New System For Reporting Toxicity Burden Of Cancer Treatment

A new system for reporting the relative toxicity burden of different cancer treatments is proposed in an Article published early Online and in the July edition of The Lancet Oncology.

Professor Andy Trotti, H Lee Moffitt Cancer Centre, University of South Florida, Tampa, Florida, USA and colleagues assessed deficiencies in established methods for summarising adverse events, and devised their new method.

The new system, named TAME, places traditional adverse-event data into three concise risk domains: short term toxicity (T), adverse long term effects (A) and mortality risk (M), which are calculated for each treatment programme to generate an end-result (E) summary index.

The authors say: “This is an entirely new concept in risk assessment. It was specifically designed for the evaluation of cancer treatments. Traditional safety reporting methods were designed for low-risk non-cancer treatments, and are simply overwhelmed by the amount of toxicity data generated in cancer treatment programs. Thus, a new way to look at risk that is more relevant to oncology is needed.”

Despite being in the early stages of development, TAME has managed to identify differences of up to 500% in acute toxicity burden between certain cancer treatments. Established methods only detected a 170% difference in short term effects between those treatments. Established summary methods were also found to disregard a large amount of important information, and only permit comparing rates of each type of side effect (in cancer treatments there are dozens of types), whereas TAME includes all types of severe side effects, and considers their relative frequency, using a concise scoring system. However there was little difference between TAME and established methods in detecting the variation of risk in events that happened late in treatment.

TAME aims to provide a “side-effects” summary index for each treatment, so that the “total toxicity price” of the various options is clear to patients and doctors before a particular course of treatment is chosen.

The researchers used data from five trials by The Radiation Therapy Oncology Group (RTOG) on patients with head and neck cancer, done between 1991 and 2000. The trials involved 13 treatment groups and more than 2,300 patients. The adverse events focused on in the study included mouth sores, skin reactions, swallowing difficulty, nausea, and blood counts.


The TAME system focuses on consolidating clinically meaningful events that have high symptom burden or that might compromise the delivery of treatment. TAME values are presented in a way that makes it easier to directly compare overall safety among treatment options. Patients have a growing number or choices in cancer treatment, and many want to be able to choose based on relative safety and quality of life, as well as effectiveness. TAME is a new metric that simplifies direct comparison of a large volume of very complex safety data.

The authors also believe that the TAME system will be applicable to multiple disease sites, although this will require site-specific development, and hope that one day patients and clinicians will be able to ask: “How ‘TAME’ are each of these treatment options”, for a number of different types of cancer.

They conclude that TAME reporting provides a concise and uniform method to compare relative safety among cancer treatment options. They say: “Routine implementation and acceptance [of TAME} might occur through documenting its accuracy in additional datasets and disease sites….and assessment of its use in clinical decision making.”

Source: University of South Florida

Related stories:

Mayo researchers explore issues related to multiple myeloma treatment
Multiple myeloma (MM) is a cancer of plasma cells that affects approximately 3 in 100,000 people each year. Although there is no cure for this disease, researchers have developed treatments that help relieve pain, control complications, and slow the progress of MM in many patients. Unfortunately, some of the most effective therapies also have toxic side effects that can pose serious health risks and reduce quality of life. In the October issue of Mayo Clinic Proceedings, two articles authored by Mayo researchers address the issue of how to balance the risks and benefits associated with MM treatments.
CRC screening before Medicare age could save millions in federal health-care dollars
A screening program for colon cancer in patients starting ten years prior to Medicare eligibility, at age 55 instead of Medicare's 65, would save at least two dollars for every dollar spent, according to a new study presented at the American College of Gastroenterology's 73rd Annual Scientific Meeting in Orlando.
New therapeutic treatment approach improves survival in esophageal cancer patients
A study released at the 73rd Annual Scientific Meeting of the American College of Gastroenterology in Orlando found that a new therapeutic treatment, when delivered endoscopically and used in combination with chemotherapy and radiation therapy, improved survival rates in patients with locally advanced esophageal cancer. Cancer of the esophagus often has a poor survival rate.
Implementation of breast health guidelines for developing countries published
A special supplement of the Oct. 15 journal Cancer for the first time details guidelines for low- and middle-income countries to implement breast cancer programs to detect and treat the most common disease among women worldwide.
Pediatric study finds alternatives for radiation of low-grade brain tumors
A multi-institutional study led by researchers at The University of Texas M. D. Anderson Cancer Center has found that using chemotherapy alone and delaying or avoiding cranial radiation altogether can be effective in treating pediatric patients with unresectable or progressive low-grade glioma. The study was presented Sunday at the 40th annual International Society of Pediatric Oncology Meeting in Berlin, Germany.
Study finds genetic variant plays role in cleft lip
University of Iowa researchers and collaborators have found, in a previously identified gene, a variation that likely contributes to one in five cases of isolated cleft lip. It is the first time a genetic variant has been associated with cleft lip alone, rather than both cleft lip and palate.
Battling cancer, one cell at a time
New research suggests that the identification and examination of key cell signaling events required for initiation and progression of cancer might be best accomplished at the single cell level. The research, published by Cell Press in the October issue of the journal Cancer Cell, provides new insight that may lead to better diagnosis and treatment of some complex cancers.
New Stanford diagnostic test for rare leukemia appears to give faster results, study finds
A new twist on a well-known cell sorting technique may allow physicians to diagnose rare leukemias in hours instead of weeks, according to a study by researchers at the Stanford University School of Medicine and UC-San Francisco. The clinical promise of the Stanford-developed approach, which eavesdrops on individual cells to decipher potentially dangerous molecular conversations, is likely to extend to many other disorders in which cell-signaling pathways are disrupted.

News discussion:

Medicine & Health news