The research team successfully utilised a platform called CURATE.AI to continuously identify the optimal doses of each drug to result in a durable response, allowing the patient to resume a completely normal and active lifestyle.
The patient with metastatic castration-resistant prostate cancer (MCRPC) was given a novel drug combination consisting of investigational drug ZEN-3694 and enzalutamide, an approved prostate cancer drug.
“Dynamic dosing in cancer therapy is not commonly used. In fact, drug dosing changes in oncology are typically performed only to reduce toxicity,” said Dean Ho, from National University of Singapore (NUS).
“CURATE.AI uniquely modifies drug dosing to increase efficacy. Our clinical study has shown that dosing can profoundly affect the efficacy and safety of treatment,” said Ho, who led the study published in the journal Advanced Therapeutics.
Combination therapy represents a cornerstone in modern cancer treatment. Using this approach, multiple drugs are used to attack the processes that support cancer growth.
A primary objective when designing combination therapies is to achieve drug synergy, where the drugs work together to substantially improve efficacy.
While combination therapy has generally improved treatment outcomes such as overall survival for many cancers, it is predominantly given at both fixed as well as high doses.
The CURATE.AI platform uses the patient’s own clinical data — such as their drug doses and corresponding changes to tumour sizes or levels of cancer biomarkers in the blood — to calibrate their unique response to treatment.
This calibration is then used to create an individualised CURATE.AI profile, or map, that identifies the drug doses which enable the best possible treatment outcome at any given point in time.
“No two patients’ profiles are alike, and as a patient’s body and the cancer itself evolve during treatment, the CURATE.AI profile evolves as well, enabling the clinical and engineering teams to optimise care for the entire duration of treatment, an unprecedented advance for combination therapy,” Ho said.
The patient with metastatic prostate cancer was given ZEN-3694 and enzalutamide.
Reducing the level of prostate specific antigen (PSA) in the patient’s blood served as the primary biomarker to determine if the patient was responding to treatment.
Computed tomography (CT) imaging of the cancer lesions monitored the extent of disease progression.
“Using CURATE.AI to dynamically modify drug doses and successfully treat a metastatic cancer patient represents a landmark breakthrough for the use of AI to truly personalise patient care,” said Ho.
“This advance is expected to dramatically improve response rates for all combination therapies that are being developed for oncology as well as virtually all other diseases. We can also expect CURATE.AI to markedly reduce the costs of drug development,” he said.