Going to extremes: determinants of extraordinary response and survival in patients with cancer

Saner Flurina A. M.; Herschtal Alan; Nelson Brad H.; deFazio Anna; Goode Ellen L.; Ramus Susan J.; Pandey Ahwan; Beach Jessica A.; Fereday Sian; Berchuck Andrew; Lheureux Stephanie; Pearce Celeste Leigh; Pharoah Paul D.; Pike Malcolm C.; Garsed Dale W.; Bowtell David D. L.

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Going to extremes: determinants of extraordinary response and survival in patients with cancer

机译：转向极端：癌症患者的非凡反应和生存的决定因素

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Research into factors affecting treatment response or survival in patients with cancer frequently involves cohorts that span the most common range of clinical outcomes, as such patients are most readily available for study. However, attention has turned to highly unusual patients who have exceptionally favourable or atypically poor responses to treatment and/or overall survival, with the expectation that patients at the extremes may provide insights that could ultimately improve the outcome of individuals with more typical disease trajectories. While clinicians can often recount surprising patients whose clinical journey was very unusual, given known clinical characteristics and prognostic indicators, there is a lack of consensus among researchers on how best to define exceptional patients, and little has been proposed for the optimal design of studies to identify factors that dictate unusual outcome. In this Opinion article, we review different approaches to identifying exceptional patients with cancer and possible study designs to investigate extraordinary clinical outcomes. We discuss pitfalls with finding these rare patients, including challenges associated with accrual of patients across different treatment centres and time periods. We describe recent molecular and immunological factors that have been identified as contributing to unusual patient outcome and make recommendations for future studies on these intriguing patients.

机译：影响癌症患者治疗反应或存活的因素经常涉及跨越最常见的临床结果范围的群体，因为这些患者最容易获得研究。然而，关注对治疗和/或整体生存的患者具有特别有利或非典型差的患者，期望极端患者可以提供最终能够改善更典型的疾病轨迹的个体结果的见解。虽然临床医生常常叙述临床旅程非常不寻常的令人惊讶的患者，但鉴于已知的临床特征和预后指标，研究人员缺乏共识，这些研究人员对如何最好地定义特殊患者，并且已经提出了最佳研究的最佳设计确定决定异常结果的因素。在本文中，我们审查了不同的方法，以鉴定癌症的特殊患者和可能的研究设计，以调查非凡的临床结果。我们讨论了寻找这些稀有患者的陷阱，包括在不同治疗中心和时间段的患者的应计相关的挑战。我们描述了最近被确定为不寻常的患者结果的分子和免疫因素，并为未来对这些有趣患者的研究提出建议。

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《Nature reviews Cancer》 |2019年第6期|共10页
作者
Saner Flurina A. M.; Herschtal Alan; Nelson Brad H.; deFazio Anna; Goode Ellen L.; Ramus Susan J.; Pandey Ahwan; Beach Jessica A.; Fereday Sian; Berchuck Andrew; Lheureux Stephanie; Pearce Celeste Leigh; Pharoah Paul D.; Pike Malcolm C.; Garsed Dale W.; Bowtell David D. L.;
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作者单位

Peter MacCallum Canc Ctr Melbourne Vic Australia;

Peter MacCallum Canc Ctr Melbourne Vic Australia;

British Columbia Canc Agcy Deeley Res Ctr Victoria BC Canada;

Westmead Hosp Dept Gynaecol Oncol Westmead NSW Australia;

Mayo Clin Div Epidemiol Dept Hlth Sci Res Rochester MN USA;

Univ New South Wales Sch Womens &

Childrens Hlth Sydney NSW Australia;

Peter MacCallum Canc Ctr Melbourne Vic Australia;

Peter MacCallum Canc Ctr Melbourne Vic Australia;

Peter MacCallum Canc Ctr Melbourne Vic Australia;

Duke Univ Med Ctr Dept Obstet &

Gynecol Durham NC 27710 USA;

Princess Margaret Canc Ctr Div Med Oncol &

Hematol Toronto ON Canada;

Univ Michigan Sch Publ Hlth Dept Epidemiol Ann Arbor MI 48109 USA;

Univ Cambridge Strangeways Res Lab Dept Publ Hlth &

Primary Care Ctr Canc Genet Epidemiol;

Mem Sloan Kettering Canc Ctr Dept Epidemiol &

Biostat New York NY 10021 USA;

Peter MacCallum Canc Ctr Melbourne Vic Australia;

Peter MacCallum Canc Ctr Melbourne Vic Australia;

