Individual prediction of thrombocytopenia at next chemotherapy cycle --
a model comparison
Abstract
Aims: Thrombocytopoenia is a common major side-effect of cytotoxic
cancer therapies. A clinically relevant problem is to predict an
individual’s thrombotoxicity in the next planned chemotherapy cycle in
order to decide on treatment adaptation. To support this task, two
dynamical mathematical models of thrombopoiesis under chemotherapy were
proposed, a simple semi-mechanistic model and a comprehensive
mechanistic model. In this study, we compare the performance of these
models. Methods: We consider close-meshed individual time series data of
135 non-Hodgkin’s lymphoma patients treated with six cycles of
CHOP/CHOEP chemotherapies. Individual parameter estimates were derived
on the basis of these data considering a varying number of cycles per
patient. Parsimony assumptions were applied to optimize parameter
identifiability. Models are compared by determining deviations of
predicted and observed degrees of thrombocytopoenia in the next cycles.
Results: The mechanistic model results in superior fits of individual
time series data. Moreover, prediction accuracy of future cycle
toxicities by the mechanistic model is higher even if it used data of
two cycles, while the semi-mechanistic model used data of five cycles
for the corresponding calibrations. Conclusions: We successfully
established a quantitative and clinically relevant method for comparing
prediction performance of biomathematical models of thrombopoiesis under
chemotherapy. We showed that the more comprehensive mechanistic model
outperforms the semi-mechanistic model. We aim at implementing the
mechanistic model into clinical practice to assess its utility in real
life clinical decision making