Oncology Clinical Reference & Terminology
Evidence-based reference for oncologists, researchers, and clinical trial investigators. Comprehensive definitions of prognostic scoring systems, staging classifications, biomarker terminology, clinical trial endpoints, and essential oncology concepts for patient care and research.
Master Calculator Panels
Comprehensive multi-tool panels that combine related calculators for streamlined clinical workflows and decision-making.
Simultaneous calculation of R2-ISS staging (incorporating beta-2 microglobulin, albumin, LDH, and high-risk cytogenetics) and IMWG frailty assessment (age, comorbidities, functional status) for newly diagnosed multiple myeloma patients. This integrated panel enables personalized treatment intensity selection, predicts chemotherapy tolerance, guides clinical trial eligibility, and stratifies patients into distinct risk groups with validated survival outcomes. Essential for balancing disease biology with patient fitness in selecting optimal induction regimens (bortezomib-based, lenalidomide-based, carfilzomib combinations), determining transplant candidacy, and planning maintenance strategies in both fit and frail elderly populations.
Open PanelDual risk stratification using MASCC score (burden of illness, hypotension, COPD, solid tumor status, dehydration, age) and CISNE index (ECOG performance status, chronic cardiovascular disease, chronic pulmonary disease, mucositis, monocytes, stress-induced hyperglycemia) to identify low-risk febrile neutropenia patients suitable for outpatient oral antibiotic management versus high-risk patients requiring hospitalization and IV broad-spectrum antibiotics. Validated across diverse cancer populations and chemotherapy regimens, this panel reduces unnecessary hospitalizations, optimizes healthcare resource utilization, improves patient quality of life, and maintains safety standards per IDSA/ASCO guidelines. Critical for emergency department triage, oncology ward admission decisions, and clinical trial adverse event management.
Open PanelComprehensive symptom burden evaluation using ESAS-r (Edmonton Symptom Assessment System-revised) quantifying pain, tiredness, nausea, depression, anxiety, drowsiness, appetite, wellbeing, and shortness of breath on 0-10 scales, combined with PPS (Palliative Performance Scale) measuring ambulation, activity level, self-care, intake, and consciousness. This panel enables systematic longitudinal tracking of symptom trajectories, objective assessment of palliative intervention efficacy, standardized communication across multidisciplinary teams, identification of patients requiring urgent symptom management, and prognostication for end-of-life care planning. Essential for hospice referral timing, family counseling, advance care planning discussions, and quality metrics reporting in palliative oncology programs.
Open PanelUnified hepatocellular carcinoma workup integrating BCLC staging (tumor burden, portal vein invasion, extrahepatic spread linked to treatment algorithms), ALBI grade (objective albumin-bilirubin liver function assessment), Child-Pugh classification (cirrhosis severity), and MELD-Na score (transplant priority). This master panel streamlines multidisciplinary tumor board discussions, guides treatment allocation from curative options (resection, ablation, transplantation per Milan criteria) to palliative approaches (TACE, sorafenib, lenvatinib, immunotherapy combinations), predicts post-treatment outcomes, assesses transplant candidacy and urgency, and stratifies clinical trial eligibility. Incorporates global staging systems (HKLC, JIS, CLIP) for Asian versus Western population validation. Indispensable for hepatology-oncology collaboration and evidence-based HCC management per EASL/AASLD guidelines.
Open PanelComprehensive pulmonary nodule risk assessment comparing four validated prediction models: Lung-RADS standardized reporting (ACR classification 1-4), Brock/PanCan model (age, sex, family history, emphysema, nodule size, type, location, spiculation, count), Mayo Clinic model (smoking history, extrathoracic cancer, nodule diameter, spiculation, upper lobe location), and Herder model (smoking status, nodule characteristics, PET avidity). This integrated panel synthesizes screening CT findings with clinical context, guides interval follow-up versus biopsy decisions, minimizes false-positive workup of benign lesions, identifies high-risk nodules requiring immediate intervention, and standardizes radiologist-pulmonologist-thoracic surgeon communication. Essential for lung cancer screening programs, incidental nodule management protocols, and shared decision-making discussions regarding surveillance versus invasive diagnostics per Fleischner Society and NCCN recommendations.
