L21: How Do You Know A Treatment Is Working

Question 1

What are the current treatments for cancer

Answer 1

Surgery 
Chemotherapy 
Radiotherapy 
Hormone therapy 
Immunotherapy 
Biological therapies

Question 2

What is the 3 aims of all treatment types

Answer 2

1) remove all cancer cells to cure patients
2) kill most cancer cells to prolong survival in advanced cancer
3) kill some cancer cell to palliate symptoms

Question 3

What is relapse

Answer 3

If the cancer cells grow again

Question 4

What is a tumour response

Answer 4

When treatment works to reduce the size of the tumour

Question 5

What does the tumour response not indicate

Answer 5

That the survival rate is increasing

Question 6

How do we measure the tumour response

Answer 6

With a method called RECIST

Question 7

What does RECIST stand for

Answer 7

Response evaluation criteria in solid tumours

Question 8

What are the 2 responses in RECIST

Answer 8

Target lesions response

Non target lesions response

Question 9

What are target lesions

Answer 9

These are measurable lesions

Question 10

What are non target lesions

Answer 10

Lesions that we cannot measure, you can only look at it qualitatively

Question 11

What are the 4 responses with target lesions

Answer 11

Complete response
Partial response
Progressive disease
Stable disease

Question 12

What is the criteria for a complete response

Answer 12

All target lesions have disappeared

Question 13

What is the criteria for partial response

Answer 13

A reduction of the sum of diameters by at least 30%

Question 14

What is the criteria for progressive disease

Answer 14

An increase in the sum of diameter of target lesions by 20%

Question 15

What is the criteria for stable disease

Answer 15

No significant change

Question 16

What are the 3 responses for a non target lesion

Answer 16

Complete response
Non complete non progressive disease
Progressive disease

Question 17

What is the criteria for a compete response

Answer 17

Disappearance of all non target lesions

Question 18

What is the criteria for non complete response/ non progressive disease

Answer 18

Persistence of one or more non target lesions

Question 19

What is the criteria for a progressive disease in non target lesions

Answer 19

Progression of existing non target lesions

Question 20

What are the 3 survival times

Answer 20

Overall survival time
Disease free survival time
Progression free survival time

Question 21

What is the overall survival time

Answer 21

The time from treatment to time of death

Question 22

What is the disease free survival time

Answer 22

Time before the relapse of the tumour after a treatment before it comes again

Question 23

What is the progression free survival time

Answer 23

Tumours is still evident but you have stopped it from progressing

Question 24

What is a clinical trial

Answer 24

An experiment that involves patients to determine future treatment

Question 25

What does a single arm clinical trial assess

Answer 25

New patients on a new treatment with no comparison to patients on current treatment

Question 26

What can a single arm trial be compares against

Answer 26

Historical controls

Question 27

Why is it not realistic to compare the single arm trial to historical trials

Answer 27

Historical patient may not math the current patients

Question 28

What is the best way to measure clinical efficacy of a new treatment

Answer 28

Randomised controlled trial

Question 29

What does a randomised controlled trial measure

Answer 29

Current and new treatment comparison

Question 30

How many phases of clinical trials are there in the research pathway

Answer 30

3

Question 31

What is the aim of phase 1

Answer 31

To find safe maximum tolerated dose of NEW treatment and understand toxicity

Question 32

What is the aim of phase 2

Answer 32

Determine if new treatment has sufficient efficacy to be worthy of further investigation

Question 33

What is the aim of phase 3 clinical trials

Answer 33

Compare STANDARD treatment and provide sufficient evidence to change clinical practise

Question 34

What type of trial is used in phase 3

Answer 34

Typically RCTs

Question 35

What is the hazard ratio

Answer 35

Risk of death in new treatment/ risk of death in standard treatment

Question 36

If the hazard ratio is less than one what does this mean

Answer 36

Risk in new treatment is less than standard treatment

Question 37

What does it mean if the hazard ratio is greater than 1

Answer 37

Risk in new treatment is higher than the standard treatment and increases the risk

Question 38

What does a hazard ratio= 1 mean

Answer 38

No difference in the risk in new or standard treatment