Efficacy of Individualized Cancer Management

Kangla Tsung
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Abstract

Individualized cancer management is the opposite of the standardized care adapted for current clinical practice by the mainstream medicine. It is not a fancy concept but a logic and inevitable reality derived from the intrinsic characteristics of cancer and host antitumor response. The question is not whether it should be done but how it is done. One missing aspect of individualized management is how to measure its effectiveness. Unlike standardized management that compares therapy efficacy among different management plans by the statistical criteria on the entire groups of patients but not individual patient in the group, individualized management can measure the efficacy on individual patient. This is not only possible, but necessary. A true individualized cancer therapy is not only based on personal situation for each patient, but must also satisfy the criterion that the outcome of selected therapy is predictable for that patient, a feature that current standardized care does not have. Therapy selection based on the individualized assessment of the status of antitumor immunity in each patient is the essential part of individualized management. Thus, treating each patient according to the status of his antitumor immunity should be the most critical skills a physician needs to master when facing each individual cancer patient. In the past seven years, we have been exploring individualized management of cancer through recognizing and manipulating antitumor immunity in each patient. Our combined experiences indicate a significant benefit to patient survival with reduced costs even when such effort was not perfect in the past. With time and more learning, we see this practice becoming more and more practical in a clinical setting. When this individualized approach becomes guideline for cancer management, we will see a significant leap of clinical improvement on both patient survival and cancer cure rate
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个性化癌症管理的功效
癌症个体化治疗与主流医学为适应当前临床实践而采取的标准化治疗截然相反。它不是一个花哨的概念,而是从癌症的内在特征和宿主抗肿瘤反应中得出的逻辑和必然的现实。问题不在于是否应该这样做,而在于如何去做。个体化管理缺少的一个方面是如何衡量其有效性。与标准化管理不同的是,标准化管理是通过对整组患者的统计标准来比较不同管理方案的疗效,而不是对组内的单个患者进行比较,而个体化管理则可以衡量单个患者的疗效。这不仅是可能的,而且是必要的。真正的癌症个体化治疗不仅要根据每个患者的个人情况,还必须满足所选疗法的结果对该患者是可预测的这一标准,而目前的标准化治疗不具备这一特点。在对每位患者的抗肿瘤免疫状况进行个体化评估的基础上选择治疗方法,是个体化治疗的重要组成部分。因此,根据每个患者的抗肿瘤免疫状况进行治疗,应该是医生面对每个癌症患者时需要掌握的最关键的技能。在过去的七年中,我们一直在探索通过识别和控制每个患者的抗肿瘤免疫来实现癌症的个体化治疗。我们的综合经验表明,即使在过去这种努力并不完美的情况下,也能显著提高患者的生存率并降低成本。随着时间的推移和更多的学习,我们看到这种做法在临床环境中越来越实用。当这种因人而异的方法成为癌症治疗的指导原则时,我们将看到患者生存率和癌症治愈率都会有一个显著的飞跃。
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