DiffDose: Differentiable Programming for Personalized Dose-Regimen Optimal Control

Dose-regimen design requires choosing how much drug to give, when to give it, and how treatment should vary across patients. Mechanistic pharmacokinetic-pharmacodynamic (PK/PD) and quantitative systems pharmacology (QSP) models can predict treatment responses, but optimizing dosing inputs depends on model-specific sensitivity derivations or derivative-free search. Here, we introduce DiffDose, a differentiable programming framework for mechanistic open-loop dose-regimen optimization that uses automatic differentiation (AD) to handle clinically interpretable dose amounts and administration times as differentiable controls. We evaluate our method in three settings: fixed-schedule dose-amplitude optimization in OptiDose PK/PD benchmarks; dose-timing optimization in a chemotherapy-induced neutropenia model with state-dependent delay; and individualized mosunetuzumab dosing in a QSP virtual population. Across these examples, AD produced gradients consistent with references, reduced model-specific derivative work, and shortened benchmark time to solution. DiffDose thereby turns mechanistic PK/PD and QSP models from tools that evaluate prespecified regimens into gradient-based engines for individualized regimen design.