Prognosis vs Treatment Interaction

JNCI Cancer Spectrum
Jack Cuzick

Abstract

There is a somewhat confused belief that a biomarker must show an interaction effect with a treatment before it can be used to determine the need for such a treatment. This is rarely true for well-established clinical markers such as tumor size or regional lymph node involvement. In many cases, this is also not true for biomarkers, especially when considering nontargeted therapies. Here I argue that for nontargeted treatments prognosis is often more important than interaction with treatment, because it is the absolute and not the relative benefit that matters, and when there is no treatment interaction, the same relative benefit translates into a larger absolute benefit for poor prognosis patients.

References

Oct 20, 2011·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Gong TangNorman Wolmark
Jul 3, 2013·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Mitch DowsettJack Cuzick
Sep 4, 2013·Clinical Trials : Journal of the Society for Clinical Trials·Lisa M McShane, Mei-Yin C Polley
Oct 19, 2013·Journal of the National Cancer Institute·Mei-Yin C PolleyLisa M McShane

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