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Measuring
the clinical response. What does it mean?
Therasse
P.
EORTC
Data Center, Av. E. Mounier, 83/11, 1200 Brussels, Belgium.
pth@eortc.be
The
clinical response to treatment is an important indicator of the therapeutic
effect of anticancer agents.
Its value and interpretation has to be carefully considered within the context
that it is used.
In daily practice, response assessment is combined with other indicators of the
patient's condition to contribute to the decision-making process.
In clinical trials, it is widely used to identify and quantify the anti-tumour
activity of new agents.
In this context, response evaluation is conducted on the basis of strict
predefined criteria such as the World Health Organization (WHO) or Response
Evaluation Criteria In Solid Tumors (RECIST) criteria.
The RECIST criteria have recently been proposed and offer a detailed guidance to
perform a response evaluation.
Clinical response is also used as an indicator of therapeutic efficacy in
combination with other indicators.
Its value as a surrogate indicator of a survival benefit remains unclear in most
instances and can hardly be established within the framework of a single
randomised trial.
With the development of new anticancer agents that behave differently to
cytotoxics, clinical benefit will have to integrate concepts of disease
stabilisation or time to progression.
Over the next decade, oncologists will be able to assess the biological response
before the clinical response, and a lot of work and energy will have to be
dedicated to assess the predictive and, possibly, the prognostic value of the
biological response with regard to the clinical response, as well as more
definitive measures of clinical benefit.
PMID:
12204662 [PubMed - indexed for MEDLINE]
Source:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12204662&dopt=Abstract
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