A mathematical justification for metronomic chemotherapy in oncology

TL;DR

This paper provides a mathematical foundation for metronomic chemotherapy, demonstrating it as an optimal strategy for drug administration in cancer treatment based on pharmacokinetic and pharmacodynamic models.

Contribution

It introduces a novel mathematical justification for metronomic chemotherapy using mixed-integer nonlinear optimization models.

Findings

Metronomic chemotherapy is mathematically shown to be optimal under certain models.

Optimization models determine the best number and timing of doses.

The approach supports clinical strategies for both curative and palliative treatments.

Abstract

We mathematically justify metronomic chemotherapy as the best strategy to apply most cytotoxic drugs in oncology for both curative and palliative approaches, assuming the classical pharmacokinetic model together with the Emax pharmacodynamic and the Norton-Simon hypothesis. From the mathematical point of view, we will consider two mixed-integer nonlinear optimization problems, where the unknowns are the number of the doses and the quantity of each one, adjusting the administration times a posteriori