Open PanelIntegrated localized prostate cancer risk stratification combining D'Amico classification (PSA, Gleason score, clinical stage into low/intermediate/high risk), CAPRA score (comprehensive preoperative nomogram predicting biochemical recurrence after radical prostatectomy or radiation), and Epstein criteria (strict active surveillance eligibility for very low-risk disease: PSA <10, Gleason 6, ≤2 positive cores, ≤50% involvement per core, no Gleason 4/5). This panel facilitates treatment discussions ranging from active surveillance (for very low/low risk), definitive local therapy (surgery, radiation for intermediate risk), to multimodal approaches (radiation+ADT, extended lymph node dissection for high risk). Essential for counseling patients on overtreatment versus undertreatment risks, selecting appropriate clinical trial cohorts, determining optimal ADT duration, and implementing risk-adapted follow-up protocols per AUA/NCCN guidelines.
Open PanelComprehensive RCC prognostication panel integrating five validated models: IMDC/Heng criteria for metastatic disease (Karnofsky performance, time to treatment, hemoglobin, calcium, neutrophils, platelets), MSKCC/Motzer criteria (Karnofsky performance, time to treatment, hemoglobin, calcium, LDH), Leibovich score for post-nephrectomy recurrence (tumor size, stage, grade, necrosis), SSIGN algorithm (stage, size, grade, necrosis combining TNM with pathology), and UISS system (stage, grade, ECOG). This master panel enables unified assessment across disease states from localized (surgical planning, adjuvant trial eligibility) to metastatic settings (first-line therapy selection: immunotherapy combinations, VEGF-TKIs), predicts response to targeted therapies and immune checkpoint inhibitors, guides surveillance intensity post-nephrectomy, and standardizes research endpoints across multicenter trials. Indispensable for personalized medicine approaches and comparative effectiveness research in kidney cancer.
Open PanelUnified lymphoma prognostic assessment integrating subtype-specific indices: IPI for diffuse large B-cell lymphoma (age, stage, LDH, performance status, extranodal sites), NCCN-IPI enhanced version (incorporating LDH ratio, specific extranodal sites), FLIPI for follicular lymphoma (age, stage, hemoglobin, LDH, nodal areas), and MIPI for mantle cell lymphoma (age, performance status, LDH, WBC). This comprehensive panel stratifies patients into distinct risk groups guiding treatment intensity (R-CHOP, dose-adjusted R-EPOCH, R-CHOP+radiation, CAR-T cell therapy timing), predicts survival outcomes across histologic subtypes, determines clinical trial eligibility and stratification factors, guides consolidation/maintenance strategies, and standardizes prognostic reporting in multicenter cooperative group studies. Essential for hematologists and hematopathologists implementing risk-adapted therapeutic approaches per NCCN/ESMO guidelines in both academic and community practice settings.
Open PanelTop 20 Essential Oncology Calculators for Clinical Practice & Research
Validated prognostic tools and staging systems most frequently utilized by oncologists, hematologists, researchers, and clinical trial coordinators. Each calculator is evidence-based with published validation studies and incorporated into major clinical practice guidelines (NCCN, ESMO, ASCO). Essential for daily clinical decision-making, treatment planning, patient counseling, clinical trial eligibility determination, and standardized documentation of prognostic factors in cancer research databases.
The Eastern Cooperative Oncology Group performance status (ECOG PS) scale is the most widely adopted functional assessment tool in oncology, measuring patient ability to perform activities of daily living on a 6-point scale (0=fully active to 5=dead). ECOG 0-1 patients are typically eligible for intensive chemotherapy regimens and clinical trials, while ECOG 2 patients may receive modified-dose therapy, and ECOG 3-4 patients are generally candidates for palliative care only. This single-item assessment is a powerful independent prognostic factor across all cancer types, predicting treatment-related toxicity, quality of life outcomes, and overall survival. Required documentation for nearly all oncology clinical trials, chemotherapy protocols, and radiation therapy planning. Inter-rater reliability is well-established, making it superior to more complex multidimensional scales for routine clinical use and research standardization.
