Chemotherapy and receptor-mediated therapy

8 important questions on Chemotherapy and receptor-mediated therapy

What is response evalutation criteria in solid tumors (RECIST)?

A set of rules which define when tumors in cancer patients improve (respond), stay the same (stabilize) or worsen (progress) during treatment.

How does targeted (receptor-mediated) therapy work?

Targeted therapy works by targeting the cancer's specific genes, proteins or tissue environment that contributes to cancer growth and survival.

How are patients with GIST (gastro-intestinal stroma cell tumors) often treated?

With Imatimib, which acts as a tyrosine kinase inhibitor of KIT. KIT is a receptor tyrosine kinase encoded by the proto-oncogene c-kit. With this treatment, the median survival increases from 9 months to 5 years.
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How does hormonal therapy work?

Hormonal therapy uses medication that inhibits or blocks the production or action of hormones. It is therefore only suitable for tumors with hormone-dependent growth; breast cancer, prostate cancer, thyroid cancer, malign lymphoma, ovarian or endometrium cancer.

Why does chemotherapy work better on small tumors instead of big tumors?

Because when a tumor is small, the tumor is growing very fast. A bigger tumor grows slower and has a lower blood flow. The larger the growth factor (small tumor) the more responsive to chemotherapy.

What happens in phase I of a clinical trial?

Phase I trials aim to find the best dose of a new drug with the fewest side effects, and often test new agents or a combination of agents. The objectives in phase I are the adverse effects, maximal tolerable dose (MTS, the pharmacodynamics and the pharmacokinetics.

What happens in phase II of a clinical trial?

Phase II trials are used to determine the efficacy (e.g. Response rate) of a drug in a uniform group of patients. During this time the drug is tested on patients with the same type of tumor and are mostly treated with one dose (MTD). These trials are often randomized to get the feeling for the difference between toxicity and effectivity, The total number of patients in Phase I trials is often 20-90 patients.

What happens in phase III of a clinical trial?

Phase III is used to compare the overall survival after treatment of the new agent versus the 'standard' treatment. It also takes into account the adverse effects and the quality of life. Also in the case of Phase III the patients have the same tumor. Phase III trials are also randomized, sometimes even double blind. The number of patients during Phase III trials is mostly between 300-1000 patients.

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