Reparameterized multiobjective control of BCG immunotherapy

Bladder cancer is a cancerous disease that mainly affects elder men and women. The immunotherapy that uses Bacillus of Calmette and Guerin (BCG) effectively treats bladder cancer by stimulating the immune response of patients. The therapeutic performance of BCG relies on drug dosing, and the design of an optimal BCG regimen is an open question. In this study, we propose the reparameterized multiobjective control (RMC) approach for seeking an optimal drug dosing regimen and apply it to the design of BCG treatment. This approach utilizes constrained optimization based on a nonlinear bladder cancer model with impulsive drug instillation. We compare the performance of RMC with Koopman model predictive control (MPC) and validate the efficacy of optimal BCG dosing regimens through numerical simulations, demonstrating the efficient elimination of cancerous cells. The proposed control framework holds the potential for generalization to other model-based treatment designs.