam1, Shumei Kato1, Jason K Sicklick2
1Division of Hematology-Oncology, University of California San Diego, La Jolla, CA, USA.
Abstract:
The objective of oncology therapeutics, especially in the age of precision medicine, is to give the right drug(s) to the right patient at the right time. Yet, a major challenge is finding the right dose for each patient. Determining safe and efficacious doses of oncology treatments, especially for novel combination therapies, can be challenging. Moreover, traditionally, dosing cancer drugs is based on giving each patient the same dose (a flat dose) or a dose based on surface area/weight. But patients' ability to tolerate drugs is influenced by additional factors including, but not limited to age, gender, race, comorbidities, organ function, and metabolism. Herein, we present evidence that, in the era of targeted drugs, individualised drug dosing determined by starting at reduced doses and using intrapatient dose escalation can yield safe and effective personalised dosing of novel combinations of approved drugs that have not previously undergone formal phase I trials and can also optimise dosing of tested drug regimens.
Insights
Personalized cancer drug dosing, using intrapatient dose escalation, offers a safe and effective approach. This method optimizes novel combination therapies and improves outcomes for individual patients.
Area of Science:
- Oncology
- Pharmacology
- Precision Medicine
Background:
- Current oncology therapeutics aim for precision medicine, but determining optimal patient-specific drug doses remains a significant challenge.
- Traditional dosing strategies (flat or weight-based) do not account for individual patient factors like age, comorbidities, and metabolism.
- Novel combination therapies present unique dosing challenges, often lacking formal Phase I trial data.
Purpose of the Study:
- To present evidence for individualized drug dosing in oncology.
- To demonstrate the safety and efficacy of intrapatient dose escalation for novel combination therapies.
- To optimize dosing for both novel and established drug regimens based on individual patient tolerance.
Main Methods:
- Implementing individualized drug dosing strategies.
- Starting novel combination therapies at reduced doses.
- Utilizing intrapatient dose escalation to determine optimal therapeutic levels.
- Applying this approach to both untested drug combinations and established regimens.
Main Results:
- Individualised drug dosing, initiated at reduced levels and escalated within patients, yields safe and effective personalized dosing.
- This approach successfully optimizes novel combination therapies, including those without prior Phase I trials.
- Dosing of previously tested drug regimens can also be optimized using this personalized strategy.
Conclusions:
- Intrapatient dose escalation is a viable method for achieving personalized oncology drug dosing.
- This strategy enhances the safety and efficacy of novel combination cancer therapies.
- Individualized dosing optimizes treatment for patients in the era of targeted therapies and precision medicine.
More Related Videos
13:24Integration of Wet and Dry Bench Processes Optimizes Targeted Next-generation Sequencing of Low-quality and Low-quantity Tumor Biopsies
Published on: April 11, 2016
12:41Multiparametric Tumor Organoid Drug Screening Using Widefield Live-Cell Imaging for Bulk and Single-Organoid Analysis
Published on: December 23, 2022
Related Concept Videos
02:50Combination Therapies and Personalized Medicine
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
01:01Dosage Regimen: Fixed Dose
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
01:19Nonlinear Pharmacokinetics: Overview
Nonlinearity can arise due to the saturation of plasma protein-binding or...
01:25Dose-Response Relationship: Selectivity and Specificity
01:15Drug Dosage Regimen: Overview
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...
02:49Cancer Therapies
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...