Who Are The Super Responders To Cancer Therapies?

Vinay Prasad MD, MPH Division of Hematology Oncology in the Knight Cancer Institute Department of Public Health and Preventive Medicine Oregon Health and Science University, Portland, OR

Dr. Prasad

MedicalResearch.com Interview with:
Vinay Prasad MD, MPH 
Division of Hematology Oncology in the Knight Cancer Institute
Department of Public Health and Preventive Medicine
Oregon Health and Science University, Portland, OR 

Medical Research: What is the background for this study? What are the main findings?

Dr. Prasad: Super responders to cancer drugs has become a hot topic.  It seems like we keep hearing about patients who were treated with some drug, and had a tremendous response.  Often, subsequent genetic sequencing explains the result.  In our investigation, we wanted to look at these responses in a systematic way.  We wanted to ask:  if you looked at every published report of a super responder, what can we learn? 

Medical Research: What should clinicians and patients take away from your report?

Dr. Prasad: We validated a few things that clinicians know:

Targeted therapies, particularly mTOR inhibitors are common among these cases.  We also found that many cases did not report potentially useful information, like the number of prior lines of therapy, best response and duration of response to a prior line.  Many did not report the number of similar patients who had to be treated with the drug to identify the super response.  In some cases, it seemed like a super responder was actually a patient who had great responses to several drugs, or simply indolent biology.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Prasad: The major take home point is that we need a standardized set of reporting criteria for super responders.  We need people to tell us in detail information for these 4 major points:

  1.  Demographic data:  What cancer does the pt have/ how old are they now/ How old were they when was it discovered/ what is their sex/ race/  How do they look and feel/  what is their performance status/  what is the performance status when they were diagnosed/  how was the cancer found/ any prior history of cancer/  Is the diagnosis biopsy proven?/
  1.  Cancer treatment history:  How many lines of therapy has the patient had/  What was the response to each of these therapies/  what were all of the prior PFS intervals/  What was the best duration of response to a prior therapy/ what were all of the drugs the pt has gotten/  what doses/ what duration/  If prior therapies were stopped was it for progression or intolerance
  1.  Origin of the exceptional response story:  How was this case discovered/  How many other people were treated similarly to find this case
  1.  Ongoing updates:  How long has the response gone on for?  What is the last status update of the patient?   Did the author of the exceptional response story call the patient at the time of writing the vignette and update the last known status?

Citation:

Mayo Clin Proc. 2015 Nov 3. pii: S0025-6196(15)00684-9. doi: 10.1016/j.mayocp.2015.08.017. [Epub ahead of print]

Characteristics of Exceptional or Super Responders to Cancer Drugs.

Prasad V1, Vandross A2.

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Dr. Vinay Prasad (2015). Who Are The Super Responders To Cancer Therapies? 

Last Updated on December 2, 2015 by Marie Benz MD FAAD

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