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  • 1
    Electronic Resource
    Electronic Resource
    Assessing the clinical impact of prognostic factors: When is "statistically significant" clinically useful? (1998)
    Springer
    Breast cancer research and treatment 52 (1998), S. 305-319 
    Details
    ISSN: 1573-7217
    Keywords: tumor markers ; prognostic factors ; predictive factors ; breast cancer ; patient management ; treatment decisions
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Very few tumor markers have been recommended for routine clinical care of patients with breast cancer [1]. A framework to determine the clinical utility of tumor markers is required. In a previous publication, a "Tumor Marker Utility Grading System" (TMUGS) was proposed [2]. TMUGS included a semi-quantitative grading scale (0-3+) which can be used to assign a score to a given tumor marker for a given outcome. Only those markers that are felt to be sufficiently strong to influence a therapeutic decision that results in improved clinical outcome for the patient are recommended. The studies from which data are used to assign a TMUGS grade can be placed into one of five Levels of Evidence (LOE). An extension of TMUGS ("TMUGS-Plus") is now proposed in which the relative strength of a prognostic or predictive factor can be estimated and expressed in terms of a risk ratio (RR) for prognostic factors or benefit ratio (BR) for predictive factors. Three categories of prognostic factors and three categories of predictive factors are proposed (strong, moderate, and weak). It is recommended that only LOE type I studies (prospective, highly powered studies of the tumor marker, or meta-analysis of LOE II or III datasets), be used to estimate the RR or BR of a given factor. Finally, a matrix, based on assumptions of acceptable absolute benefits relative to risks, is proposed in which any given tumor marker can be assessed for its clinical utility. TMUGS-Plus should aid in the assessment of published data regarding clinical utility of tumor markers. Perhaps more important, clinical investigators can use TMUGS-Plus to design tumor marker studies that will fulfill criteria for clinical utility, resulting in more rapid acceptance of tumor markers for routine clinical use.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006197805041
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  • 2
    Electronic Resource
    Electronic Resource
    Circulating tumor markers in breast cancer: Accepted utilities and novel prospects (1998)
    Springer
    Breast cancer research and treatment 52 (1998), S. 239-259 
    Details
    ISSN: 1573-7217
    Keywords: tumor markers ; tumor-associated antigens ; serum markers ; breast cancer ; metastatic disease
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Detecting and/or monitoring changes in circulating tumor markers might assist in evaluating cancer risk, diagnosis, prognosis, or response to treatment. Several categories of circulating tumor markers have been investigated in breast cancer. These categories include classical tumor-associated antigens, such as CEA and CA 15-3, markers of tumor biology, including markers of angiogenesis, adhesion, and invasion, and antibody response to tumor-associated antigens such as HER2/neu and p53. We used a recently proposed Tumor Marker Utility Grading System to evaluate the use of several circulating tumor markers for different clinical utilities in breast cancer. While there are no tumor markers with established clinical utilities for most uses, tumor-associated antigens can be used for monitoring patients with metastatic disease. In addition, markers of tumor biology such as the circulating extracellular domain of HER2/neu might be useful in determining not only prognosis, but also response to specific treatments. However, further investigations are required to further assess the utility of individual tumor markers for specific clinical uses.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1006137619153
    Location Call Number Limitation Availability
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    Paper (German National Licenses)
    Fulltext
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