Immune checkpoint inhibitors (ICIs) are approved for the treatment of a variety of cancer types. The doses of these drugs, though approved by the Food and Drug Administration (FDA), have never been optimised, likely leading to significantly higher doses than required for optimal efficacy. Dose optimisation would hypothetically decrease the risk, severity, and duration of immune-related adverse events, as well as provide an opportunity to reduce costs through interventional pharmacoeconomic strategies such as off-label dose reductions or less frequent dosing. We summarise existing evidence for ICI dose optimisation to advocate for the role of interventional pharmacoeconomics.
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AW is funded by training grant T32CA009566 from the National Cancer Institute. KP is funded by the Clinical Therapeutics Training Grant (T32GM007019).
AW, KP, CJP and WDF declare no competing interests. DAG declares the following interests: institutional research funding (Merck, Bristol-Myers Squibb, and Jennsen); consulting fees (VIVIO Health); and stock ownership (VIVIO Health and TailorMed). MJR is co-founder, director and treasurer of the Optimal Cancer Care Alliance, is an inventor on pending patent applications for low-dose tocilizumab, and has testified as an expert witness on behalf of multiple generic companies regarding the optimal dosing of anticancer agents.
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Wesevich, A., Goldstein, D.A., Paydary, K. et al. Interventional pharmacoeconomics for immune checkpoint inhibitors through alternative dosing strategies. Br J Cancer 129, 1389–1396 (2023). https://doi.org/10.1038/s41416-023-02367-y
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