De-escalator.

Top Line: What inevitably follows major improvements in outcomes with cancer treatment? The search for de-escalated therapies in selected populations.

The Study: Here is an excellent review on just that for nasopharyngeal cancers. A lot hinges on the Will Rogers effect of more advanced PET and MR imaging, leading to cancers of all stages harboring inherently better biology. One area of contention is concurrent chemo for stage II disease where you’ll find quite the grab bag of both primary and nodal tumor extent, with an ongoing trial assessing omission of chemo with low pre-treatment EBV titers. While the role of concurrent platinum chemo is cemented for locally-advanced disease, there may be options to de-escalate from the standard three tri-weekly doses of cisplatin to two doses, to lower dosing weekly, or to another agent nedaplatin (not yet approved in the US). Finally, when it comes to radiation de-escalation, a reduced dose (~60 Gy) may prove sufficient for T1-2 primary tumors or those that respond well to induction chemo, and a reduced volume (without elective nodal coverage of IB, VB or maybe even IV) may prove the best balance of risk and reward.

TBL: With greater patient selection via advanced imaging and biomarkers, individualized treatment de-escalation is on the horizon for nasopharyngeal cancers. | Lee, JAMA Oncol 2020

Comments

  1. To know more about Chief Dr Lucky you can visit his website (https://chiefdrluckyherbaltherapy.wordpress.com/)
     
     A friend that suffered from Herpes and was cure with the help of this great herbal doctor Chief Lucky so i decided to contact him for help in getting rid of my families genital herpes virus 1/2 which i did and all i was told to provide was just some useful information and some materials used in preparation of the natural cure and that i did and now i am the happiest person on earth because i am writing this testimony of mine with joy and happiness in my heart to the whole world to know that natural remedy is real because i am a living testimony of Chief Lucky traditional herbal cure and i want you all to contact Chief Lucky via his email: chiefdrlucky@gmail.com or WhatsApp him +2348132777335 am sure he will help you too.

    ReplyDelete
  2. This is such a great resource that you are providing and you give it away for free. I love seeing blog that understand the value of providing a quality resource for free kubet

    ReplyDelete

Post a Comment

Popular Posts