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Neoadjuvant Model in Cancer Treatment: From Clinical Opportunity to Health-Care Utility
Daniele Generali1, Stephen B Fox2, Massimo Cristofanilli2
1U.O. Multidisciplinare di Patologia Mammaria, U.S Terapia Molecolare e Farmacogenomica (DG, AB), Direzione Sanitaria (CR), A.O. Istituti Ospitalieri di Cremona, Cremona, Italy (DG, AB); Department of Anatomical Pathology, Peter MacCallum Cancer Centre, East Melbourne, Australia (SBF); Thomas Jefferson University Hospital, Philadelphia, PA (MC); San Raffaele - Scientific Institute, Milan, Italy (GB); Medical Oncology, Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy (AZ); Section of Medical Oncology, Yale Cancer Center, Yale School of Medicine, New Haven, CT (CH); Division of Pathology, European Institute of Oncology, Milan, Italy (MB); Department of Policy Analysis and Public Management, Research Center on Health and Social Care Management, CERGAS, SDA Bocconi School of Management, Bocconi University, Milan, Italy (RT); Health Technology Assessment - Regione Lombardia, Italy (MT). d.generali@ospedale.cremona.it.
Abstract:
In the last few decades, research has demonstrated that cancer can be treated and cured if diagnosed at very early stage and a proper therapeutic strategy is adopted. Recent omics-based approaches have unveiled the molecular mechanisms of cancer tumorigenesis and have aided in identifying next-generation molecular markers for early diagnosis, prognosis, and targeted therapy. New tests based on genomic profiling, circulating tumor cells, or mutation profiling are appraised for purpose by Health Technology Assessment. The potential clinical utility of these tests lies on their ability to discriminate between patients who will benefit to a greater or lesser extent from a therapeutic intervention. Assessment of new technologies for the management of cancer could be of interest to other countries given the potentially high impact that they can have on the quality and cost of health care services.
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