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...

Descripción completa

Detalles Bibliográficos
Autores principales: Saini, Kamal S., Twelves, Chris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
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
_version_ 1783724837701681152
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
work_keys_str_mv AT sainikamals determininglinesoftherapyinpatientswithsolidcancersaproposednewsystematicandcomprehensiveframework
AT twelveschris determininglinesoftherapyinpatientswithsolidcancersaproposednewsystematicandcomprehensiveframework