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When a tumor is said to be resistant or refractory to a drug, what does this mean and how is this determined?
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DonDizonMD (Physician - Oncology - Hematology/Oncology (Verified) ) - 07 / 10 / 2012
Drug resistance or refractoriness means that the cancer is no longer responding, or is progressing to that particular agent. usually it also means that the class of agent is not likely to work either, although this is not necessarily true. For example, one can have disease progression on paclitaxel when given every 3 weeks, which means continued treatment is not likely to work (hence, the tumor is resistant to paclitaxel). But, one can still see a response if paclitaxel is given every week. The determination of drug resistance or refractoriness is tumor-specific and not uniformly defined. It's most commonly employed as a concept in the treatment of recurrent ovarian cancer, where an arbitrary treatment-free interval (that is, the TFI or the time from the stop of first-line treatment to the time the second-line treatment starts) of six months is used to define platinum-resistant (less than 6 months TFI) or platinum-sensitive (6 months or longer TFI). We would re-administer carboplatin in the context of platinum-sensitive disease, but would not in someone who was platinum-resistant.
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