Rational approach to the clinical protocol design for drug combinations: A review Journal Article


Authors: Chang, Tai-Tsung; Chou, Ting-Chao
Article Title: Rational approach to the clinical protocol design for drug combinations: A review
Abstract: Based on the median-effect equation of Chou and the combination index (CI) equation of Chou-Talalay, a computer software for automated dose-effect analysis has been developed. This method provides quantitation of synergism (CI<1) and antagonism (CI>1) at different dose and effect levels. Therefore, it allows the selection of the best pair (or triplet) of combination, optimal combination ratio, and the best schedule of treatment. These analyses has been shown to be useful for the clinical protocol design. (Chang et al. Cancer Res. 45: 2434-2439, 1985). The user-friendly computer program also gives dose-reduction index (DRI) which determines how many fold of dose-reduction is allowed for each drug in synergistic combinations. Dose reduction leads to reduced toxicity while maintaining the desired efficacy (Chou et al. Encyclopedia of Human Biology 2:675-683, 1997; Encyclopedia of Cancer 1:368-379, 1997). The Chou-Talalay method distincts from all other methods by the fact that it not only takes into account the "potency" but also the "shape" of dose-effect curves of each drug and their combinations (Chou and Hayball, CalcuSyn for Windows, Biosoft, Cambridge UK, 1996). This method has been applied in combination of anticancer agents, anti-HIV agents, purging leukemic cells for autologous bone marrow transplantation (Chang et al. Cancer Res. 47:119-122, 1987) and combination of immunosuppressants for organs transplants. Specific examples of the theoretical equations, the median-effect plot, the CI plot, the isobologram, and the polygonogram are illustrated.
Keywords: drug combinations; clinical protocol design
Journal Title: Acta Paediatrica Taiwanica
Volume: 41
Issue: 6
ISSN: 1608-8115
Publisher: Taiwan Xiao'erke Yixuehui  
Date Published: 2000-01-01
Start Page: 294
End Page: 302
Language: English
ACCESSION: BCI:BCI200100315258
PROVIDER: biosis
PUBMED: 11198934
Notes: Article -- Presented in part at the 10th Asia Congress of Pediatrics in Taipei, Taiwan, March 26-30, 2000 -- Source: Biosis
Citation Impact
MSK Authors
  1. Ting-Chao Chou
    319 Chou