{"entity":{"id":"dose-modification","kind":"term","name":"Dose reduction, interruption and discontinuation","aka":["dose reduction","dose reductions","dose-reduction","dose reduced","dose interruption","dose interruptions","dose delay","dose delays","treatment delay","dose hold","hold treatment","dose modification","dose modifications","dose adjustment","dose adjustments","discontinuation","discontinuations","discontinued","treatment discontinuation","discontinuation rate","discontinuation due to adverse events","permanent discontinuation","stopped treatment","treatment cessation","relative dose intensity","RDI","adherence","non-adherence","compliance","real-world dosing","starting dose","dose holds","treatment delays"],"tldr":"The everyday tools for living with side effects: pausing a drug until a problem settles (interruption), restarting at a lower dose (reduction), or stopping it for good (discontinuation). Between 30 and 60% of patients on oral targeted drugs need a reduction, so these rates are the clearest test of whether a dose was set right.","summary":"Labels specify dose modification rules by toxicity grade; in practice 30-60% of patients on oral targeted drugs need a reduction, and discontinuation for adverse events (typically 5-20% in trials, higher in real-world older populations) directly reduces benefit. Relative dose intensity below 85% is associated with worse outcomes for curative chemotherapy, whereas for targeted drugs lower doses often work as well (Project Optimus's rationale). Adherence to daily pills over years (endocrine therapy, imatinib) is a hidden determinant of efficacy. Trials report dose reductions and discontinuations alongside grade 3-4 events as the clearest summary of tolerability.","asOf":"2026-09-09","wikipedia":"https://en.wikipedia.org/wiki/Dose_(biochemistry)","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Dose_(biochemistry)"}],"tags":[],"related":["ctcae-grading","mtd","therapeutic-index","pharmacokinetics","qol-pro"],"cancers":[],"sections":["supportive-care"],"technologies":["project-optimus"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Side effects"},"route":"/terms/dose-modification/","neighbours":{"term":[{"id":"ctcae-grading","kind":"term","name":"CTCAE toxicity grading (grade 3-4 adverse events)","route":"/terms/ctcae-grading/"},{"id":"febrile-neutropenia","kind":"term","name":"Febrile neutropenia","route":"/terms/febrile-neutropenia/"},{"id":"hand-foot-syndrome","kind":"term","name":"Hand-foot syndrome and hand-foot skin reaction","route":"/terms/hand-foot-syndrome/"},{"id":"hepatotoxicity","kind":"term","name":"Hepatotoxicity (liver enzyme elevation)","route":"/terms/hepatotoxicity/"},{"id":"hyperglycaemia","kind":"term","name":"Hyperglycaemia (PI3K/AKT inhibitor class effect)","route":"/terms/hyperglycaemia/"},{"id":"immune-colitis","kind":"term","name":"Immune-mediated colitis and diarrhoea","route":"/terms/immune-colitis/"},{"id":"mtd","kind":"term","name":"Maximum tolerated dose (MTD)","route":"/terms/mtd/"},{"id":"neutropenia","kind":"term","name":"Neutropenia","route":"/terms/neutropenia/"},{"id":"ocular-toxicity","kind":"term","name":"Ocular toxicity (keratopathy, blurred vision)","route":"/terms/ocular-toxicity/"},{"id":"performance-status","kind":"term","name":"Performance status (ECOG, Karnofsky)","route":"/terms/performance-status/"},{"id":"peripheral-neuropathy","kind":"term","name":"Peripheral neuropathy (chemotherapy-induced)","route":"/terms/peripheral-neuropathy/"},{"id":"pharmacokinetics","kind":"term","name":"Pharmacokinetics (PK), half-life and exposure","route":"/terms/pharmacokinetics/"},{"id":"project-optimus","kind":"term","name":"Project Optimus","route":"/terms/project-optimus/"},{"id":"qol-pro","kind":"term","name":"Quality of life and patient-reported outcomes (QoL, PRO)","route":"/terms/qol-pro/"},{"id":"rash-skin-toxicity","kind":"term","name":"Rash and skin toxicity (acneiform rash, paronychia)","route":"/terms/rash-skin-toxicity/"},{"id":"chemotherapy-regimen","kind":"term","name":"Regimen and cycles","route":"/terms/chemotherapy-regimen/"},{"id":"therapeutic-index","kind":"term","name":"Therapeutic index (therapeutic window)","route":"/terms/therapeutic-index/"}],"section":[{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"ct-body-composition-sarcopenia","kind":"technology","name":"CT body composition and sarcopenia measurement","route":"/technologies/ct-body-composition-sarcopenia/"},{"id":"dpyd-genotyping","kind":"technology","name":"DPYD genotyping and DPD phenotyping before fluoropyrimidines","route":"/technologies/dpyd-genotyping/"},{"id":"g8-geriatric-screening","kind":"technology","name":"G8 geriatric screening tool","route":"/technologies/g8-geriatric-screening/"},{"id":"tpmt-nudt15-genotyping","kind":"technology","name":"TPMT and NUDT15 genotyping before thiopurines","route":"/technologies/tpmt-nudt15-genotyping/"},{"id":"ugt1a1-genotyping","kind":"technology","name":"UGT1A1 genotyping before irinotecan","route":"/technologies/ugt1a1-genotyping/"}]}}