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Gregor Mendel's work (1822 - 1884) was primarily focused on pea plants. Through his initial experiments, he determined that every gene in a diploid cell has two variants called alleles inherited from each parent. He suggested that amongst these two alleles, one allele is dominant in character and the other recessive. The combination of alleles determines the phenotype of a gene in an organism.
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An experiment often consists of more than a single step. In this case, measurements at each step give rise to uncertainty. Because the measurements occur in successive steps, the uncertainty in one step necessarily contributes to that in the subsequent step. As we perform statistical analysis on these types of experiments, we must learn to account for the propagation of uncertainty from one step to the next. The propagation of uncertainty depends on the type of arithmetic operation performed on...
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An increasing function exhibits a rise in output values as input values increase. This behavior is depicted graphically as a curve or line that slopes upward from left to right. Such a function satisfies the condition that if x1 < x2, then f(x1) < f(x2), indicating that the function values grow with increasing inputs. This concept is fundamental in understanding growth trends across various domains, such as population dynamics, financial investments, or resource consumption.The...
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Not all progression is equal.

Shivaek Venkateswaran1, Rohit V Mantena1, Jonas Willmann2,3

  • 1Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA.

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This summary is machine-generated.

Progression in cancer trials is often oversimplified. New research suggests considering the speed, location, and extent of disease spread can improve clinical trial endpoints and treatment decisions.

Keywords:
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Area of Science:

  • Oncology
  • Clinical Trial Design
  • Cancer Research

Background:

  • Current oncology trial progression is typically assessed using Response Evaluation Criteria in Solid Tumors (RECIST).
  • RECIST oversimplifies the complex biological nature of treatment failure.
  • Existing adaptations like immune RECIST (iRECIST) address immunotherapy response but not all dimensions of progression.

Purpose of the Study:

  • To explore the temporal and spatial dimensions of cancer progression in clinical trials.
  • To investigate how disease spread velocity, tropism, and burden impact prognostic and therapeutic significance.
  • To advocate for integrating these dimensions into clinical trial endpoints for better interpretability.

Main Methods:

  • Review of emerging evidence from lung and prostate cancer studies.
  • Analysis of prognostic and therapeutic significance of disease spread characteristics.
  • Conceptual framework for integrating novel progression dimensions into trial endpoints.

Main Results:

  • Not all cancer progression is equivalent; velocity, organ tropism, and burden are significant.
  • These factors can indicate distinct resistance mechanisms and microenvironments.
  • Faster or organ-specific progression has implications for local versus systemic therapy choices.

Conclusions:

  • Integrating pattern, velocity, and burden of progression into trial endpoints can enhance clinical decision-making.
  • Standardized, prospective data collection is crucial for validating these advanced approaches.
  • Refining trial endpoints to reflect the biological realities of metastatic disease is essential for future cancer treatment strategies.