Open CalculatorThe Karnofsky Performance Status (KPS) is a comprehensive 11-point functional capacity scale (0-100% in 10% increments) developed in 1949 and remaining widely used, particularly in neuro-oncology, radiation oncology, and palliative medicine. KPS ≥70% indicates ability to care for self and is often the threshold for clinical trial eligibility and aggressive treatment approaches, while KPS 50-60% suggests considerable assistance required, and KPS ≤40% indicates disabled patients requiring special care. More granular than ECOG (approximately KPS 90-100%=ECOG 0, 70-80%=ECOG 1, 50-60%=ECOG 2, 30-40%=ECOG 3, 10-20%=ECOG 4), KPS provides finer prognostic discrimination and is particularly valuable for longitudinal assessment of functional decline, hospice referral timing, and radiation therapy tolerance prediction in brain metastases, primary CNS tumors, and patients receiving palliative radiotherapy.
Open CalculatorThe Albumin-Bilirubin (ALBI) grade is an objective, evidence-based liver function assessment tool specifically developed and validated for hepatocellular carcinoma (HCC) patients, using only two readily available laboratory values: serum albumin and total bilirubin. ALBI stratifies patients into three grades (Grade 1: best liver function, Grade 2: intermediate, Grade 3: worst) with distinct survival outcomes. Multiple studies have demonstrated ALBI's superiority over Child-Pugh classification due to elimination of subjective variables (ascites, encephalopathy), better discrimination within Child-Pugh A patients, and more accurate prediction of treatment tolerance and survival across all HCC therapeutic modalities including resection, transplantation, ablation, TACE, and systemic therapy. ALBI is increasingly incorporated into modern HCC staging systems (ALBI-T, modified BCLC) and clinical trial stratification, with particular utility in Asian populations and patients receiving immune checkpoint inhibitor combinations.
Open CalculatorThe Child-Pugh classification is the historical gold standard for assessing cirrhosis severity and predicting prognosis in chronic liver disease, incorporating five variables: serum bilirubin, albumin, INR/prothrombin time, presence and severity of ascites, and hepatic encephalopathy grade. Total score (5-15 points) stratifies patients into Class A (5-6 points: well-compensated disease, 1-year survival ~100%), Class B (7-9 points: significant functional compromise, 1-year survival ~80%), and Class C (10-15 points: decompensated disease, 1-year survival ~45%). Essential for liver transplant evaluation (MELD-Na has replaced it for allocation but Child-Pugh remains clinically relevant), HCC treatment selection (surgery reserved for Child-Pugh A, TACE for A/B, sorafenib for B/C), and dosing adjustments for medications with hepatic metabolism. Limitations include subjective elements (ascites, encephalopathy) and ceiling effect in advanced disease, leading to ALBI and MELD score development for specific contexts.
Open CalculatorThe Barcelona Clinic Liver Cancer (BCLC) staging system is the most widely adopted and externally validated classification for hepatocellular carcinoma (HCC), endorsed by AASLD, EASL, and ESMO guidelines. BCLC uniquely integrates tumor characteristics (size, number, vascular invasion, extrahepatic spread), liver function (Child-Pugh), performance status (ECOG), and cancer-related symptoms to assign patients to stages (0=very early, A=early, B=intermediate, C=advanced, D=terminal) that directly link to evidence-based treatment algorithms. Stage 0/A patients receive curative-intent therapies (resection, transplantation, ablation), Stage B patients undergo transarterial chemoembolization (TACE), Stage C patients receive systemic therapy (atezolizumab-bevacizumab, sorafenib, lenvatinib), and Stage D patients receive supportive care only. The system has been repeatedly validated across Western and Asian populations, though regional adaptations (HKLC in Hong Kong, modified BCLC) exist to account for different healthcare systems and patient selection for surgical therapies. Essential for multidisciplinary tumor board treatment allocation and clinical trial eligibility determination.
Open CalculatorLiver Cancer calculator for clinical assessment and risk stratification.
Open CalculatorThe International Metastatic RCC Database Consortium (IMDC) model, also known as the Heng criteria, is the most extensively validated prognostic tool for metastatic renal cell carcinoma in the contemporary targeted therapy era. Incorporating six readily available clinical and laboratory parameters (Karnofsky performance status <80%, time from diagnosis to systemic treatment <1 year, hemoglobin below lower limit of normal, corrected calcium above upper limit of normal, absolute neutrophil count above upper limit of normal, platelet count above upper limit of normal), IMDC stratifies patients into favorable (0 factors, median OS ~43 months), intermediate (1-2 factors, median OS ~23 months), and poor-risk (≥3 factors, median OS ~8 months) groups. Originally validated in VEGF-TKI treated patients, IMDC now guides first-line therapy selection (immunotherapy combinations for favorable/intermediate risk: nivolumab-ipilimumab, pembrolizumab-axitinib, avelumab-axitinib; VEGF-TKI monotherapy or IO combinations for poor risk), clinical trial stratification, and cross-trial outcome comparisons. Superior to older MSKCC/Motzer criteria for modern practice and regulatory endpoints in drug development.
