This talk delves into the complexities of defining disease progression in the context of systemic therapy. Expert insights guide clinicians on prioritizing patient symptoms, exploring alternative treatment options, and evaluating the accuracy of progression documentation.
Professor, Department of Medicine, Weill Cornell Medical College; Attending Physician, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NYServe as a director, officer, partner, employee, advisor, consultant, or trustee for: AstraZeneca; Roche/Genentech; Ariad Pharmaceuticals
First, a couple of thoughts as to what you need to consider when you're making this decision about whether progression is happening and what to do.I think the single most important thing is to focus on symptoms. Does a growing lesion lead to a symptom? Does a growing lesion lead to a disruption of somebody's lifestyle and their ability to live the kind of life they want?
Also, there are some things that occur that can cloud the interpretation. One of the common ones — and many more people know about this now — is that lytic bony lesions under effective therapy often are inapparent, but they become apparent and become sclerotic a s the healing process takes place. I think all of us have seen these cases where people had a “negative” PET scan that suddenly became positive while a patient was clearly benefiting from the therapy.
Progression Systemic Therapy RECIST Patient Symptoms Alternative Treatments
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