1/
Our new editorial asks whether MDT for OMD has been too often treated as a one-time upfront intervention.
Have we overlooked the value of a comprehensive, longitudinal strategy—combining close surveillance with serial, strategic SABR when needed?
👉 doi.org/10.1016/j.canl…
Our new editorial asks whether MDT for OMD has been too often treated as a one-time upfront intervention.
Have we overlooked the value of a comprehensive, longitudinal strategy—combining close surveillance with serial, strategic SABR when needed?
👉 doi.org/10.1016/j.canl…
2/
In SABR-COMET, re-tx w/ SABR occurred only in the MDT arm, but later trials—where clinical equipoise faded—showed frequent crossovers.
Re-tx rates reached 26% (up to 50%) in MDT arms and 36.5% (up to 78%) in controls.
This approach resembles how brain mets are managed.
In SABR-COMET, re-tx w/ SABR occurred only in the MDT arm, but later trials—where clinical equipoise faded—showed frequent crossovers.
Re-tx rates reached 26% (up to 50%) in MDT arms and 36.5% (up to 78%) in controls.
This approach resembles how brain mets are managed.
3/
Simple tumor-growth modeling illustrates the potential advantage of integrating close surveillance w/ add’l MDT:
by periodically reducing tumor burden through serial interventions, disease control can be prolonged and survival substantially increased vs single upfront MDT.
Simple tumor-growth modeling illustrates the potential advantage of integrating close surveillance w/ add’l MDT:
by periodically reducing tumor burden through serial interventions, disease control can be prolonged and survival substantially increased vs single upfront MDT.
4/
Classical RECIST v1.1 PFS may not fully capture the benefit of serial strategic MDT for new or subsequent mets.
We propose alternative endpoints—PFS2, mPFS, TTNT—each w/ distinct pros and cons, potentially reflecting the true impact of longitudinal MDT more effectively.
Classical RECIST v1.1 PFS may not fully capture the benefit of serial strategic MDT for new or subsequent mets.
We propose alternative endpoints—PFS2, mPFS, TTNT—each w/ distinct pros and cons, potentially reflecting the true impact of longitudinal MDT more effectively.
5/
Grateful to my OligoKarma guru @MitchCCLiu; to @FTHWU for tremendous help; and to SarahBaker and @emmadunne for their thoughtful contributions.
@ChadTangMD @CancerConnector @_ShankarSiva @drdavidpalma @jryckman3 @CJTsaiMDPhD @rweichselbaum @HimanshuNagarMD
Grateful to my OligoKarma guru @MitchCCLiu; to @FTHWU for tremendous help; and to SarahBaker and @emmadunne for their thoughtful contributions.
@ChadTangMD @CancerConnector @_ShankarSiva @drdavidpalma @jryckman3 @CJTsaiMDPhD @rweichselbaum @HimanshuNagarMD
@MitchCCLiu @FTHWU @emmadunne @ChadTangMD @CancerConnector @_ShankarSiva @drdavidpalma @jryckman3 @CJTsaiMDPhD @rweichselbaum @HimanshuNagarMD 6/
The key figure shows why endpoints like mPFS, PFS2, mPFS2, or TTNT may better capture the benefit of serial strategic RT than conventional PFS.
Excited that the upcoming STOP-II randomized trial adopts this framework.
The key figure shows why endpoints like mPFS, PFS2, mPFS2, or TTNT may better capture the benefit of serial strategic RT than conventional PFS.
Excited that the upcoming STOP-II randomized trial adopts this framework.
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