Targeted Toxicities: Protocols for Monitoring the Adverse Events of Targeted Therapies Used in the Treatment of Non-Small Cell Lung Cancer

Hines, Jacobi; Bowar, Benjamin Charles; Levine, Emma; Esposito, Alessandra; Garassino, Marina Chiara; Bestvina, Christine M.

doi:10.3390/ijms24119429

Cited by 4 publications

(3 citation statements)

References 60 publications

(79 reference statements)

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“…Relatively few works have been published on modeling therapy adverse effects. However, this is slowly beginning to change, as quantified data on these effects start to appear, also in the case of adverse effects in lung-cancer-targeted therapies [124]. In [114], mathematical models led to the formulation of guidelines concerning adjuvant steroid protocols that are used to support targeted therapy of metastatic lung cancer.…”

Section: Discussionmentioning

confidence: 99%

Mathematical Modeling Support for Lung Cancer Therapy—A Short Review

Smieja

2023

IJMS

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The paper presents a review of models that can be used to describe dynamics of lung cancer growth and its response to treatment at both cell population and intracellular processes levels. To address the latter, models of signaling pathways associated with cellular responses to treatment are overviewed. First, treatment options for lung cancer are discussed, and main signaling pathways and regulatory networks are briefly reviewed. Then, approaches used to model specific therapies are discussed. Following that, models of intracellular processes that are crucial in responses to therapies are presented. The paper is concluded with a discussion of the applicability of the presented approaches in the context of lung cancer.

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Section: Discussionmentioning

confidence: 99%

Mathematical Modeling Support for Lung Cancer Therapy—A Short Review

Smieja

2023

IJMS

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“…For example, individual variations in drug responses [1], differences among populations [2], different drug formulations [3], single or multiple drug administration [4] and different routes of drug administration [5] all have different effects on treatments. Similarly, the need for optimal, target-specific therapies including drug combinations as well as other parameters will also effect overall treatments [6][7][8][9][10]. The risk/benefit assessment of drug posology selection and effective use is a continuous developmental process even after drug registration and during post-marketing surveillance [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Drug Selection and Posology, Optimal Therapies and Risk/Benefit Assessment in Medicine: The Paradigm of Iron-Chelating Drugs

Kontoghiorghes

2023

IJMS

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The design of clinical protocols and the selection of drugs with appropriate posology are critical parameters for therapeutic outcomes. Optimal therapeutic protocols could ideally be designed in all diseases including for millions of patients affected by excess iron deposition (EID) toxicity based on personalised medicine parameters, as well as many variations and limitations. EID is an adverse prognostic factor for all diseases and especially for millions of chronically red-blood-cell-transfused patients. Differences in iron chelation therapy posology cause disappointing results in neurodegenerative diseases at low doses, but lifesaving outcomes in thalassemia major (TM) when using higher doses. In particular, the transformation of TM from a fatal to a chronic disease has been achieved using effective doses of oral deferiprone (L1), which improved compliance and cleared excess toxic iron from the heart associated with increased mortality in TM. Furthermore, effective L1 and L1/deferoxamine combination posology resulted in the complete elimination of EID and the maintenance of normal iron store levels in TM. The selection of effective chelation protocols has been monitored by MRI T2* diagnosis for EID levels in different organs. Millions of other iron-loaded patients with sickle cell anemia, myelodysplasia and haemopoietic stem cell transplantation, or non-iron-loaded categories with EID in different organs could also benefit from such chelation therapy advances. Drawbacks of chelation therapy include drug toxicity in some patients and also the wide use of suboptimal chelation protocols, resulting in ineffective therapies. Drug metabolic effects, and interactions with other metals, drugs and dietary molecules also affected iron chelation therapy. Drug selection and the identification of effective or optimal dose protocols are essential for positive therapeutic outcomes in the use of chelating drugs in TM and other iron-loaded and non-iron-loaded conditions, as well as general iron toxicity.

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“…Importantly, a comprehensive discussion is warranted regarding patient-reported outcomes and whether clinical trials and the selection of systemic therapies should incorporate these critical endpoints ( 16 - 18 ). This consideration becomes particularly relevant in the context of the potential risks of adverse immune reactions associated with immunotherapy and/or combination therapies ( 19 , 20 ). Ensuring transparent discussions with patients before initiating systemic therapy is imperative to genuinely assess the significance of quality versus length of survivorship in the personalized decision-making process.…”

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confidence: 99%