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CAN > L21: How Do You Know A Treatment Is Working > Flashcards

L21: How Do You Know A Treatment Is Working Flashcards

1
Q

What are the current treatments for cancer

A 
Surgery 
Chemotherapy 
Radiotherapy 
Hormone therapy 
Immunotherapy 
Biological therapies
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2
Q

What is the 3 aims of all treatment types

A

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

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3
Q

What is relapse

A

If the cancer cells grow again

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4
Q

What is a tumour response

A

When treatment works to reduce the size of the tumour

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5
Q

What does the tumour response not indicate

A

That the survival rate is increasing

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6
Q

How do we measure the tumour response

A

With a method called RECIST

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7
Q

What does RECIST stand for

A

Response evaluation criteria in solid tumours

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8
Q

What are the 2 responses in RECIST

A

Target lesions response

Non target lesions response

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9
Q

What are target lesions

A

These are measurable lesions

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10
Q

What are non target lesions

A

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

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11
Q

What are the 4 responses with target lesions

A

Complete response
Partial response
Progressive disease
Stable disease

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12
Q

What is the criteria for a complete response

A

All target lesions have disappeared

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13
Q

What is the criteria for partial response

A

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

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14
Q

What is the criteria for progressive disease

A

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

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15
Q

What is the criteria for stable disease

A

No significant change

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16
Q

What are the 3 responses for a non target lesion

A

Complete response
Non complete non progressive disease
Progressive disease

17
Q

What is the criteria for a compete response

A

Disappearance of all non target lesions

18
Q

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

A

Persistence of one or more non target lesions

19
Q

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

A

Progression of existing non target lesions

20
Q

What are the 3 survival times

A

Overall survival time
Disease free survival time
Progression free survival time

21
Q

What is the overall survival time

A

The time from treatment to time of death

22
Q

What is the disease free survival time

A

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

23
Q

What is the progression free survival time

A

Tumours is still evident but you have stopped it from progressing

24
Q

What is a clinical trial

A

An experiment that involves patients to determine future treatment

25
Q

What does a single arm clinical trial assess

A

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

26
Q

What can a single arm trial be compares against

A

Historical controls

27
Q

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

A

Historical patient may not math the current patients

28
Q

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

A

Randomised controlled trial

29
Q

What does a randomised controlled trial measure

A

Current and new treatment comparison

30
Q

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

A

3

31
Q

What is the aim of phase 1

A

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

32
Q

What is the aim of phase 2

A

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

33
Q

What is the aim of phase 3 clinical trials

A

Compare STANDARD treatment and provide sufficient evidence to change clinical practise

34
Q

What type of trial is used in phase 3

A

Typically RCTs

35
Q

What is the hazard ratio

A

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

36
Q

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

A

Risk in new treatment is less than standard treatment

37
Q

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

A

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

38
Q

What does a hazard ratio= 1 mean

A

No difference in the risk in new or standard treatment

CAN (25 decks)

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