Optimal Control of Immune Checkpoint Inhibitor Therapy in a Heart-Tumour Model

by Solveig A. van der Vegt, Ruth E. Baker, and Sarah L. Waters

In modelling the impact of cancer therapy, side effects are almost never explicitly considered, despite the severe risk they can pose to patients. Notably, immune checkpoint inhibitors (ICIs), a commonly used class of drugs, can cause autoimmune myocarditis. This paper presents a framework for optimising the timing of doses of ICIs, where both the effects on the tumour and on the heart are explicitly considered. It demonstrates that it is feasible, in regimes where standard-of-care schedules lead to autoimmune myocarditis, to identify dosing schedules that prevent cardiac side effects while inhibiting tumour growth. This framework represents a significant advancement towards the modelling of safe and effective cancer therapies.

A framework combining optimal control theory and a heart-tumour model which explicitly considers both the effects on the tumour and on the heart, can identify dosing schedules that prevent cardiac side effects while inhibiting tumour growth.