Revisiting Bevacizumab + Cytotoxics Scheduling Using Mathematical Modeling: Proof of Concept Study in Experimental Non-Small Cell Lung Carcinoma.

Fiche publication


Date publication

janvier 2018

Journal

CPT: pharmacometrics & systems pharmacology

Auteurs

Membres identifiés du Cancéropôle Est :
Pr MASCAUX Céline


Tous les auteurs :
Imbs DC, El Cheikh R, Boyer A, Ciccolini J, Mascaux C, Lacarelle B, Barlesi F, Barbolosi D, Benzekry S

Résumé

Concomitant administration of bevacizumab and pemetrexed-cisplatin is a common treatment for advanced nonsquamous non-small cell lung cancer (NSCLC). Vascular normalization following bevacizumab administration may transiently enhance drug delivery, suggesting improved efficacy with sequential administration. To investigate optimal scheduling, we conducted a study in NSCLC-bearing mice. First, experiments demonstrated improved efficacy when using sequential vs. concomitant scheduling of bevacizumab and chemotherapy. Combining this data with a mathematical model of tumor growth under therapy accounting for the normalization effect, we predicted an optimal delay of 2.8 days between bevacizumab and chemotherapy. This prediction was confirmed experimentally, with reduced tumor growth of 38% as compared to concomitant scheduling, and prolonged survival (74 vs. 70 days). Alternate sequencing of 8 days failed in achieving a similar increase in efficacy, thus emphasizing the utility of modeling support to identify optimal scheduling. The model could also be a useful tool in the clinic to personally tailor regimen sequences.

Mots clés

Animals, Antineoplastic Combined Chemotherapy Protocols, administration & dosage, Bevacizumab, administration & dosage, Carcinoma, Non-Small-Cell Lung, drug therapy, Cell Line, Tumor, Cell Proliferation, drug effects, Drug Administration Schedule, Humans, Lung Neoplasms, drug therapy, Mice, Models, Theoretical, Proof of Concept Study, Xenograft Model Antitumor Assays

Référence

CPT Pharmacometrics Syst Pharmacol. 2018 01;7(1):42-50