Test alternating drug schedules against giving both drugs at once
Two drugs might work better given in turns rather than together, with less toxicity. Almost no trial has tested this.
Evolutionary models and mouse studies suggest that alternating two non-cross-resistant agents can delay resistance as well as concurrent dosing at lower cumulative toxicity, and that some pairs are antagonistic when concurrent (for example cytostatic agents that protect cells from cytotoxics). Randomised trials of schedule rather than of drug are rare.
- Too many combinations to test · There are thousands of possible drug pairs and sequences. Trials can test a few dozen a year.
- Acquired resistance to every therapy · Nearly every targeted therapy stops working within months to a few years as the tumour adapts.
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not linked directly; found by shared links- PersonPasi A. Jänne
Shares FLAURA2, Osimertinib, Non-small-cell lung cancer.
- IdeaSlow the tumour's mutation engine with APOBEC inhibitors during targeted therapy
Shares Osimertinib, Acquired resistance to every therapy, Non-small-cell lung cancer.
- TrialLAURA
Shares Osimertinib, Non-small-cell lung cancer.
- IdeaAdd the second drug on day one when the escape route is predictable
Shares Osimertinib, Too many combinations to test, Acquired resistance to every therapy, Non-small-cell lung cancer.
- IdeaPause a failed drug so the tumour becomes sensitive to it again
Shares Osimertinib, Acquired resistance to every therapy, Non-small-cell lung cancer.
- IdeactDNA-guided dose holidays for lung cancer targeted therapy
Shares Osimertinib, Acquired resistance to every therapy, Non-small-cell lung cancer.
- IdeaRotate between drugs on a fixed schedule instead of waiting for failure
Shares Too many combinations to test, Acquired resistance to every therapy.
- IdeaAdd a drug when the blood test turns, without stopping the one that works
Shares Osimertinib, Acquired resistance to every therapy, Non-small-cell lung cancer.