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正文语种 eng
中图分类肿瘤学;
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1. Going to extremes: determinants of extraordinary response and survival in patients with cancer [J] . Saner Flurina A. M., Herschtal Alan, Nelson Brad H., Nature reviews Cancer . 2019,第6期

机译：转向极端：癌症患者的非凡反应和生存的决定因素
2. Pathologic response after neoadjuvant therapy is the major determinant of survival in patients with esophageal cancer. [J] . Meredith KL, Weber JM, Turaga KK, Annals of surgical oncology . 2010,第4期

机译：新辅助治疗后的病理反应是食管癌患者生存的主要决定因素。
3. Determinants of tumor response and survival with erlotinib in patients with non--small-cell lung cancer. [J] . Perez Soler R, Chachoua A, Hammond LA, Journal of Clinical Oncology . 2004,第16期

机译：非小细胞肺癌患者厄洛替尼的肿瘤反应和生存率的决定因素。
4. Kernel Mixture Survival Models for Identifying Cancer Subtypes, Predicting Patients Cancer Types and Survival Probabilities [C] . Tomohiro Ando, Seiya Imoto, Satoru Miyano International Workshop on Bioinformatics and Systems Biology . 2004

机译：核混合物鉴定癌症亚型的存活模型，预测患者癌症类型和生存概率
5. An investigation of the determinates of survival in patients with inoperable non-small cell lung cancer: The role of the systemic inflammatory response [D] . Forrest, Lynn M. 2004

机译：不可手术的非小细胞肺癌患者生存决定因素的研究：全身炎症反应的作用
6. TP53 Status Patient Sex and the Immune Response as Determinants of Lung Cancer Patient Survival [O] . Donald Freudenstein, Cassandra Litchfield, Franco Caramia, 2020

机译：TP53的状态患者的性别和免疫反应是肺癌患者生存的决定因素
7. Table 5.5.a.1 Tumor size and treatment (rate of resectability) Figure 5.5.a.2 Cumulative survival of the patients after pancreatectomy for TS1 cancer according to residual tumors Figure 5.5.a.3 Cumulative survival of the patients with TS1 cancer according to extent of lymph node dissection Figure 5.5.a.4 Combined resection of portal vein and cumulative survival of the patients after pancreatectomy for TS1 cancer of UICC Stage IIa or IIb in the pancreatic head Figure 5.5.a.5 Combined resection of peripancreatic plexus and cumulative survival of the patients after pancreatectomy for TS1 cancer of UICC Stage IIa or IIb in the pancreatic head Figure 5.5.a.6 Combined resection of peripancreatic plexus when there is no plexus infiltration and cumulative survival of the patients after pancreatectomy for TS1 cancer of UICC Stage IIa or IIb in the pancreatic head Figure 5.5.a.7 Combined resection of artery and cumulative survival of the patients after pancreatectomy for TS1 cancer of UICC Stage IIa or IIb in the pancreatic head Figure 5.5.a.8 Combined resection of portal vein and cumulative survival of the patients after pancreatectomy for TS2 (2.1-4.0 cm) cancer of UICC Stage IIa or IIb in the pancreatic head Figure 5.5.a.9 Combined resection of peripancreatic plexus and cumulative survival of the patients after pancreatectomy for TS2 (2.1-4.0 cm) cancer of UICC Stage IIa or IIb in the pancreatic head [O] . 2007

机译：表5.5.a.1肿瘤大小和治疗（重新切性率）图5.5.a.2根据残留肿瘤对TS1癌胰腺切除后患者的累积存活图5.5.A.3累积存活根据淋巴结解剖的程度，TS1癌症的患者图5.5.A.4在胰头胰腺IIA或IIB癌症术后胰岛切除术后的门静脉和累积患者的累积存活图5.5。 A.5在胰头术后IIA或IIB胰腺切除术后，患者胰腺癌丛和患者累积存活的组合图5.5.A.6当没有丛浸润时，围裙丛生的围嘴巴丛的切除胰腺切除术后胰腺切除术后胰腺炎癌症的累积存活图5.5.A.7在TS1癌症胰腺切除后患者的动脉和累积存活的组合UICC阶段IIA或IIB在胰头图5.5.A.8在胰头胰腺阶段IIA或IIB癌症的胰腺切除后，患者的门静脉和累积患者的累积存活率图5.5.A.9在胰头胰腺阶段IIA或IIB的胰腺切除术后胰腺切除术后患者患者患者患者的累积生存的组合和胰腺头

Going to extremes: determinants of extraordinary response and survival in patients with cancer

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