The term describes adverse effects of a treatment, typically in cancer therapy, that prevent the administration of higher doses. These toxicities are severe enough to necessitate a reduction in the amount of drug administered or, in some cases, the complete cessation of treatment. An example is severe neutropenia resulting from chemotherapy, where the lowered white blood cell count increases the risk of life-threatening infections, thus limiting further dose escalation.
The identification and understanding of these significant toxicities are paramount in drug development and clinical trial design. Characterizing these effects allows researchers and clinicians to establish safe and effective dosage regimens. Furthermore, this understanding informs the development of supportive care strategies aimed at mitigating or preventing such occurrences, leading to improved patient outcomes and treatment adherence. Historically, dose escalation trials have focused intently on defining this specific boundary of tolerability to maximize therapeutic benefit while minimizing harm.