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When a scan shows most tumours shrinking but one growing, that odd lesion holds the escape mechanism. Sampling it, and treating it locally, should be routine.
Mixed responses are common on targeted therapy and immunotherapy, yet the discordant lesion is rarely biopsied and the systemic drug is often abandoned. The proposal is a protocolised pathway: automated lesion-level response tracking on CT, biopsy of the outlier, targeted sequencing, and continuation of systemic therapy with local ablation or SBRT to the outlier lesion.
Shares Tumour heterogeneity and clonal evolution, Acquired resistance to every therapy, Melanoma, Non-small-cell lung cancer.
Shares Tumour heterogeneity and clonal evolution, Acquired resistance to every therapy, Melanoma, Non-small-cell lung cancer.
Shares Tumour heterogeneity and clonal evolution, Acquired resistance to every therapy, Comprehensive genomic profiling, Non-small-cell lung cancer.
Shares RECIST, Oligometastatic disease.
Shares Oligometastatic disease, Tumour heterogeneity and clonal evolution, SBRT / SABR (stereotactic radiotherapy), Non-small-cell lung cancer.
Shares Tumour heterogeneity and clonal evolution, Comprehensive genomic profiling, Non-small-cell lung cancer.
Shares RECIST, CT (computed tomography).