A multi-cancer platform trial of adaptive (dose-holiday) therapy
Instead of hitting a tumour with the maximum dose until it stops working, adjust the dose to keep the tumour small and let drug-sensitive cells suppress resistant ones. Test this properly across several cancers.
Adaptive therapy, in which dosing is modulated on a tumour burden marker to maintain a stable population of sensitive cells, extended time to progression in a pilot of abiraterone in prostate cancer. It has not been tested at scale or outside prostate. A platform trial would run adaptive versus continuous dosing arms in prostate (PSA), ovarian (CA-125) and melanoma (ctDNA) simultaneously with a shared evolutionary modelling core.
- Tumour heterogeneity and clonal evolution · A tumour is many tumours. Treatments that kill most cells leave the rest to grow back, changed.
- Wrong doses · Most drug doses were chosen as the highest a person can tolerate, which is often more than they need.
Pages like this
not linked directly; found by shared links- IdeaEvolution-guided 'adaptive therapy' dosing tested in randomised phase 2 trials
Shares Moffitt Cancer Center, Wrong doses, Ovarian cancer, Melanoma.
- IdeaSwitch drugs at maximum response, not at relapse
Shares Moffitt Cancer Center, Tumour heterogeneity and clonal evolution, Melanoma.
- IdeaEvolutionary tumour boards with a modeller in the room
Shares Moffitt Cancer Center, Tumour heterogeneity and clonal evolution.
- PersonShari Pilon-Thomas
Shares Moffitt Cancer Center, Melanoma.
- IdeaAutonomous closed-loop adaptive therapy driven by blood tests and evolutionary models
Shares Moffitt Cancer Center, Wrong doses, Prostate cancer.
- PersonRobert A. Gatenby
Shares Moffitt Cancer Center, Prostate cancer.
- PersonPatrick Hwu
Shares Moffitt Cancer Center, Melanoma.
- ProductNirogacestat
Shares Intermittent or stop-and-restart nirogacestat in desmoid tumours, Wrong doses.