Finding the Right Dose: Optimizing Cancer Treatment


How can we optimize anti-cancer therapies to ensure we are receiving the full potential of the drug without significantly compromising quality of life?In the realm of cancer treatment, finding the right dose is paramount. It's a delicate balance between delivering enough medication to combat the disease effectively while minimizing adverse effects on the patient's overall health. Let's delve into the nuances of dosing in cancer therapy and explore how patients can be their best advocates when asking about dosage and how oncologists navigate this crucial aspect of treatment.

Understanding Dose Selection

In 2021, Stefanie Groenland and team published “The Right Dose: From Phase I to Clinical Practice” where they explored ways for optimizing the right dose. While drug labels will typically state what the maximum dose is, it may not be optimal for the specific patient, noting that the majority of patients may be receiving excessive doses of therapies which result in increased toxicity.More recently, in the 2024 article, The Right Dose: Results of a Patient Advocate–Led Survey of Individuals With Metastatic Breast Cancer Regarding Treatment-Related Side Effects and Views About Dosage Assessment to Optimize Quality of Life researchers suggest that

patient-physician discussions may facilitate the identification of the most favorable dose for each patient, and that the majority of patients would be receptive to this conversation.

The process of determining the right dose for cancer treatment involves several key considerations and conversations between the patient and the medical physicians. Factors to consider include the type and stage of cancer, the one’s overall health and tolerance to medications, the specific drugs being used, and any previous treatments or therapies the patient has undergone. Oncologists rely on a combination of clinical guidelines, research data, and personalized assessments to tailor the dose to each individual's needs.

Factors Influencing Dosing:

Body Weight and Surface Area: In many cases, medications are dosed based on a patient's body weight or surface area to ensure optimal efficacy and safety. This approach helps account for variations in drug metabolism and distribution among different individuals.

Kidney and Liver Function: The functioning of vital organs like the kidneys and liver plays a crucial role in drug clearance and metabolism. Oncologists may adjust doses accordingly for patients with impaired organ function to prevent toxicity or suboptimal treatment.