论文标题
确定多发性骨髓瘤患者的最佳组合方案
Determining Optimal Combination Regimens for Patients with Multiple Myeloma
论文作者
论文摘要
尽管近年来已经批准了许多新型疗法用于治疗多发性骨髓瘤患者，但仍然没有建立的治疗方案，尤其是对于患有高风险疾病的患者。在这项工作中，我们使用一种数学建模方法来确定组合治疗方案，以最大程度地适用于多发性骨髓瘤患者的健康寿命。我们从用于潜在疾病和免疫动力学的普通微分方程模型开始，该方程先前已介绍和分析。我们将三种疗法的效果添加到该模型中：Pomalidomide，地塞米松和Elotuzumab。我们考虑了优化这些疗法组合的多种方法。我们发现，与近似结合的最佳控制能力优于其他方法，因为它们可以迅速产生临床上可行且几乎最佳的组合方案。这项工作的含义可用于优化剂量并提高药物的调度。
While many novel therapies have been approved in recent years for treating patients with multiple myeloma, there is still no established curative regimen, especially for patients with high risk disease. In this work, we use a mathematical modeling approach to determine combination therapy regimens that maximize healthy lifespan for patients with multiple myeloma. We start with a model of ordinary differential equations for the underlying disease and immune dynamics, which was presented and analyzed previously. We add the effects of three therapies to the model: pomalidomide, dexamethasone, and elotuzumab. We consider multiple approaches to optimizing combinations of these therapies. We find that optimal control combined with approximation outperforms other methods, in that they can quickly produce a combination regimen that is clinically-feasible and near-optimal. Implications of this work can be used to optimize doses and advance the scheduling of drugs.
