EBOT key terms

A five-point scale (0 to 4, plus 5 for death) describing how much a patient's daily functioning is limited by disease. It guides treatment intensity, trial eligibility, and prognosis, with higher scores indicating greater impairment.

A 0 to 100 scale in deciles describing a patient's ability to carry out normal activity and self-care. Lower scores reflect greater dependence and are used to judge fitness for aggressive therapy and to stratify trial populations.

A system classifying malignant disease by primary tumour extent (T), regional lymph node involvement (N), and distant metastasis (M). Combined into stage groups, it standardises prognosis estimation, treatment selection, and comparison across studies.

A structured multidisciplinary evaluation of older adults covering function, comorbidity, cognition, nutrition, medication, and social support. It identifies vulnerabilities that predict chemotherapy toxicity and informs treatment modification or supportive interventions.

A standardised set of rules for measuring tumour burden on imaging and categorising change as complete response, partial response, stable disease, or progression. It relies on measurable target lesions and reproducible measurement technique.

Adapted tumour-response rules for immunotherapy that allow for initial enlargement or appearance of lesions before benefit, and require confirmation of progression on repeat imaging. They reduce premature discontinuation of agents that may still be working.

Apparent worsening of tumour burden on imaging caused by inflammation, necrosis, or treatment effect rather than true cancer growth. It is most associated with immunotherapy and with chemoradiation in brain tumours, and usually resolves on later scans.

Absence of residual invasive tumour in the resected specimen after neoadjuvant therapy, sometimes including absence of nodal disease depending on the definition used. It is a prognostic marker and an endpoint in neoadjuvant trials.

Systemic or radiation treatment given before planned definitive surgery to shrink tumour, test drug sensitivity in vivo, or treat micrometastases early. It can convert borderline resectable disease to operable and informs postoperative planning.

Treatment given after macroscopically complete resection, aiming to eliminate occult micrometastatic disease and reduce recurrence risk. Choice depends on stage, histology, biomarker profile, and estimated absolute benefit versus toxicity.

A scheduled meeting of surgeons, medical and radiation oncologists, radiologists, pathologists, and allied staff who review cases and agree on management recommendations. It improves guideline concordance and coordination but requires documented decisions and accountability.

The process of giving a patient adequate information about diagnosis, options, expected benefits, material risks, and alternatives, then obtaining voluntary agreement. It must be documented, revisited when circumstances change, and respect the patient's decision-making capacity.

A patient's ability to understand relevant information, appreciate the consequences of choices, reason about options, and communicate a decision. It is task-specific and assessed clinically; lacking it triggers substitute decision-making processes.

An ongoing conversation in which a person records goals, values, and preferences for future care, sometimes naming a substitute decision-maker. It guides treatment when the patient can no longer participate and reduces unwanted interventions.

A conversation clarifying what matters most to a patient and aligning treatment plans with those priorities, including what to avoid. It differs from informed consent for a specific procedure and should occur early and be revisited.

Interdisciplinary care focused on relieving suffering and improving quality of life for patients with serious illness and their families. It addresses physical, psychological, social, and spiritual needs and can be delivered alongside curative-intent treatment.

Fever (generally 38.3 degrees Celsius once or 38.0 degrees Celsius sustained) with an absolute neutrophil count below 500 per microlitre, or expected to fall below that. It is a medical emergency requiring prompt cultures and empiric broad-spectrum antibiotics.

Life-threatening organ dysfunction or haemodynamic instability in a neutropenic patient with suspected infection. It demands immediate resuscitation and antibiotics, with escalation guided by cultures, imaging, and response rather than waiting for confirmation.

The number of circulating neutrophils, calculated from the white cell count and the percentage of segmented and band forms. Values below 500 per microlitre define severe neutropenia and drive infection risk and dose decisions.

A growth factor that stimulates neutrophil production, shortening the duration of chemotherapy-induced neutropenia. It is used as primary prophylaxis when febrile neutropenia risk is high, and as secondary prophylaxis after an event.

A metabolic emergency from rapid destruction of malignant cells, producing hyperkalaemia, hyperphosphataemia, hyperuricaemia, and hypocalcaemia, with risk of acute kidney injury and arrhythmia. Prevention with hydration and urate-lowering therapy is central in high-risk disease.

A recombinant urate oxidase that rapidly converts uric acid to soluble allantoin, used to prevent or treat hyperuricaemia in high-risk tumour lysis. It can cause haemolysis in G6PD deficiency and invalidates uric acid measurements for a period.

Pressure on the spinal cord or cauda equina from epidural tumour, causing back pain, weakness, sensory loss, or bladder and bowel dysfunction. It is an emergency needing urgent imaging and corticosteroids before definitive radiation or surgery.

