Dose adjustments driven by patients' own symptom reports, tested against clinician judgement
Patients report symptoms on their phone each week; a set of rules turns severe or worsening symptoms into a dose hold or reduction before the next clinic visit. This could keep people on treatment longer and feeling better.
Protocolised dose-modification algorithms triggered by weekly PRO-CTCAE reports (with nurse review), compared in a randomised trial with standard clinician-assessed dose modification at scheduled visits. Builds on the randomised evidence that symptom monitoring with alerts improved QoL and survival in chemotherapy patients, extending it to dosing decisions for oral agents.
- Wrong doses · Most drug doses were chosen as the highest a person can tolerate, which is often more than they need.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.
- Patients lack understanding, navigation and agency · Most patients cannot understand their options, find trials, or push back, so decisions are made for them.
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not linked directly; found by shared links- IdeaAnalyse and dose by sex: women get more toxicity from many cancer drugs at the same dose
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Shares Wrong doses, Toxicity and quality of life are undervalued, Small-molecule kinase inhibitors.
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Shares Wrong doses, Toxicity and quality of life are undervalued, Small-molecule kinase inhibitors.
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Shares Wrong doses, Toxicity and quality of life are undervalued.
- IdeaReport time toxicity, the days a treatment consumes, in every trial and decision aid
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- IdeaDefine tolerability endpoints as rigorously as efficacy endpoints
Shares Wrong doses, Toxicity and quality of life are undervalued.