Dose-response Relationship11 Jul 2022 21:58
Dox is a double-edged sword. It’s tumour response rate is over 70%. But the adverse effects are almost guaranteed at doses required to achieve this efficacy.
Efficacious dose is generally above 60mg/m2. Anything less and you’re not getting any bang for your buck*. But at this level, the limiting factor is the cardiotox threshold. As RAH states, this is LIFETIME limited.
The biggest challenge for oncologists is designing the dose schedule. Variables such as age, weight, height, wellbeing, race, are all factored. As above, They are constrained by that cum. dose limit.
Therefore, if we can increase this lifetime limit, we can exponentially increase ORR and offer greater, less complicated dosing designs. Some that may offer longer periods of lower doses, rather than huge dumps of dox.
In summary; AVA doesn’t have to be a miracle. It just has to allow oncologists greater scope in designing an appropriate dosing regime for the patient. At the current rate, with DE’s it could be assumed we’re headed toward this conclusion.
*https://pubmed.ncbi.nlm.nih.gov/858124/