Use a blood test at six weeks to decide whether to keep going
Scans at three months often cannot tell whether immunotherapy is working. A blood test at six weeks may give a clearer, earlier answer.
On-treatment ctDNA change at four to eight weeks predicted checkpoint outcomes across tumour types in several cohorts, including pan-cancer analyses, and outperformed early imaging in distinguishing pseudoprogression from true progression. The step never taken is a randomised trial in which the ctDNA result actually drives the decision to continue, intensify or switch.
- No one can predict who responds to immunotherapy · Checkpoint drugs cure some patients and do nothing for most. We still cannot tell the two apart before treating.
- Prices and value · New cancer drugs routinely cost over $150,000 a year, often for months of benefit. Systems cannot afford them and patients go bankrupt.
- Trial design, endpoints and cost · A phase 3 trial takes years and hundreds of millions of dollars, and often answers a question that has already moved on.
Pages like this
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- PersonAsh A. Alizadeh
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