Lower doses of numerous precision cancer drugs are being explored to minimize side effects and expenses.
The article discusses the testing of dozens of precision cancer drugs at lower doses to reduce side effects and cut costs. It highlights the case of sotorasib, a lung cancer drug, which showed that a four-times-lower dose had nearly the same effect as the higher dose but with reduced toxicity and cost. This approach challenges the traditional belief that higher doses lead to better outcomes in cancer treatment. The article emphasizes the importance of conducting more clinical trials to explore alternative dosing regimens for cancer drugs.
The focus is on the need for de-escalation trials to test the efficacy of lower doses and alternative regimens for existing cancer drugs. While efforts like the FDA's Project Optimus aim to reform dose-selection paradigms for new drugs, post-approval de-escalation trials are crucial for drugs already on the market. These trials face challenges, particularly in countries with private healthcare systems where prescribing lower doses may not align with financial incentives for doctors and clinics.
The article also addresses the resistance from physicians to adopt lower doses, citing regulatory concerns and ingrained prescribing habits. However, studies have shown that alternative dosing strategies, based on real-world evidence or initial pharmaceutical studies, can be effective in reducing costs and toxicity. For example, some cancer drugs were initially approved at weight-based doses but later switched to fixed doses, which were found to be higher and more expensive than necessary for many patients.
Furthermore, the article highlights the importance of patient involvement in treatment decisions and the potential benefits of lower doses in improving quality of life. It underscores the role of clinical trials in supporting alternative dosing regimens and advocates for shared decision-making between doctors and patients. The article also discusses ongoing efforts in various countries, including the Netherlands, India, Brazil, and the United States, to explore optimal dosing strategies for cancer treatments.
In conclusion, the article calls for a shift in the traditional approach to cancer drug dosing, emphasizing the need for more research, collaboration between stakeholders, and patient-centered care to ensure the best possible outcomes for cancer patients while managing costs and minimizing side effects.
Source: https://www.nature.com/articles/s41591-024-02845-7
The focus is on the need for de-escalation trials to test the efficacy of lower doses and alternative regimens for existing cancer drugs. While efforts like the FDA's Project Optimus aim to reform dose-selection paradigms for new drugs, post-approval de-escalation trials are crucial for drugs already on the market. These trials face challenges, particularly in countries with private healthcare systems where prescribing lower doses may not align with financial incentives for doctors and clinics.
The article also addresses the resistance from physicians to adopt lower doses, citing regulatory concerns and ingrained prescribing habits. However, studies have shown that alternative dosing strategies, based on real-world evidence or initial pharmaceutical studies, can be effective in reducing costs and toxicity. For example, some cancer drugs were initially approved at weight-based doses but later switched to fixed doses, which were found to be higher and more expensive than necessary for many patients.
Furthermore, the article highlights the importance of patient involvement in treatment decisions and the potential benefits of lower doses in improving quality of life. It underscores the role of clinical trials in supporting alternative dosing regimens and advocates for shared decision-making between doctors and patients. The article also discusses ongoing efforts in various countries, including the Netherlands, India, Brazil, and the United States, to explore optimal dosing strategies for cancer treatments.
In conclusion, the article calls for a shift in the traditional approach to cancer drug dosing, emphasizing the need for more research, collaboration between stakeholders, and patient-centered care to ensure the best possible outcomes for cancer patients while managing costs and minimizing side effects.
Source: https://www.nature.com/articles/s41591-024-02845-7
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