The influence of toxicity constraints in models of chemotherapeutic protocol escalation.

The prospect of exploiting mathematical and computational models to gain insight into the influence of scheduling on cancer chemotherapeutic effectiveness is increasingly being considered. However, the question of whether such models are robust to the inclusion of additional tumour biology is relati...

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Main Authors: Boston, E, Gaffney, E
Format: Journal article
Language:English
Published: 2011
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author Boston, E
Gaffney, E
author_facet Boston, E
Gaffney, E
author_sort Boston, E
collection OXFORD
description The prospect of exploiting mathematical and computational models to gain insight into the influence of scheduling on cancer chemotherapeutic effectiveness is increasingly being considered. However, the question of whether such models are robust to the inclusion of additional tumour biology is relatively unexplored. In this paper, we consider a common strategy for improving protocol scheduling that has foundations in mathematical modelling, namely the concept of dose densification, whereby rest phases between drug administrations are reduced. To maintain a manageable scope in our studies, we focus on a single cell cycle phase-specific agent with uncomplicated pharmacokinetics, as motivated by 5-Fluorouracil-based adjuvant treatments of liver micrometastases. In particular, we explore predictions of the effectiveness of dose densification and other escalations of the protocol scheduling when the influence of toxicity constraints, cell cycle phase specificity and the evolution of drug resistance are all represented within the modelling. For our specific focus, we observe that the cell cycle and toxicity should not simply be neglected in modelling studies. Our explorations also reveal the prediction that dose densification is often, but not universally, effective. Furthermore, adjustments in the duration of drug administrations are predicted to be important, especially when dose densification in isolation does not yield improvements in protocol outcomes.
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spelling oxford-uuid:92c93d14-8a23-40a7-b02f-0b380e8a8c442022-03-26T23:27:58ZThe influence of toxicity constraints in models of chemotherapeutic protocol escalation.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:92c93d14-8a23-40a7-b02f-0b380e8a8c44EnglishSymplectic Elements at Oxford2011Boston, EGaffney, EThe prospect of exploiting mathematical and computational models to gain insight into the influence of scheduling on cancer chemotherapeutic effectiveness is increasingly being considered. However, the question of whether such models are robust to the inclusion of additional tumour biology is relatively unexplored. In this paper, we consider a common strategy for improving protocol scheduling that has foundations in mathematical modelling, namely the concept of dose densification, whereby rest phases between drug administrations are reduced. To maintain a manageable scope in our studies, we focus on a single cell cycle phase-specific agent with uncomplicated pharmacokinetics, as motivated by 5-Fluorouracil-based adjuvant treatments of liver micrometastases. In particular, we explore predictions of the effectiveness of dose densification and other escalations of the protocol scheduling when the influence of toxicity constraints, cell cycle phase specificity and the evolution of drug resistance are all represented within the modelling. For our specific focus, we observe that the cell cycle and toxicity should not simply be neglected in modelling studies. Our explorations also reveal the prediction that dose densification is often, but not universally, effective. Furthermore, adjustments in the duration of drug administrations are predicted to be important, especially when dose densification in isolation does not yield improvements in protocol outcomes.
spellingShingle Boston, E
Gaffney, E
The influence of toxicity constraints in models of chemotherapeutic protocol escalation.
title The influence of toxicity constraints in models of chemotherapeutic protocol escalation.
title_full The influence of toxicity constraints in models of chemotherapeutic protocol escalation.
title_fullStr The influence of toxicity constraints in models of chemotherapeutic protocol escalation.
title_full_unstemmed The influence of toxicity constraints in models of chemotherapeutic protocol escalation.
title_short The influence of toxicity constraints in models of chemotherapeutic protocol escalation.
title_sort influence of toxicity constraints in models of chemotherapeutic protocol escalation
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