Objective
- Interpatient differences in the dose-response relationship for cytotoxic drug therapy in ovarian and breast cancer by applying a population PK-PD approach. Breast and ovarian cancer have been chosen as examples of common chemo sensitive yet often incurable tumours.
- Quantitative relationships between interpatient differences in the exposure to anticancer agents and toxicities of the therapy.
- Whether patients should benefit from individualized drug treatment.
- Subpopulations of patients for which anticancer therapy has a low likelihood of tumour response, using a panel of tumour related pharmacodynamic markers (p53, Her-2/neu ER/PR, EGFR, LRP).
- Subpopulations of patients which are particularly at risk; for the development of severe side effects.
Patients with locally advanced or metastatic solid tumours vary widely in their response and tolerance of systemic therapy with anticancer agents. The variability in the dose-response and dose-toxicity relationship is determined by both pharmacokinetic (PK) and pharmacodynamic (PD) (tumour and end-organ related factors respectively). Application of the 'population approach' for characterization of variability in dose-response and dose-toxicity relationships as well as new insights in mechanisms of anticancer drug resistance, form the basis for the current large scale clinical-pharmacologic studies in patients with solid tumours. The studies will be carried out within the framework of the PAMM and ECSG and IDBBC-group of the EORTC. The population approach offers the possibility of gaining integrated information on PK, PD and response from sparse observational data and allows analysis of a variety of unbalanced study designs. Recent in vitro and in vivo studies have revealed that estrogen/progesteron (ER/PR) receptor status and overexpression of lung resistance protein (LRP), epidermal growth factor receptor (EGFR) or (mutant) oncogenes, such as p53 and Her-2/neu may cause resistance to anticancer agents in breast or ovarian cancer. We propose to apply the population approach in phase III/IV studies in ovarian and breast cancer using NONMEM (nonlinear mixed effect models, USF, CA USA). We will implement procedures for crossvalidation of analytical and biologic methods to prevent methodological bias. We define the following covariates for population PK analysis body weight, WHO performance score, age, albumin, renal, liver and bone marrow function, comedication; and add tumour stage, differentiation, TNM classification and p53, Her-2/neu ER/PR, LRP and EGFR tumour status for population PK-PD analysis
Fields of science
Topic(s)
Call for proposal
Data not availableFunding Scheme
CSC - Cost-sharing contractsCoordinator
1066 CX AMSTERDAM
Netherlands
See on map
Participants (20)
3075 EA Rotterdam
See on map
9713 EZ Groningen
See on map
06189 Nice
See on map
31052 Toulouse
See on map
69373 Lyon
See on map
92210 saint cloud
See on map
1081 JC Amsterdam
See on map
OX3 9DS OXFORD/HEADINGTON
See on map
33076 BORDEAUX
See on map
33081 Aviano
See on map
3000 Leuven
See on map
1066 EC AMSTERDAM
See on map
40136 BOLOGNA
See on map
AB9 2ZD Aberdeen
See on map
G12 8QQ Glasgow
See on map
45110 Ioannina
See on map
NE2 4HH Newcastle upon Tyne
See on map
1000 BRUXELLES
See on map
751 23 Uppsala
See on map
1081 HV AMSTERDAM
See on map