Combination Therapy

Combination therapy refers to the use of two or more therapeutic agents or modalities simultaneously or sequentially to treat a disease, aiming to enhance efficacy, reduce resistance, and improve patient outcomes.

• Synergistic effect: Achieve greater therapeutic impact than with monotherapy
• Target multiple pathways: Interrupt tumor growth, survival, or resistance mechanisms
• Delay resistance: Reduce the likelihood of tumor adaptation to single agents
• Lower doses: Reduce toxicity by using lower doses of each component

• Drug + Drug:
  • EGFR inhibitor + Chemotherapy (e.g., Gefitinib + Cisplatin)
  • Immunotherapy + Antiangiogenic agent (e.g., Nivolumab + Bevacizumab)
• Drug + Radiotherapy:
  • Radiation + EGFR inhibitor (e.g., Cetuximab + Radiotherapy in HNSCC)
• Targeted + Immunotherapy:
  • EGFR-TKI + PD-1/PD-L1 inhibitor (under investigation)
• Multimodal (surgery, chemo, radio):
  • Glioblastoma: Surgical resection + Radiotherapy + Temozolomide

• Oncology:
  • Lung cancer, breast cancer, glioblastoma, colorectal cancer
• Infectious diseases:
  • HIV, tuberculosis, malaria
• Chronic diseases:
  • Hypertension, diabetes

• Pharmacokinetic and pharmacodynamic interactions
• Increased risk of toxicity
• Sequential vs. simultaneous administration
• Cost-effectiveness and patient compliance

• First-line: EGFR-TKI (e.g., Erlotinib)
• Resistance phase: Add anti-MET agent or immune checkpoint inhibitor
• Investigational: EGFR-TKI + anti-VEGF or ALK inhibitor in co-mutated tumors

• Monotherapy
• Drug Synergy
• EGFR Inhibitors
• Immunotherapy
• Adverse Effects and Toxicity