Improving patient outcomes through personalised chemotherapy dosing

Background

Chemotherapy drugs are widely used to treat cancer. However, it is estimated that some patients receiving chemotherapy will receive a dose that is too high for them, and some will receive a dose that is lower than what is needed for optimal effectiveness.

This happens because the dose of chemotherapy clinicians give is either a fixed amount for every patient or an amount based on the patient’s body size. Although this approach is based on best available evidence, it doesn’t account for other individual variables such as how easily the body absorbs oral drugs, how quickly the body metabolises drugs, how sensitive tissue is to the drug’s effects and whether or not a patient has other conditions affecting their health.

Patients who receive a higher dose than is optimal for them may experience more or more severe side-effects, may have reduced quality-of-life, and often are unwilling to continue with treatment. For patients who receive a lower than optimal chemotherapy dosing, the consequences may be inadequate tumour control, with worse quality of life, earlier relapse and lower survival.

The research

With this project, Professor Martin and her team will test and validate how new available technologies could be utilised to monitor the concentration of chemotherapy in a patient’s blood in real-time. By monitoring chemotherapy levels early in treatment, clinicians will be able to adjust doses to achieve the ideal concentration. This will mean fewer side-effects and greater tumour control for each patient.

For many chemotherapy drugs, the optimal concentration in the blood is already known. However, for some drugs, particularly the newer ones, the ideal concentration hasn’t been identified. The researchers will establish projects to address this gap for a number of common and new chemotherapy drugs. They will also explore the factors that lead to variability in drug levels such as diet and other drugs used (e.g. reflux drugs).