Abstract
Prompted by data from our own experiments on therapy of AIDS, we have taken a fresh look at the problem of analyzing potentiation, synergy, antagonism, enhancement of therapeutic index, and other types of drug interactions (1–3). Initial stages of that inquiry revealed the need for new concepts and new analytical methods that include:
-
1.
Flexible choice of interaction models (clearly, no single type of model can fit all types of interactions).
-
2.
Appropriately robust statistical methods to estimate p-values and confidence intervals (a sound statistical basis is critical in this field, if one is to be confident that there actually is an interaction).
-
3.
Flexibility with respect to experimental design (e.g., checkerboard, constant-ratio, etc.).
-
4.
Statistical techniques for reducing the size of experiments by reducing the number of replicates needed.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
P. Ashorn, B. Moss, J. N. Weinstein, V. K. Chaudhary, D. J. FitzGerald, I. Pastan & E. A. Berger (1990). Elimination of infectious human immunodeficiency virus from human T-cell cultures by synergistic action of CD4-Pseudomonas exotoxin and reverse transcriptase inhibitors.Proc. Natl. Acad. Sci. USA 87, 8889–8893.
B. Bunow & J. N. Weinstein (1990). COMBO: A new approach to the analysis of drug combinations in vitro.Annals N.Y. Acad. Sci. 616, 490–494.
J. N. Weinstein, B. Bunow, R. F. Schinazi, S. M. Wahl, L. M. Wahl, O. S. Weislow & J. Szebeni (1990). Synergistic drug combinations in AIDS therapy: Dipyridamole-zidovudine in particular and principles of analysis in general.Annals N.Y. Acad. Sci. 616, 367–384.
K. L. Hartshorn, M. W. Vogt, T.-C. Chou, R. S. Blumberg, R. Byington, R. T. Schooley & M. S. Hirsch (1987). Synergistic inhibition of human immunodeficiency virus in vitro by azidothymidine and recombinant alpha A interferon.Antimicrob. Agents Chemother. 31, 168–172.
M. C. Berenbaum (1977). Synergy, additivism and antagonism in immunosuppression.Clin. exp. Immunol. 28, 1–18.
W. R. Greco, H. S. Park & Y. M. Rustum (1990). Application of a new approach for the quantitation of drug synergism to the combination of cis-diamminedichloroplatinum and 1-β-D-arabinofuranosylcytosine.Cancer Research 50, 5318–5327.
R. F. Schinazi (1991). Combined chemotherapeutic modalities for viral infections: Rationale and clinical potential. In: T.-C. Chou and D. C. Rideout, Synergism and Antagonism in Chemotherapy, Academic Press, Orlando, FL, 109–181.
G. G. Steel & M. J. Peckham (1979). Exploitable mechanisms in combined radiotherapy-chemotherapy: The concept of additivity.J. Radiation Oncology Biol. Phys. 5, 85–91.
J. Suhnel (1990). Evaluation of synergism or antagonism for the combined action of antiviral agents.Antiviral Research 13, 23–40.
C.-M. Tsai, A. F. Gazdar, D. J. Venzon, S. M. Steinberg, R. L. Dedrick, J. L. Mulshine & B. S. Kramer (1989). Lack of in vitro synergy between etoposide and cis-diamminedichloroplatinum(II).Cancer Research 49, 2390–2397.
V. A. Johnson, M. A. Barlow, T.-C. Chou, R. A. Fisher, B. D. Walker, M. S. Hirsch & R. T. Schooley (1989). Synergistic inhibition of human immunodeficiency virus type 1 (HIV-1) replication in vitro by recombinant soluble CD4 and 3’-azido-3’-deoxythymidine. J. Infec. Dis. 159,837–844.
T.-C. Chou & P. Talalay (1984). Quantitation analysis of dose-effect relationships: the combined effects of multiple drugs or enzyme inhibitors.Adv. Enz. Regulation 22, 27–55.
K. C. Syracuse & W. R. Greco (1986). Proceedings of the Biopharmaceutical Section of the American Statistical Association.Proc. Biopharm. Sec. Amer. Stat. Assoc. 127–132.
M. N. Prichard & C. Shipman Jr. (1991). A three-dimensional model to analyze drug-drug interactions.Antivira/ Research in press.
B. D. Efron (1979). Bootstrap methods: Another look at the jackknife.Ann. Statistics 7, 1–26.
B. Efron & G. Gong (1983). A leisurely look at the bootstrap, the jackknife, and cross-validation.Amer. Statistician 37, 36–48.
M. C. Berenbaum (1978). A method for testing for synergy with any number of agents.J. Infect. Dis. 137, 122–130.
O. S. Weislow, R. Kiser, D. L. Fine, J. Bader, R. H. Shoemaker & M. R. Boyd (1989). New soluble formazan assay for HIV-1 cytopathic effects: Application to high-flux screening of synthetic and natural products for AIDS-antiviral activity.J. NatL Cancer Inst. 81, 577–586.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1992 Springer Science+Business Media New York
About this chapter
Cite this chapter
Weinstein, J.N., Bunow, B. (1992). COMBO: New Concepts and Methods for Designing and Analyzing Experiments on Combination Therapy. In: Goldstein, A.L., Garaci, E. (eds) Combination Therapies. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-3340-5_4
Download citation
DOI: https://doi.org/10.1007/978-1-4615-3340-5_4
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4613-6472-6
Online ISBN: 978-1-4615-3340-5
eBook Packages: Springer Book Archive