Lecture 17 - How do you know that a treatment works? NOT FINISHED

Question 1

What are the current cancer treatments available?

Answer 1

• surgery
• chemotherapy
• radiotherapy
• hormone therapy
• immunotherapy
• biological therapies

Question 2

What are the objectives of these treatments?

Answer 2

1. care the patient, care or remove all cancer cells
2. prolong patient survival, kill most cancer cells
3. palliate symptoms, kill some cancer cells

Question 3

What is another name for treatment failure and treatment efficacy?

Answer 3

Treatment failure –> tumour progression

Treatment efficacy –> tumour response

Question 4

What criteria are used to assess treatment efficacy and tumour response?

Answer 4

• RECIST criteria

- Response Evaluation Criteria in Solid Tumours

Question 5

Describe the RECIST criteria

Answer 5

1. complete response = disappearance of all signs of disease
2. partial response = a reduction of tumour volume by at least 30%
3. stable disease = no significant change
4. disease progression = an increase of tumour volume by at least 20% or new metastases

Question 6

How is tumour response measured?

Answer 6

• choose max of 5 target lesions

- add lengths together

Question 7

Define the following in terms of assessing treatment efficacy:

• overall survival
• disease-free survival
• progression-free survival

Answer 7

• overall survival = survival time from the start of treatment
• disease-free survival = survival prior to tumour relapse after radical treatment
• progression-free survival = survival time prior to tumour progression

Question 8

What is a clinical trial?

Answer 8

• any form of planned experiment which involves patients and is designed to elucidate the most appropriate method of treatment of future patients with a medical condition

Question 9

What are the options for clinical trials in order of how valid they are?

Answer 9

• single arm clinical trial for assessment of new treatment
• single arm clinical trial compared against historical controls
• clinical trial with comparison against concurrent controls
• randomised controlled trial

Question 10

How do we assess whether one drug works better than another drug?

Answer 10

• estimate the treatment effect from the sample of data
• estimates the confidence in travel around the estimate to reflect uncertainty
• test the research hypothesis that the new treatment works better than the standard