What is the Biology Underlying a Mixed Response?

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As a second part of a recent video I did that introduces the concept of a mixed response in lung cancer (or many other cancers) and how we might manage that situation, I wanted to cover the biology of what is presumably occurring.  Here's a video that covers this issue, as well as the implication that we can learn more about this by doing multiple biopsies, more than is considered as the typical standard now.

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How do we manage a "mixed response" to lung cancer treatment?

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Here's a brief video that explains my approach to a so-called "mixed response" to treatment for a lung cancer.  

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There isn't a formal teaching or "best answer" about how to approach this issue, but what I explain here is a common and I think very sensible strategy for a still controversial clinical setting (if I do say so myself).  I'd welcome your comments.

I hope you find it helpful if you or someone you care about faces this situation.

Heterogeneity in EGFR Mutations: Explaining a "Mixed Response" to EGFR TKIs in Patients with a Reported Mutation

Article

One of the questions that comes up fairly frequently is what to make of a "mixed response" to systemic therapy: after several weeks or months of treatment, a scan shows some areas of known disease shrinking, but others are growing.  Why might this happen? What does it mean? And what should it lead us to do?