Determining lines of therapy in patients with solid cancers: a proposed new systematic and comprehensive framework
The complexity of neoplasia and its treatment are a challenge to the formulation of general criteria that are applicable across solid cancers. Determining the number of prior lines of therapy (LoT) is critically important for optimising future treatment, conducting medication audits, and assessing e...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8292475/ https://www.ncbi.nlm.nih.gov/pubmed/33850304 http://dx.doi.org/10.1038/s41416-021-01319-8 |
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author | Saini, Kamal S. Twelves, Chris |
author_facet | Saini, Kamal S. Twelves, Chris |
author_sort | Saini, Kamal S. |
collection | PubMed |
description | The complexity of neoplasia and its treatment are a challenge to the formulation of general criteria that are applicable across solid cancers. Determining the number of prior lines of therapy (LoT) is critically important for optimising future treatment, conducting medication audits, and assessing eligibility for clinical trial enrolment. Currently, however, no accepted set of criteria or definitions exists to enumerate LoT. In this article, we seek to open a dialogue to address this challenge by proposing a systematic and comprehensive framework to determine LoT uniformly across solid malignancies. First, key terms, including LoT and ‘clinical progression of disease’ are defined. Next, we clarify which therapies should be assigned a LoT, and why. Finally, we propose reporting LoT in a novel and standardised format as LoT N (CLoT + PLoT), where CLoT is the number of systemic anti-cancer therapies (SACT) administered with curative intent and/or in the early setting, PLoT is the number of SACT given with palliative intent and/or in the advanced setting, and N is the sum of CLoT and PLoT. As a next step, the cancer research community should develop and adopt standardised guidelines for enumerating LoT in a uniform manner. |
format | Online Article Text |
id | pubmed-8292475 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-82924752021-07-23 Determining lines of therapy in patients with solid cancers: a proposed new systematic and comprehensive framework Saini, Kamal S. Twelves, Chris Br J Cancer Perspective The complexity of neoplasia and its treatment are a challenge to the formulation of general criteria that are applicable across solid cancers. Determining the number of prior lines of therapy (LoT) is critically important for optimising future treatment, conducting medication audits, and assessing eligibility for clinical trial enrolment. Currently, however, no accepted set of criteria or definitions exists to enumerate LoT. In this article, we seek to open a dialogue to address this challenge by proposing a systematic and comprehensive framework to determine LoT uniformly across solid malignancies. First, key terms, including LoT and ‘clinical progression of disease’ are defined. Next, we clarify which therapies should be assigned a LoT, and why. Finally, we propose reporting LoT in a novel and standardised format as LoT N (CLoT + PLoT), where CLoT is the number of systemic anti-cancer therapies (SACT) administered with curative intent and/or in the early setting, PLoT is the number of SACT given with palliative intent and/or in the advanced setting, and N is the sum of CLoT and PLoT. As a next step, the cancer research community should develop and adopt standardised guidelines for enumerating LoT in a uniform manner. Nature Publishing Group UK 2021-04-13 2021-07-20 /pmc/articles/PMC8292475/ /pubmed/33850304 http://dx.doi.org/10.1038/s41416-021-01319-8 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Perspective Saini, Kamal S. Twelves, Chris Determining lines of therapy in patients with solid cancers: a proposed new systematic and comprehensive framework |
title | Determining lines of therapy in patients with solid cancers: a proposed new systematic and comprehensive framework |
title_full | Determining lines of therapy in patients with solid cancers: a proposed new systematic and comprehensive framework |
title_fullStr | Determining lines of therapy in patients with solid cancers: a proposed new systematic and comprehensive framework |
title_full_unstemmed | Determining lines of therapy in patients with solid cancers: a proposed new systematic and comprehensive framework |
title_short | Determining lines of therapy in patients with solid cancers: a proposed new systematic and comprehensive framework |
title_sort | determining lines of therapy in patients with solid cancers: a proposed new systematic and comprehensive framework |
topic | Perspective |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8292475/ https://www.ncbi.nlm.nih.gov/pubmed/33850304 http://dx.doi.org/10.1038/s41416-021-01319-8 |
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