| Literature DB >> 34018069 |
Carmen Pin1, Teresa Collins1, Megan Gibbs2, Holly Kimko3.
Abstract
Quantitative Systems Toxicology (QST) models, recapitulating pharmacokinetics and mechanism of action together with the organic response at multiple levels of biological organization, can provide predictions on the magnitude of injury and recovery dynamics to support study design and decision-making during drug development. Here, we highlight the application of QST models to predict toxicities of cancer treatments, such as cytopenia(s) and gastrointestinal adverse effects, where narrow therapeutic indexes need to be actively managed. The importance of bifurcation analysis is demonstrated in QST models of hematologic toxicity to understand how different regions of the parameter space generate different behaviors following cancer treatment, which results in asymptotically stable predictions, yet highly irregular for specific schedules, or oscillating predictions of blood cell levels. In addition, an agent-based model of the intestinal crypt was used to simulate how the spatial location of the injury within the crypt affects the villus disruption severity. We discuss the value of QST modeling approaches to support drug development and how they align with technological advances impacting trial design including patient selection, dose/regimen selection, and ultimately patient safety.Entities:
Keywords: agent-based modeling; bifurcation analysis; quantitative systems pharmacology; quantitative systems toxicology; systems modeling
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Year: 2021 PMID: 34018069 PMCID: PMC8137611 DOI: 10.1208/s12248-021-00580-2
Source DB: PubMed Journal: AAPS J ISSN: 1550-7416 Impact factor: 4.009
Fig. 1Impact of the parameter γ, i.e., strength of the feedback between mature cells and proliferative progenitors, on the qualitative behavior of the classical Friberg model (22) of neutrophil dynamics following drug insult. We used several values of γ and previously published values for the other model parameters (22). The chosen values of γ ensured stable non-cyclic neutrophil blood counts in homeostasis and return to baseline value after drug treatment discontinuity (γ < 0.5685). a Simulation results of neutrophil and progenitor recovery after a single treatment killing 95% of proliferative progenitors indicated that high values of γ resulted in long periods of non-physiological large oscillations of neutrophils and progenitors before returning to constant homeostatic levels. b Multiple treatments killing 95% of proliferative progenitors every 21 days resulted in large feedback-driven oscillations of neutrophils and progenitors with highly irregular profiles and no return to homeostatic values in between treatments for the largest value of γ. Dashed lines represent limit values defining the common terminology criteria for adverse effects (grade 1, 2, or 3 neutropenia)
Fig. 2Impact of the crypt spatial configuration on simulated dynamics of epithelial injury and recovery. a Cartoon representing snapshots of an agent based model of a mouse small intestinal crypt recovering after induction of cell cycle arrest in 85% proliferative cells located at low and high positions (from the base) of the transit amplifying (TA) compartment. Recovery is achieved by proliferation of non-injured cells. Boxes mark affected crypt areas. b The spatiotemporal simulation of the percentage of proliferative cells in the crypt shows that cells located between approximate positions 5 and 20 in the crypt axis are mostly proliferative progenitors forming the TA compartment in healthy intestine. Simulation of the injuries described in a showed that the recovery of the TA compartment required more than 2 days following the arrest of 85% cells at lower positions but shorter time if the same injury was located at the higher position of the TA compartment. c The simulated number of cells over time after the injuries described in a indicated that the total number of cells in the crypt is not affected in these scenarios because arrested cells are replaced by newly generated cells within the crypt before the onset of cell senescence. However, the number of cells in the simulated villus is compromised for a relatively long period following the injury at lower position but not affected when the same injury was located at higher position in the crypt