Open CalculatorKidney Cancer calculator for clinical assessment and risk stratification.
Open CalculatorThe International Prognostic Index (IPI) is the cornerstone prognostic model for diffuse large B-cell lymphoma (DLBCL), the most common aggressive non-Hodgkin lymphoma, validated across >2000 patients from multiple international studies. IPI incorporates five independent adverse prognostic factors: age >60 years, elevated serum LDH above normal, ECOG performance status ≥2, Ann Arbor stage III/IV disease, and >1 extranodal site involvement. Total score (0-5) stratifies patients into four risk groups: low (0-1 factors, 5-year OS ~73%), low-intermediate (2 factors, ~51%), high-intermediate (3 factors, ~43%), and high risk (4-5 factors, ~26%) with R-CHOP therapy. The enhanced NCCN-IPI incorporates continuous LDH values and specific high-risk extranodal sites for improved discrimination. IPI remains essential for treatment intensity discussions (R-CHOP ± radiation versus dose-adjusted R-EPOCH versus CAR-T cell therapy timing), clinical trial eligibility and stratification, CNS prophylaxis decision-making, and interim PET response interpretation. Adapted versions exist for follicular lymphoma (FLIPI) and other subtypes.
Open CalculatorBrowse all calculators organized by category below, or use the search to find specific tools.
Essential Oncology Terminology for Clinical Practice & Research
Detailed definitions of validated prognostic tools, staging systems, clinical trial endpoints, biomarkers, and key concepts in precision oncology. Each term includes clinical context, research applications, and evidence-based references for healthcare professionals.
Adjuvant Therapy
Treatment given after primary therapy (usually surgery) to lower the risk of cancer recurrence and eliminate microscopic residual disease. Examples include adjuvant chemotherapy, radiation therapy, hormonal therapy, targeted therapy, or immunotherapy. Clinical trials have demonstrated improved disease-free survival and overall survival with adjuvant treatment in many solid tumors including breast, colorectal, lung, and gastric cancers.
ALBI Score (Albumin-Bilirubin Grade)
A prognostic tool for hepatocellular carcinoma (HCC) that assesses liver function using only two objective laboratory values: serum albumin and bilirubin. The ALBI grade stratifies patients into three categories (Grade 1, 2, or 3) and has been validated as superior to Child-Pugh classification for predicting survival in HCC patients. Used extensively in clinical trials and treatment selection for patients with liver cancer.
ANC (Absolute Neutrophil Count)
The total number of neutrophils (segmented neutrophils + band forms) in the blood, calculated from the white blood cell count and differential. Critical for assessing infection risk in cancer patients receiving chemotherapy. ANC < 500/μL defines severe neutropenia and significantly increases risk of life-threatening infections requiring prophylactic antibiotics or growth factor support.
BCLC Staging (Barcelona Clinic Liver Cancer)
The most widely used staging system for hepatocellular carcinoma that integrates tumor burden, liver function (Child-Pugh score), performance status (ECOG), and cancer-related symptoms to guide treatment decisions. BCLC stages (0, A, B, C, D) directly link to specific treatment recommendations ranging from curative therapies (resection, transplantation, ablation) to palliative approaches. Extensively validated in clinical trials and endorsed by major oncology societies.
Biomarker
A measurable biological indicator of disease state, prognosis, or treatment response. In oncology, biomarkers include tumor markers (PSA, CEA, CA-125), genetic mutations (EGFR, KRAS, BRAF), protein expression (PD-L1, HER2), and molecular signatures (microsatellite instability, tumor mutational burden). Biomarker-driven treatment selection is fundamental to precision oncology and clinical trial design.
