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Xenobiotica
the fate of foreign compounds in biological systems
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Review Article

Application of quantitative pharmacology analysis to support early clinical development of oncology drugs: dose selection

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Received 29 Apr 2024, Accepted 04 Jul 2024, Accepted author version posted online: 12 Jul 2024
 
Accepted author version

Abstract

  1. The selection of appropriate starting dose and suitable method to predict an efficacious dose for novel oncology drug in the early clinical development stage poses significant challenges. The traditional methods of using body surface area transformation from toxicology studies to predict the first-in human (FIH) starting dose, or simply selecting the maximum tolerated dose (MTD) or maximum administered dose (MAD) as efficacious dose or recommended phase 2 dose (RP2D), are usually inadequate and risky for novel oncology drugs.

  2. Due to the regulatory efforts aimed at improving dose optimization in oncology drug development, clinical dose selection is now shifting away from these traditional methods towards a comprehensive benefit/risk assessment-based approach. Quantitative pharmacology analysis (QPA) plays a crucial role in this new paradigm. This mini-review summarizes the use of QPA in selecting the starting dose for oncology FIH studies and potential efficacious doses for expansion or phase 2 trials. QPA allows for a more rational and scientifically based approach to dose selection by integrating information across studies and development phases.

  3. In conclusion, the application of QPA in oncology drug development has the potential to significantly enhance the success rates of clinical trials and ultimately support clinical decision-making, particularly in dose selection.

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Funding

The author(s) reported there is no funding associated with the work featured in this article.

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