Dr. Baselga Discusses Fine Tuning Drug Doses

José Baselga, MD, PhD, Physician-in-Chief, Memorial Sloan-Kettering Cancer Center (MSKCC), discusses the need to fine tune mTOR and PI3K inhibitor doses.

Fine tuning is an art, Baselga says, and takes place with all drugs, including chemotherapy. Dose and scale matter as a patient can see significant benefit increase with a finely tuned regimen. As an example, Baselga mentions paclitaxels, which can be given every three weeks or every week and demonstrate a big difference in terms of activity and side effects. Capecitabine can also be given on different scales: The one week on, one week off regimen developed at MSKCC, allows patients to stay on capecitabine for a far longer period of time.

In the case of mTOR inhibitors, evidence exists to support the notion that tailored therapy and decreased dosing can show similar benefit. Baselga says that physicians need to be open to tailoring therapies as much as possible.