Radius additivity score: a novel combination index for tumour growth inhibition in fixed-dose xenograft studies

The effect of combination therapies in many cancers has often been shown to be superior to that of monotherapies. This success is commonly attributed to drug synergies. Combinations of two (or more) drugs in xenograft tumor growth inhibition (TGI) studies are typically designed at fixed doses for ea...

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Main Authors: Nicola Melillo, Jake Dickinson, Lu Tan, Hitesh B. Mistry, Heinrich J. Huber
Format: Article
Language:English
Published: Frontiers Media S.A. 2023-10-01
Series:Frontiers in Pharmacology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2023.1272058/full
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author Nicola Melillo
Jake Dickinson
Lu Tan
Hitesh B. Mistry
Hitesh B. Mistry
Heinrich J. Huber
author_facet Nicola Melillo
Jake Dickinson
Lu Tan
Hitesh B. Mistry
Hitesh B. Mistry
Heinrich J. Huber
author_sort Nicola Melillo
collection DOAJ
description The effect of combination therapies in many cancers has often been shown to be superior to that of monotherapies. This success is commonly attributed to drug synergies. Combinations of two (or more) drugs in xenograft tumor growth inhibition (TGI) studies are typically designed at fixed doses for each compound. The available methods for assessing synergy in such study designs are based on combination indices (CI) and model-based analyses. The former methods are suitable for screening exercises but are difficult to verify in in vivo studies, while the latter incorporate drug synergy in semi-mechanistic frameworks describing disease progression and drug action but are unsuitable for screening. In the current study, we proposed the empirical radius additivity (Rad-add) score, a novel CI for synergy detection in fixed-dose xenograft TGI combination studies. The Rad-add score approximates model-based analysis performed using the semi-mechanistic constant-radius growth TGI model. The Rad-add score was compared with response additivity, defined as the addition of the two response values, and the bliss independence model in combination studies derived from the Novartis PDX dataset. The results showed that the bliss independence and response additivity models predicted synergistic interactions with high and low probabilities, respectively. The Rad-add score predicted synergistic probabilities that appeared to be between those predicted with response additivity and the Bliss model. We believe that the Rad-add score is particularly suitable for assessing synergy in the context of xenograft combination TGI studies, as it combines the advantages of CI approaches suitable for screening exercises with those of semi-mechanistic TGI models based on a mechanistic understanding of tumor growth.
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spelling doaj.art-2fb9f17c94f341c29efa76fab03780632023-10-13T05:08:26ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122023-10-011410.3389/fphar.2023.12720581272058Radius additivity score: a novel combination index for tumour growth inhibition in fixed-dose xenograft studiesNicola Melillo0Jake Dickinson1Lu Tan2Hitesh B. Mistry3Hitesh B. Mistry4Heinrich J. Huber5Seda Pharmaceutical Developments Services Unit D Cheadle Royal Business Park, Stockport, United KingdomSeda Pharmaceutical Developments Services Unit D Cheadle Royal Business Park, Stockport, United KingdomDivision Drug Discovery Sciences, Boehringer Ingelheim RCV GmbH & Co KG, Vienna, AustriaSeda Pharmaceutical Developments Services Unit D Cheadle Royal Business Park, Stockport, United KingdomDivision of Pharmacy, University of Manchester, Manchester, United KingdomDivision Drug Discovery Sciences, Boehringer Ingelheim RCV GmbH & Co KG, Vienna, AustriaThe effect of combination therapies in many cancers has often been shown to be superior to that of monotherapies. This success is commonly attributed to drug synergies. Combinations of two (or more) drugs in xenograft tumor growth inhibition (TGI) studies are typically designed at fixed doses for each compound. The available methods for assessing synergy in such study designs are based on combination indices (CI) and model-based analyses. The former methods are suitable for screening exercises but are difficult to verify in in vivo studies, while the latter incorporate drug synergy in semi-mechanistic frameworks describing disease progression and drug action but are unsuitable for screening. In the current study, we proposed the empirical radius additivity (Rad-add) score, a novel CI for synergy detection in fixed-dose xenograft TGI combination studies. The Rad-add score approximates model-based analysis performed using the semi-mechanistic constant-radius growth TGI model. The Rad-add score was compared with response additivity, defined as the addition of the two response values, and the bliss independence model in combination studies derived from the Novartis PDX dataset. The results showed that the bliss independence and response additivity models predicted synergistic interactions with high and low probabilities, respectively. The Rad-add score predicted synergistic probabilities that appeared to be between those predicted with response additivity and the Bliss model. We believe that the Rad-add score is particularly suitable for assessing synergy in the context of xenograft combination TGI studies, as it combines the advantages of CI approaches suitable for screening exercises with those of semi-mechanistic TGI models based on a mechanistic understanding of tumor growth.https://www.frontiersin.org/articles/10.3389/fphar.2023.1272058/fulldrug combinationbiostatisticmathematical modelsynergyxenograft
spellingShingle Nicola Melillo
Jake Dickinson
Lu Tan
Hitesh B. Mistry
Hitesh B. Mistry
Heinrich J. Huber
Radius additivity score: a novel combination index for tumour growth inhibition in fixed-dose xenograft studies
Frontiers in Pharmacology
drug combination
biostatistic
mathematical model
synergy
xenograft
title Radius additivity score: a novel combination index for tumour growth inhibition in fixed-dose xenograft studies
title_full Radius additivity score: a novel combination index for tumour growth inhibition in fixed-dose xenograft studies
title_fullStr Radius additivity score: a novel combination index for tumour growth inhibition in fixed-dose xenograft studies
title_full_unstemmed Radius additivity score: a novel combination index for tumour growth inhibition in fixed-dose xenograft studies
title_short Radius additivity score: a novel combination index for tumour growth inhibition in fixed-dose xenograft studies
title_sort radius additivity score a novel combination index for tumour growth inhibition in fixed dose xenograft studies
topic drug combination
biostatistic
mathematical model
synergy
xenograft
url https://www.frontiersin.org/articles/10.3389/fphar.2023.1272058/full
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AT jakedickinson radiusadditivityscoreanovelcombinationindexfortumourgrowthinhibitioninfixeddosexenograftstudies
AT lutan radiusadditivityscoreanovelcombinationindexfortumourgrowthinhibitioninfixeddosexenograftstudies
AT hiteshbmistry radiusadditivityscoreanovelcombinationindexfortumourgrowthinhibitioninfixeddosexenograftstudies
AT hiteshbmistry radiusadditivityscoreanovelcombinationindexfortumourgrowthinhibitioninfixeddosexenograftstudies
AT heinrichjhuber radiusadditivityscoreanovelcombinationindexfortumourgrowthinhibitioninfixeddosexenograftstudies