Example 1: Model approach for CT data analysis

Problem: to optimize dosing regime of drug X for individual patients to achieve maximal therapeutic effect with minimal damage for the organism.

Drugs assessed: drug X is effective chemotherapeutic drug candidate

Motivation:

  • drug X demonstrates its therapeutic effect at concentrations > 5 μM
  • toxicity of drug X  becomes apparent at concentrations > 1.5 μM

Approach:

  • In framework of non-linear mixed effects modeling (NLME) approach to develop population PK model,
  • verify it on the basis of available population PK data
  • apply the model to predict optimal dosing regime for individual patients
CT1.jpg
Data Available: Pharmacokinetic data from 12 patients.

 

CT2.jpg

 

Result 1: Population PK Model describing available clinical data has been constructed, individual values of PK-parameters (CL - clearance and V - volume of distribution) have been estimated and correlation of the PK-parameters with physiological parameters (WT – weight and AGE - age) has been found.
ct_3_eng.jpg

Result 2: Taking into account these linear correlations between PK and physiological parameters we have predicted inter-individual variability in pharmacokinetics in more accurate manner.

CT4

Result 3: Using the model we have found that standard multiple dosing schedule is not appropriate for some patients. For example, in framework of standard dosing schedule two patients (patient N1 and patient N2) would receive one 25 μM dosage daily. This treatment would go quite well for patient N1 BUT for patient N2 concentration of the drug X has never reached therapeutic level and it has been almost always higher than toxic level.

CT5

Result 4: MBDDA enables us to predict optimal multiple dosing schedule which is appropriate for patient N2. Indeed, we have discovered that administration of one 40 μM dosage per 36 hours (1) allows drug X to reach therapeutic concentrations and (2) decreases time periods with its toxic concentrations.

Conclusion:
  • physiological parameters (WT, AGE) have been found to affect the PK-parameters
  • optimal dosing regime of drug X for individual patients to achieve maximal therapeutic effect with minimal damage for the organism has been identified.


PDF-description:

ISBSPb Clinical Trials.pdf (120.77 Kb)


 

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