Effective chemotherapy of heterogeneous and drug-resistant early colon cancers by intermittent dose schedules: a computer simulation study

David E. Axelrod, Sudeepti Vedula, James Obaniyi

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Purpose: The effectiveness of cancer chemotherapy is limited by intra-tumor heterogeneity, the emergence of spontaneous and induced drug-resistant mutant subclones, and the maximum dose to which normal tissues can be exposed without adverse side effects. The goal of this project was to determine if intermittent schedules of the maximum dose that allows colon crypt maintenance could overcome these limitations, specifically by eliminating mixtures of drug-resistant mutants from heterogeneous early colon adenomas while maintaining colon crypt function. Methods: A computer model of cell dynamics in human colon crypts was calibrated with measurements of human biopsy specimens. The model allowed simulation of continuous and intermittent dose schedules of a cytotoxic chemotherapeutic drug, as well as the drug’s effect on the elimination of mutant cells and the maintenance of crypt function. Results: Colon crypts can tolerate a tenfold greater intermittent dose than constant dose. This allows elimination of a mixture of relatively drug-sensitive and drug-resistant mutant subclones from heterogeneous colon crypts. Mutants can be eliminated whether they arise spontaneously or are induced by the cytotoxic drug. Conclusions: An intermittent dose, at the maximum that allows colon crypt maintenance, can be effective in eliminating a heterogeneous mixture of mutant subclones before they fill the crypt and form an adenoma.

Original languageEnglish (US)
Pages (from-to)889-898
Number of pages10
JournalCancer chemotherapy and pharmacology
Volume79
Issue number5
DOIs
StatePublished - May 1 2017

All Science Journal Classification (ASJC) codes

  • Oncology
  • Toxicology
  • Pharmacology
  • Cancer Research
  • Pharmacology (medical)

Keywords

  • Adenoma
  • Colon cancer
  • Crypt
  • Dose schedules
  • Drug resistance
  • Heterogeneity
  • Intermittent

Fingerprint Dive into the research topics of 'Effective chemotherapy of heterogeneous and drug-resistant early colon cancers by intermittent dose schedules: a computer simulation study'. Together they form a unique fingerprint.

  • Cite this