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Toxicities from cancer treatment: should we change our way of reporting?

Presentation by Dr. Paolo Bossi at the TAO Congress on 19/20 November 2015


Dr. Paolo Bossi discusses the question whether the assessment of adverse events in cancer treatment needs to be changed. The findings concerning toxicities in randomized controlled trials may not always be transferable to other patients, for example, due to patient selection bias or inclusion of too few patients in the trials. Late effects cannot be assessed when drugs receive fast-track approval or the duration of the follow-up is not indicated; Dr. Bossi also reviews other reasons why most trials fail to detect late toxicities.

Besides, many trials only report grade 3 toxicities or higher and do not take into account the duration of such adverse events; however, lower grade toxicities that last for several months may affect the patients’ quality of life to the same extent or more than high-grade toxicities that last only for a short time. Scientific evidence also shows that health professionals often underestimate the burden and severity of symptoms; detailed patient-reported questionnaires help to discover more adverse events compared with unstructured reporting.

Dr. Paolo Bossi, National Cancer Institute, Milan, Italy

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