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Rational trial design to include biomarkers in risk stratification requires tumor multisampling and reliable delineation of ITGH and tumor evolution.
As always, our eagerness to advance this field must be tempered with rational trial design, with statistically appropriate analyses with independent validation as required and always with an eye towards the allocation of patient resources and safety.
Nevertheless, phase I trial candidates and physicians highly support biomarker selection (Miller et al, 2013), hoping that rational trial selection will improve the odds of response and relevance to cancer treatment.
If we can match the process of consent to the attitudes and expectations of patients and relatives, more rational trial conduct is likely to result to the benefit of all involved in ICU trialsand society.
The pharmacokinetic (PK) profiles obtained in animal models and human volunteers are combined with values of drug potency in vitro and efficacy in animal models to calculate PK-PD indices that inform rational trial design (9 – 11).
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The expanding knowledge of the underlying molecular abnormalities in this once very poorly understood cancer should allow for increasingly rational clinical trial design and improved patient outcomes.
These new approaches to drug development are very useful for predicting pharmacokinetic outcomes in early phase clinical studies where models can provide rational clinical trial designs.
In breast cancer this paradigm was changed most clearly with the development of trastuzumab, which included translation of preclinical models into a rational human trial demonstrating improved survival compared with the sequential application of the same agents (chemotherapy and trastuzumab) [ 4, 5].
These observations may be beneficial for the design of more rational therapeutic trials associating CDDP, 5-FU and FA.
Rational clinical trials using these inhibitors should be designed with the aim of boosting the cytotoxic action of chemotherapy in PDAC.
Performing molecular studies on all AS patients will allow us to define the pathophysiology of this disease and guide rational clinical trials.
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