1. Session 4: Quality of life and targeted therapy

2. Panel: Christoph ZielinskiViennaAustrialecture Jan VermorkenAntwerpBelgium Jeffrey MyersHoustonTexas, USA Lisa LicitraMilanoItaly Johan WennerbergLundSwedenmoderation

3. Health: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity is a fundamental human right.” WHO, 1948

4. Disability: "... any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being." WHO 1980

5. QoL: "Quality of life refers to patient's appraisal of and satisfaction with their current level of functioning as compared to what they perceive to be a possible ideal.” (Cella & Tulsky. Measuring quality of life today: Methodological aspects. Oncology 1990;4(5):29-38)

6. How do we measure QoL? E. Hammerlid, thesis, 1997

7. How do we measure H&N QoL? E. Hammerlid, thesis, 1997

8. EORTC QLQ-C30 (version 3)

12. Whats the Quality of Life for H&N Ca Patients? Mats Nordgren, Thesis: HRQL in H&N Ca; A five-year prospective multicenter study, 2005

13. HRQL in oral cancer survivors Mats Nordgren, Thesis: HRQL in H&N Ca; A five-year prospective multicenter study, 2005

14. Targeted therapy – Therapeutic strategies Signal transduction pathwaysEGFR AntiangiogenesisVEGF Unique metabolic requirementsIodine 131 Hypoxic cell sensitizers

15. Promises for the future! Targeted therapy! Advertisment, EJC 2006;42

16. Depicting a bright future … Advertisment, Acta Oncologica 2005; 44

17. What’s the base of evidence?

18. Questions to consider: - Which are the common types of toxicity induced through „targeted“ treatment? - Can we reduce chemotherapeutic dosage – and thereby toxicity - by adding targeted drugs to the treatment regimen?

19. Issues to discuss (1): - The learning curve to handle toxicities - The relationship of QoL and survival in targeted therapy - Which evidence level (1-8) has the data collection?

20. Issues to discuss (2): -May QoL (QLQ C-30; H&N35) serve as an outcome end point? -Can we anticipate new toxicities? -QoL v.s. cost/benefit of targeted therapy.

21. What can we expect to achieve? Advertisment, EJC 2006;42

22. ”Is our enthusiasm adequate?”