从前性评估到实践:在瘤学中基于模型的剂量优化
Bram C Agema1,2, Birgit C P Koch3,4, Ron H J Mathijssen5
1Department of Medical Oncology, Erasmus MC Cancer Institute, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands. b.agema@erasmusmc.nl.
基于模型的精确剂量定制,为个别患者量身定制癌症药物治疗. 虽然它还不是标准,但研究表明它可以改善结果,并减少某些瘤药物的毒性,突出显示其未来的临床价值.
科学领域:
- 在瘤学瘤学.
- 药理动力学 药理动力学
- 临床药理学 临床药理学
背景情况:
- 药物反应的个体变化需要在瘤学中个性化剂量策略.
- 目前的瘤治疗药物的剂量方案往往导致副作用和治疗失败.
- 基于模型的精确剂量 (MIPD) 为优化癌症治疗提供了一种有前途的方法.
研究的目的:
- 为瘤学中基于模型的精确剂量提供临床视角.
- 审查MIPD在癌症治疗中的潜在实施和验证研究.
- 评估MIPD在临床瘤学的现状和未来潜力.
主要方法:
- 对瘤学中基于模型的精确剂量研究的前性研究的文献综述.
- 用实施或验证的MIPD协议识别药物.
- 对研究结果的分析,重点关注药物暴露,变异性,临床疗效和毒性.
主要成果:
- 确定了16种药物与潜在的MIPD验证/实施研究.
- 观察到布苏尔方和高剂量甲状腺素与MIPD一起改善了临床结果.
- 在布苏尔方和环胺治疗时,注意到毒性降低.
- 通过卡尔维特公式 (一种MIPD形式) 给药卡博普拉丁因其已建立的治疗窗口而不需要进一步的结果验证.
结论:
- 基于模型的精确剂量证明了瘤学中的附加值.
- MIPD有可能显著改变未来的癌症药物剂量方案.
- 预计将MIPD进一步纳入常规临床实践.
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