Obstruction of the superior vena cava by tumour, thrombus, or device, producing facial and upper limb swelling, distended veins, and breathlessness. Management depends on histology and acuity, and includes supportive measures, radiation, stenting, or systemic therapy.

Raised serum calcium caused by tumour secretion of parathyroid hormone-related peptide or by osteolytic metastases. Symptoms include confusion, constipation, polyuria, and dehydration, and treatment relies on intravenous fluids plus antiresorptive agents.

An intravenous bisphosphonate that inhibits osteoclast activity, used to reduce skeletal-related events in bone metastases and to treat malignancy-associated hypercalcaemia. Renal function and dental status must be checked before repeated dosing.

Exposed, non-healing bone in the jaw occurring in patients treated with antiresorptive or antiangiogenic drugs, often after dental extraction. Prevention relies on dental assessment before starting therapy and avoiding invasive dental work during treatment.

Delayed tissue death in previously irradiated brain or other tissue, appearing months to years later with imaging changes that can mimic tumour recurrence. Diagnosis may need advanced imaging or biopsy, and management is often conservative with corticosteroids.

A monoclonal antibody blocking regulatory receptors such as CTLA-4, PD-1, or PD-L1, restoring T-cell attack on tumour cells. Response patterns differ from chemotherapy, and immune-related toxicity can affect almost any organ.

Organ inflammation caused by checkpoint blockade, commonly affecting skin, gut, thyroid, lung, and liver, and occasionally the heart or nervous system. Management is graded and uses treatment interruption, corticosteroids, and sometimes additional immunosuppression.

Inflammation of the colon from checkpoint inhibitor therapy, presenting with diarrhoea, abdominal pain, or blood in stool. Severe cases need high-dose corticosteroids, exclusion of infection, and sometimes infliximab, with permanent discontinuation considered.

Drugs designed to inhibit specific molecules or pathways driving a cancer, such as mutated kinases or overexpressed receptors. Benefit usually depends on the tumour harbouring the corresponding biomarker, and resistance often emerges through secondary alterations.

An oral small molecule blocking kinase enzymes that drive proliferation or survival signalling in cancer cells. Effects depend on the specific target, and common issues include drug interactions, hepatic enzyme rises, and skin or gastrointestinal toxicity.

A measurable tumour or host characteristic that indicates likely benefit or harm from a particular treatment, such as a mutation, amplification, or protein expression level. It differs from a prognostic marker, which forecasts outcome regardless of therapy.

A test validated and often required to identify patients for whom a specific drug is appropriate, such as a mutation assay before a matched inhibitor. Its analytical performance and specimen adequacy directly affect treatment access.

The amount of drug delivered per unit time relative to the planned regimen, accounting for dose reductions and delays. Maintaining it matters in curable settings, where reductions can compromise outcome, but must be balanced against toxicity.

The number of patients who must receive an intervention for one additional patient to experience the specified benefit. It is the reciprocal of the absolute risk reduction and falls as benefit increases.

The arithmetic difference in event rates between control and treatment groups, expressed on an absolute scale. It reflects real clinical benefit better than relative measures and depends heavily on baseline risk.

A ratio comparing the instantaneous event rate in one group with another over follow-up, commonly reported in time-to-event trials. A value below one favours the treatment, but it does not by itself convey the size of absolute benefit.

The time from randomisation or treatment start until documented disease progression or death from any cause. It is used as a primary endpoint in trials but does not always translate into improved overall survival or quality of life.

Analysis that includes all randomised participants in the groups to which they were assigned, regardless of adherence or crossover. It preserves randomisation and gives an unbiased estimate of the effect of offering a treatment policy.

A study in which participants are allocated by chance to interventions, so that known and unknown confounders are balanced between groups. It provides the strongest evidence for causal treatment effects when properly designed and reported.

Analysis restricted to participants who received treatment and were followed according to the protocol. It can estimate efficacy under ideal conditions but is vulnerable to bias because the compared groups may no longer be balanced.

An early study, often dose-escalating, whose main aims are safety, tolerability, and identifying a recommended dose, usually in a small heterogeneous population. Modern designs add expansion cohorts to look for early signals of activity.

A large randomised comparison of a new approach with the current standard, designed to establish efficacy and safety with adequate power for clinically meaningful endpoints. Results usually inform regulatory approval and guideline changes.

The highest dose tested at which a predefined proportion of participants experiences dose-limiting toxicity. It is a conventional phase I endpoint for cytotoxic drugs but is less appropriate for targeted and immune agents with flat dose-response curves.

A predefined adverse event of specified grade or organ impact that prevents further dose escalation in a trial. Its definition is protocol-specific and determines the recommended dose carried forward into later studies.