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27.06.2017 | Original Article | Ausgabe 2/2017 Open Access

Cancer Chemotherapy and Pharmacology 2/2017

Model-based prediction of myelosuppression and recovery based on frequent neutrophil monitoring

Zeitschrift:
Cancer Chemotherapy and Pharmacology > Ausgabe 2/2017
Autoren:
Ida Netterberg, Elisabet I. Nielsen, Lena E. Friberg, Mats O. Karlsson
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00280-017-3366-x) contains supplementary material, which is available to authorized users.

Abstract

Purpose

To investigate whether a more frequent monitoring of the absolute neutrophil counts (ANC) during myelosuppressive chemotherapy, together with model-based predictions, can improve therapy management, compared to the limited clinical monitoring typically applied today.

Methods

Daily ANC in chemotherapy-treated cancer patients were simulated from a previously published population model describing docetaxel-induced myelosuppression. The simulated values were used to generate predictions of the individual ANC time-courses, given the myelosuppression model. The accuracy of the predicted ANC was evaluated under a range of conditions with reduced amount of ANC measurements.

Results

The predictions were most accurate when more data were available for generating the predictions and when making short forecasts. The inaccuracy of ANC predictions was highest around nadir, although a high sensitivity (≥90%) was demonstrated to forecast Grade 4 neutropenia before it occurred. The time for a patient to recover to baseline could be well forecasted 6 days (±1 day) before the typical value occurred on day 17.

Conclusions

Daily monitoring of the ANC, together with model-based predictions, could improve anticancer drug treatment by identifying patients at risk for severe neutropenia and predicting when the next cycle could be initiated.

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