Figure 4 Example of PK/PD simulation to optimize a vinorelbine treatment regimen Figure 4 | Example of PK/PD simulation to optimize a vinorelbine treatment.

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Figure 4 Example of PK/PD simulation to optimize a vinorelbine treatment regimen Figure 4 | Example of PK/PD simulation to optimize a vinorelbine treatment regimen. The empirical metronomic regimen, incorporating a 50 mg fixed dose of vinorelbine on days 1, 3 and 5 (D1-D3-D5 50 mg) of a 7-day cycle (left panels), can provide substantial clinical benefit to many patients; however, mathematical modelling has helped to identify an alternative dynamic dosing schedule (right panels) of 30 mg, 60 mg and 30 mg on days 1, 2 and 4 (D1-D2-D4 30-60-30), respectively, which was predicted to achieved a higher antiproliferative efficacy (lower panels), while displaying the same safety profile based on absolute neutrophil count (middle panels)112. Shading represents confidence intervals. Permission obtained from Springer International Publishing © Barbolosi, D. et al. Cancer Chemother. Pharmacol. 74, 647–652 (2014). Permission obtained from Springer International Publishing © Barbolosi, D. et al. Cancer Chemother. Pharmacol. 74, 647–652 (2014) Barbolosi, D. et al. (2015) Computational oncology — mathematical modelling of drug regimens for precision medicine Nat. Rev. Clin. Oncol. doi:10.1038/nrclinonc.2015.204