Most recent by Joseph R. Bertino, MD
Breakthroughs in T-cell physiology, new oral anticoagulants among highlights of 2012
Approval of treatments for Hodgkin’s lymphoma, myelofibrosis, prostate cancer among highlights of 2011
Targeted therapies usher in new era in cancer treatment
Maximum tolerated exposure: A more rational approach to drug dosing
The standard of care in dosing chemotherapeutic agents is based on body surface area — or BSA. The BSA-based dose for any given drug is recommended by the manufacturer according to the maximum tolerated dose established during phase 1 studies. MTD, in turn, is generally determined using the Fibonacci dose escalation “3 + 3 schema” in which three patients are enrolled at each proposed dose level and if one patient experiences a drug limiting toxicity, three additional patients are then enrolled at that same dose level. If two or more additional patients at a particular dose level present a drug limiting toxicity, enrollment of patients to that dose level is discontinued and the immediate preceding dose level is considered the MTD.