Chemotherapy dosing is currently calculated based on a patient’s body surface area, but this method does not take into account the various factors that can affect drug metabolism. This can result in patients receiving either too much or too little of a drug, leading to avoidable toxicity or insufficient benefit. To address this issue, MIT engineers have developed an alternative approach to personalize chemotherapy dosing. By measuring the amount of drug in a patient’s system and adjusting the infusion rate accordingly, the dose can be tailored to the individual.
The new system developed by MIT engineers, known as CLAUDIA, utilizes continuous monitoring and an automated controller to adjust the infusion rate of chemotherapy drugs in real time. This personalized approach takes into consideration factors such as body composition, genetic makeup, circadian fluctuations in drug-metabolizing enzymes, and interactions with other medications or foods consumed. By maintaining drug levels within a target range, this closed-loop system aims to improve the safety and efficacy of chemotherapy treatments for cancer patients.
One of the key challenges in current chemotherapy dosing is the lack of personalized adjustments to account for individual variations in drug metabolism. Circadian fluctuations in enzymes responsible for breaking down chemotherapy drugs can lead to significant changes in drug levels over the course of an infusion. Therapeutic drug monitoring is one approach to counteract this variability, but it is not widely used and relies on manual adjustments between treatment cycles. The CLAUDIA system automates this monitoring process, enabling personalized drug dosing in real time.
In animal tests, the researchers found that using CLAUDIA resulted in keeping drug concentrations within the target range 45% of the time, compared to just 13% without continuous monitoring. This continuous adjustment helped maintain drug levels even when an enzyme inhibitor was introduced, preventing dangerous increases in drug concentrations. The researchers plan to automate the system further to eliminate the need for human intervention and to adapt the technique for detecting other drug types using high-performance liquid chromatography mass spectroscopy.
The potential of the CLAUDIA system extends beyond just one type of chemotherapy drug, as the technique could be applied to any drug with the right pharmacokinetic properties and detectable using HPLC-MS. By providing personalized dosing for a variety of drugs, this approach has the potential to revolutionize the way chemotherapy treatments are administered, enhancing both safety and efficacy. This research represents a valuable step toward transforming drug dosing practices and improving outcomes for cancer patients undergoing chemotherapy.
