{"slug":"de-escalation","tag":"de-escalation","variants":["de-escalation"],"description":"People and trials concerned with giving less treatment where it is safe to do so.","count":17,"kinds":{"person":16,"trial":1},"related":[{"slug":"breast","tag":"breast","shared":9},{"slug":"surgery","tag":"surgery","shared":6},{"slug":"head-and-neck","tag":"head-and-neck","shared":2},{"slug":"trialist","tag":"trialist","shared":2},{"slug":"cervical","tag":"cervical","shared":1},{"slug":"cns","tag":"cns","shared":1},{"slug":"colorectal","tag":"colorectal","shared":1},{"slug":"ctdna","tag":"ctdna","shared":1},{"slug":"ecog-acrin","tag":"ecog-acrin","shared":1},{"slug":"genomics","tag":"genomics","shared":1},{"slug":"ghsg","tag":"ghsg","shared":1},{"slug":"guidelines","tag":"guidelines","shared":1}],"records":[{"id":"joseph-sparano","kind":"person","name":"Joseph A. Sparano","route":"/people/joseph-sparano/","tldr":"Led TAILORx, which showed most women with intermediate Oncotype scores can safely skip chemotherapy."},{"id":"kevin-kalinsky","kind":"person","name":"Kevin Kalinsky","route":"/people/kevin-kalinsky/","tldr":"Led RxPONDER, which showed postmenopausal women with 1-3 positive nodes and low recurrence scores do not need chemotherapy."},{"id":"nadia-harbeck","kind":"person","name":"Nadia Harbeck","route":"/people/nadia-harbeck/","tldr":"German breast oncologist whose ADAPT trials use biology to decide who can have less chemotherapy."},{"id":"helena-earl","kind":"person","name":"Helena Earl","route":"/people/helena-earl/","tldr":"Led PERSEPHONE, which showed six months of trastuzumab is nearly as good as twelve for most patients."},{"id":"aleix-prat","kind":"person","name":"Aleix Prat","route":"/people/aleix-prat/","tldr":"Translational oncologist who built genomic tests (HER2DX) to decide which HER2-positive patients can skip chemotherapy."},{"id":"monica-morrow","kind":"person","name":"Monica Morrow","route":"/people/monica-morrow/","tldr":"Breast surgeon whose margin and axillary guidelines cut unnecessary re-excisions and lymph node surgery worldwide."},{"id":"armando-giuliano","kind":"person","name":"Armando E. Giuliano","route":"/people/armando-giuliano/","tldr":"Brought sentinel node biopsy to breast cancer and led ACOSOG Z0011, which ended routine axillary dissection for many women."},{"id":"jeanne-tie","kind":"person","name":"Jeanne Tie","route":"/people/jeanne-tie/","tldr":"Led DYNAMIC, the first randomised trial to show ctDNA can safely guide who needs chemotherapy after colon cancer surgery."},{"id":"mark-faries","kind":"person","name":"Mark B. Faries","route":"/people/mark-faries/","tldr":"Surgeon who led MSLT-II, showing that removing all lymph nodes after a positive sentinel node does not improve melanoma survival."},{"id":"maura-gillison","kind":"person","name":"Maura L. Gillison","route":"/people/maura-gillison/","tldr":"Established that HPV causes a distinct, better-prognosis form of throat cancer and led RTOG 1016 on how to treat it."},{"id":"hisham-mehanna","kind":"person","name":"Hisham Mehanna","route":"/people/hisham-mehanna/","tldr":"Surgeon who led De-ESCALaTE and PET-NECK, two trials that changed how HPV-positive throat cancer is treated and followed up."},{"id":"martin-schlumberger","kind":"person","name":"Martin Schlumberger","route":"/people/martin-schlumberger/","tldr":"Led SELECT (lenvatinib) and the ESTIMABL trials that showed many thyroid cancer patients can have lower radioiodine doses or none at all."},{"id":"andreas-engert","kind":"person","name":"Andreas Engert","route":"/people/andreas-engert/","tldr":"Led the GHSG for two decades, running the HD10 to HD18 trials that cure over 90% of Hodgkin lymphoma with less treatment."},{"id":"charlotte-coles","kind":"person","name":"Charlotte E. Coles","route":"/people/charlotte-coles/","tldr":"Led IMPORT LOW, which showed partial-breast radiotherapy is as effective as whole-breast treatment with fewer side effects."},{"id":"shelley-hwang","kind":"person","name":"E. Shelley Hwang","route":"/people/shelley-hwang/","tldr":"Duke surgeon who led COMET, the trial testing whether women with low-risk DCIS can safely be monitored instead of having surgery straight away."},{"id":"marie-plante","kind":"person","name":"Marie Plante","route":"/people/marie-plante/","tldr":"Quebec surgeon who pioneered fertility-sparing surgery for cervical cancer and led SHAPE, the trial that showed a simple hysterectomy is enough for low-risk early cervical cancer."},{"id":"acns0331","kind":"trial","name":"COG ACNS0331","route":"/trials/acns0331/","status":"mixed","tldr":"This trial asked whether children with average-risk medulloblastoma could safely receive less radiation. Shrinking the boost to the tumour bed was safe; cutting the dose to the whole brain and spine in young children was not, so 23.4 Gy remains the floor for most."}]}