Pharmacodynamic Modeling

Pharmacodynamic Modeling, Pharmacokinetic Modeling

Optimal Scheduling of First-Line Therapeutics in Non-Small Cell Lung Cancer

In the United States, lung cancer causes more deaths per year (135,720 estimated for 2020) than does any other type of cancer, and 84% of lung cancer deaths are caused by non-small cell lung cancer (NSCLC) (Siegel et al., 2020). Treatment for NSCLC has expanded from a limited set of chemotherapeutics and surgery to include immunotherapy, radiotherapy, targeted adjunct therapy, and immune checkpoint inhibitors (Jászai & Schmidt, 2019; Liu et al., 2017). Between 1996 and 2010, it’s estimated that the percentage of NSCLC patients receiving some combination of targeted therapy and chemotherapy has increased by 20% for stage I/II patients, 28% for stage IIIA patients, and at least 15% for stage IIIB/IV patients (Kaniski et al., 2017). Parallel with the advancements in treatments, the prognosis for these patients has also been improving. The 5-year survival rate in NSCLC has advanced from 10.7% in 1973 to slightly less than 21% as of 2019 (Lu et al., 2019). Today, a combination of chemotherapy (including platinum-based doublets), immune checkpoint inhibitors (e.g. PD-1/PD-L1), and antiangiogenics (e.g. bevacizumab) is recommended as first-line therapy for the management of metastatic or recurrent NSCLC (Lung Cancer – Non-Small Cell – Types of Treatment, 2012). (more…)