Building an adaptive dose simulation framework to aid dose and schedule selection

AbstractEstablishing a dosing regimen that maximizes clinical benefit and minimizes side effects for novel therapeutics is a key objective for drug developers. Finding an optimal dose and schedule can be particularly challenging for compounds with a narrow therapeutic window such as in oncology. Modeling and simulation tools can be valuable to conduct in-silico evaluations of various dosing scenarios with the goal to identify those that could minimize toxicities, avoid unscheduled dose-interruptions, or minimize premature discontinuations, which all could limit the potential for therapeutic benefit.In this tutorial we present a stepwise development of an adaptive dose simulation framework that can be used for dose-optimization simulations. The tutorial first describes the general workflow, followed by a technical description with basic to advanced practical examples of its implementation inmrgsolve and is concluded with examples on how to utilize this in decision making around dose and schedule optimization.The adaptive simulation framework is built with pharmacokinetic, pharmacodynamic (i.e., biomarkers, activity markers, target engagement markers, efficacy markers) and safety models that include evaluations of unexplained inter-individual and intra-individual variability and covariate impact, which can be replaced and expanded (e.g., combination setting, comparator setting) with user-defined models. Subsequent adaptive simulations allow to investigate the impact of starting...
Source: CPT: Pharmacometrics and Systems Pharmacology - Category: Drugs & Pharmacology Authors: Tags: TUTORIAL Source Type: research