PCL102H1 Lecture Notes - Lecture 18: Neoadjuvant Therapy, Breast Cancer Awareness, Randomized Controlled Trial
15 Mar 2015
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Lecture 18: advanced issues in clinical trial design. Need more herceptins in toolkit to treat more forms of breast cancer. Need to introduce + rapidly evaluate new drugs; target @ high risk for recurrence. Intervene @ time of primary cancer diagnosis rather than waiting until metastatic: goal: identify indicators of response to neo-adjuvant (treatment before main treatment) chemotherapy predicting survival in women w/ high-risk (stage ii-iii) breast cancer. Good prognosis: patients fared well regardless of chemotherapy given. Poor prognosis: patient tumour response had good predictor of long term, disease free survival form neo-adjuvant chemotherapy. Change in tumour size during treatment measured by mri; good predictor of ultimate response of cancer to treatment. Key novel features of i-spy trial (1 + 2: uses biomarkers from individual patients" tumours to screen promising new treatments. Match therapy to specific markers: adaptive trial design. Use early data from 1 set of patients to guide decisions about more useful treatments in future w/o rewriting protocol.
