Disease kinetics for decision-making in advanced melanoma: a call for scenario-driven strategy trials.
Identifieur interne : 002F14 ( Main/Exploration ); précédent : 002F13; suivant : 002F15Disease kinetics for decision-making in advanced melanoma: a call for scenario-driven strategy trials.
Auteurs : Jean Jacques Grob [France] ; Georgina V. Long [Australie] ; Dirk Schadendorf [Allemagne] ; Keith Flaherty [États-Unis]Source :
- The Lancet. Oncology [ 1474-5488 ] ; 2015.
Descripteurs français
- KwdFr :
- Algorithmes, Cinétique, Essais cliniques comme sujet (), Facteurs de risque, Humains, Mélanome (mortalité), Mélanome (secondaire), Mélanome (traitement médicamenteux), Plan de recherche, Programme clinique, Pronostic, Protocoles de polychimiothérapie antinéoplasique (effets indésirables), Protocoles de polychimiothérapie antinéoplasique (usage thérapeutique), Techniques d'aide à la décision, Tumeurs cutanées (anatomopathologie), Tumeurs cutanées (mortalité), Tumeurs cutanées (traitement médicamenteux), Valeur prédictive des tests, Évaluation des risques, Évolution de la maladie.
- MESH :
- anatomopathologie : Tumeurs cutanées.
- effets indésirables : Protocoles de polychimiothérapie antinéoplasique.
- mortalité : Mélanome, Tumeurs cutanées.
- secondaire : Mélanome.
- traitement médicamenteux : Mélanome, Tumeurs cutanées.
- usage thérapeutique : Protocoles de polychimiothérapie antinéoplasique.
- Algorithmes, Cinétique, Essais cliniques comme sujet, Facteurs de risque, Humains, Plan de recherche, Programme clinique, Pronostic, Techniques d'aide à la décision, Valeur prédictive des tests, Évaluation des risques, Évolution de la maladie.
English descriptors
- KwdEn :
- Algorithms, Antineoplastic Combined Chemotherapy Protocols (adverse effects), Antineoplastic Combined Chemotherapy Protocols (therapeutic use), Clinical Trials as Topic (methods), Critical Pathways, Decision Support Techniques, Disease Progression, Humans, Kinetics, Melanoma (drug therapy), Melanoma (mortality), Melanoma (secondary), Predictive Value of Tests, Prognosis, Research Design, Risk Assessment, Risk Factors, Skin Neoplasms (drug therapy), Skin Neoplasms (mortality), Skin Neoplasms (pathology).
- MESH :
- adverse effects : Antineoplastic Combined Chemotherapy Protocols.
- drug therapy : Melanoma, Skin Neoplasms.
- methods : Clinical Trials as Topic.
- mortality : Melanoma, Skin Neoplasms.
- pathology : Skin Neoplasms.
- secondary : Melanoma.
- therapeutic use : Antineoplastic Combined Chemotherapy Protocols.
- Algorithms, Critical Pathways, Decision Support Techniques, Disease Progression, Humans, Kinetics, Predictive Value of Tests, Prognosis, Research Design, Risk Assessment, Risk Factors.
Abstract
In the past 5 years, the treatment of metastatic melanoma has changed from almost no effective treatment to the use of targeted and immune therapies with proven improvements in survival. The time has now come to define the optimal drug combinations, sequence of treatment, and drug regimens (intermittent vs continuous dosing) in the treatment of patients with metastatic melanoma. In view of the prevalence of advanced melanoma, finite resources, and the heterogeneity of disease characteristics, not all possibilities can be tested in therapeutic trials starting from an unselected population of patients with metastatic melanoma. In practice, clinicians rely on a few clinically derived signals, especially dynamic signals, to categorise patients into scenarios, from fast disease kinetics to slow disease kinetics, which drive clinicians' therapeutic decision making. The realistic goals of therapy are different in each scenario. We recommend that these scenarios are incorporated into clinical trials as either patient inclusion criteria or stratification factors. This approach is not only feasible but is also the only way to generate evidence for more effective and individualised treatment strategies for patients with metastatic melanoma.
DOI: 10.1016/S1470-2045(15)00003-0
PubMed: 26433825
Affiliations:
- Allemagne, Australie, France, États-Unis
- Massachusetts, Nouvelle-Galles du Sud, Provence-Alpes-Côte d'Azur
- Marseille, Sydney
- Université de Sydney
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Le document en format XML
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The time has now come to define the optimal drug combinations, sequence of treatment, and drug regimens (intermittent vs continuous dosing) in the treatment of patients with metastatic melanoma. In view of the prevalence of advanced melanoma, finite resources, and the heterogeneity of disease characteristics, not all possibilities can be tested in therapeutic trials starting from an unselected population of patients with metastatic melanoma. In practice, clinicians rely on a few clinically derived signals, especially dynamic signals, to categorise patients into scenarios, from fast disease kinetics to slow disease kinetics, which drive clinicians' therapeutic decision making. The realistic goals of therapy are different in each scenario. We recommend that these scenarios are incorporated into clinical trials as either patient inclusion criteria or stratification factors. This approach is not only feasible but is also the only way to generate evidence for more effective and individualised treatment strategies for patients with metastatic melanoma.</div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Australie</li><li>France</li><li>États-Unis</li></country><region><li>Massachusetts</li><li>Nouvelle-Galles du Sud</li><li>Provence-Alpes-Côte d'Azur</li></region><settlement><li>Marseille</li><li>Sydney</li></settlement><orgName><li>Université de Sydney</li></orgName></list><tree><country name="France"><region name="Provence-Alpes-Côte d'Azur"><name sortKey="Grob, Jean Jacques" sort="Grob, Jean Jacques" uniqKey="Grob J" first="Jean Jacques" last="Grob">Jean Jacques Grob</name></region></country><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Long, Georgina V" sort="Long, Georgina V" uniqKey="Long G" first="Georgina V" last="Long">Georgina V. Long</name></region></country><country name="Allemagne"><noRegion><name sortKey="Schadendorf, Dirk" sort="Schadendorf, Dirk" uniqKey="Schadendorf D" first="Dirk" last="Schadendorf">Dirk Schadendorf</name></noRegion></country><country name="États-Unis"><region name="Massachusetts"><name sortKey="Flaherty, Keith" sort="Flaherty, Keith" uniqKey="Flaherty K" first="Keith" last="Flaherty">Keith Flaherty</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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