A Brilliant Approach to a "Mixed" Therapeutic Response

I just saw this and thought it well worth mentioning, although it is still in the "talking phase" and has not been moved into practice.

• Consider the following when assessing therapeutic response: From: https://www.eurekalert.org/pub_releases/2017-11/uoca-in110617.php
  • If a patient has a small pocket of resistant disease, consider using localized therapy to target that area and continuing the treatment as long as it remains effective against the majority of the patient's cancer (currently, pockets of resistant disease are interpreted as treatment failure necessitating a change of treatment [or dismissal from a clinical trial]). This approach implies that an oncologist or investigator might use a localized, targeted therapy on area(s) of resistant disease while continuing the treatment as long as it remains effective against the majority of the patient's cancer.
  • Consider evaluating therapeutic response in the brain separately from the response in the rest of the body. Some drugs used to treat brain metastases are effective against brain mets in patients who have had multiple prior lines of therapy. In these patients, the disease in the body resists the new drug due to heavy pre-treatment, but the disease in the brain (that hasn't been affected by previous therapies) may respond much more dramatically. Hence, the implication is that outcomes in the body and the brain should potentially be measured separately (possibly in clinical trials as well as in clinical practice).

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