Forecasting in Oncology.

Staging and Types of Cancer
Cancer is staged using the TNM system or a number system. Both classify a cancer by how far it has spread. The number system classifies cancer stages from 0 to 4, with 0 meaning no cancer or cells with the potential to become cancerous, 4 meaning metastatic or advanced cancer which has spread from the initial site to another part of the body. Within each stage, patients are often treated with multiple types of therapy, ranging from radiation, surgery, chemotherapy and targeted or immunotherapies. When modelling, each different treatment the patient receives is termed a line of therapy.
There are several terms which describe the type of therapy a patient can receive. Neoadjuvant, also known as induction therapy, describes therapy which is given before a main treatment, usually surgery, to reduce the tumour. Adjuvant therapy, is given in addition to the main therapy to prevent recurrence. Curative treatment aims to destroy the cancer, and palliative treatment aims to relieve symptoms and pain. When forecasting, recurrence is often grouped with relapsed, to refer to the return of the cancer after a period of improvement or during a time in which the cancer could not be detected. These can be further defined based on where the tumour is located upon relapse, known as local recurrence or regional recurrence.
Biomarkers are biological molecules which are found in blood, cells or tissues and can be used to measure normal processes or disease. Biomarkers can be used to assess which treatment would be most suitable for a patient, or how well a patient responds to treatment. Over the past few years, many therapies have been designed which target the PD-1 biomarker. These therapies cover melanoma, non-small cell lung, bladder, and urothelial cancers. Biomarkers are typically applied within the epidemiology or patient definition section of a model, where testing and the results can be inputted in order to more accurately calculate your target patient population.
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