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Related Concept Videos

Therapeutic Drug Monitoring: Overview and Classification01:16

Therapeutic Drug Monitoring: Overview and Classification

Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood at designated intervals to ensure the drug concentration stays within a therapeutic range. This monitoring is crucial for optimizing individual dosage regimens, enhancing therapeutic efficacy, and minimizing drug-related toxicity. TDM is vital for drugs with narrow therapeutic windows, significant variability in pharmacokinetics, and a clear correlation between plasma levels and...
Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
Pulmonary Tuberculosis V01:28

Pulmonary Tuberculosis V

Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the progression...
Therapeutic Communication01:30

Therapeutic Communication

Communication is a lifelong learning process. Through therapeutic communication, nurses can collect relevant assessment data, provide education and counseling, and interact during nursing interventions. Sending and receiving messages occur through verbal and nonverbal communication techniques and can happen separately or simultaneously.
Verbal communication depends on language or a prescribed way of using words so that people can share information effectively. The critical aspects of verbal...
Therapeutic Drug Monitoring: Drug Analysis Methods01:26

Therapeutic Drug Monitoring: Drug Analysis Methods

Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood or body tissues to tailor drug therapy effectively. This monitoring is critical for managing drugs with narrow therapeutic indices like digoxin and phenytoin, ensuring they are both safe and effective. For instance, monitoring theophylline levels in asthma patients involves precision and sensitivity to adjust doses according to individual responses to therapy, ensuring efficacy and...
Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...

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Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery
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Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery

Published on: May 4, 2022

TNM: therapeutically not mandatory.

Richard J Epstein1

  • 1Division of Haematology/Oncology, Department of Medicine, The University of Hong Kong, 4/F, Professorial Block, Queen Mary Hospital, Pokfulam, Hong Kong.

European Journal of Cancer (Oxford, England : 1990)
|March 31, 2009
PubMed
Summary
This summary is machine-generated.

Cancer staging is shifting from risk-based TNM to benefit-led biomarker use. A new METS system (molecular/extra-primary/tumour/symptoms) aims to guide personalized cancer treatment decisions.

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Area of Science:

  • Oncology
  • Cancer Biology
  • Translational Medicine

Background:

  • Traditional cancer staging relies on the Tumor-Node-Metastasis (TNM) system to assess prognosis.
  • The increasing role of biomarkers, predicting therapeutic benefit rather than solely disease outcome, is challenging TNM's dominance.
  • This shift impacts the distinction between curable (adjuvant) and incurable (palliative) disease treatment strategies.

Purpose of the Study:

  • To introduce a modernized, decision-oriented disease staging system called METS (molecular/extra-primary/tumour/symptoms).
  • To address the evolving landscape of cancer treatment driven by biomarkers and personalized medicine.
  • To better guide treatment decisions by integrating molecular and symptomatic information alongside traditional staging.

Main Methods:

  • Conceptual development of the METS staging system.
  • Analysis of the impact of biomarkers on treatment decisions in both early-stage (M0) and metastatic (M1) cancer.
  • Exploration of how personalized drug regimens can be applied across different disease stages.

Main Results:

  • Biomarker-positive patients with high TNM (M1) disease may achieve survival benefits comparable to low TNM (M0) patients with adjuvant therapy.
  • M0 patients may opt for personalized, better-tolerated regimens, similar to those used in palliative settings, even without level 1 data.
  • The distinction between adjuvant and palliative treatment is blurring due to personalized medicine approaches.

Conclusions:

  • The METS system offers a modern approach to cancer staging, integrating molecular and symptomatic data for improved decision-making.
  • Personalized medicine and biomarker use are reshaping cancer treatment paradigms, moving beyond traditional TNM-based risk stratification.
  • Future cancer staging should be more dynamic and patient-centric, reflecting individual therapeutic benefits and quality-of-life considerations.