BSA (Body Surface Area)
A measurement of total body surface area used to calculate chemotherapy dosing, typically expressed in square meters (m²). Common calculation methods include Mosteller formula (most widely used), DuBois formula, and Haycock formula. BSA-based dosing aims to reduce inter-patient pharmacokinetic variability and optimize therapeutic index. Critical for clinical trial protocols and routine oncology practice.
CAPRA Score (Cancer of the Prostate Risk Assessment)
A validated prognostic tool for localized prostate cancer that predicts biochemical recurrence after radical prostatectomy or radiation therapy. Incorporates PSA, Gleason score, clinical stage, percentage of positive biopsy cores, and patient age. CAPRA scores (0-10) stratify patients into low, intermediate, and high-risk groups, guiding treatment selection and surveillance strategies in clinical practice and research.
Child-Pugh Score
A scoring system to assess the severity and prognosis of chronic liver disease, particularly cirrhosis. Incorporates five clinical and laboratory parameters: serum bilirubin, albumin, INR (prothrombin time), presence of ascites, and hepatic encephalopathy. Classifies patients into Class A (5-6 points, well-compensated), Class B (7-9 points, significant functional compromise), or Class C (10-15 points, decompensated disease). Essential for treatment planning in hepatocellular carcinoma and liver transplant evaluation.
Complete Response (CR)
The disappearance of all detectable signs of cancer in response to treatment as assessed by physical examination, laboratory tests, and imaging studies. Defined by RECIST criteria as disappearance of all target and non-target lesions. CR is a key endpoint in clinical trials but does not always indicate cure, as microscopic disease may persist. Duration of CR is an important prognostic indicator across hematologic and solid malignancies.
Disease-Free Survival (DFS)
The length of time after treatment during which a patient survives without any signs or symptoms of cancer recurrence. A primary endpoint in adjuvant therapy clinical trials. DFS includes local recurrence, distant metastasis, second primary cancers, and death from any cause. Also called relapse-free survival (RFS) or recurrence-free survival in some contexts.
ECOG Performance Status
The Eastern Cooperative Oncology Group scale measuring patient functional status from 0 (fully active, no restrictions) to 5 (dead). ECOG 0-1 patients are typically eligible for aggressive therapies and clinical trials, while ECOG 3-4 patients receive palliative or supportive care. Performance status is a strong independent prognostic factor and critical inclusion criterion for oncology clinical trials. Inter-rater reliability is well-established in research settings.
FLIPI Score (Follicular Lymphoma International Prognostic Index)
A validated prognostic scoring system for follicular lymphoma using five clinical and laboratory factors: age >60 years, Ann Arbor stage III/IV, hemoglobin <12 g/dL, elevated serum LDH, and number of nodal areas >4. Stratifies patients into low (0-1 factors), intermediate (2 factors), and high-risk (≥3 factors) groups with distinct survival outcomes. Extensively used in clinical trials and treatment planning for indolent lymphomas.
G8 Screening Tool
A brief geriatric screening instrument specifically validated for elderly cancer patients to identify those who may benefit from comprehensive geriatric assessment (CGA). Comprises eight items assessing nutritional status, mobility, neuropsychological function, and general health. Scores ≤14 (out of 17) indicate impaired status requiring full CGA. Widely used in geriatric oncology research and clinical practice to optimize treatment decisions in older adults.
Gleason Score
The standard histologic grading system for prostate cancer that evaluates architectural patterns of tumor growth. Ranges from 6 (3+3, least aggressive) to 10 (5+5, most aggressive). The Gleason Grade Group system (1-5) was introduced in 2014 to simplify reporting. Gleason score is a powerful predictor of biochemical recurrence, metastasis, and cancer-specific mortality, essential for risk stratification in clinical trials and practice guidelines.
Hazard Ratio (HR)
A statistical measure comparing the risk of an event (death, progression, recurrence) between treatment groups in clinical trials. HR < 1 indicates reduced risk with experimental treatment, while HR > 1 indicates increased risk. For example, HR 0.70 means 30% reduction in risk. Hazard ratios are derived from Cox proportional hazards regression and are fundamental to interpreting survival data in oncology research.
HER2 Status
Human epidermal growth factor receptor 2 protein expression or gene amplification status in breast, gastric, and other cancers. Assessed by immunohistochemistry (IHC 0, 1+, 2+, 3+) and/or fluorescence in situ hybridization (FISH). HER2-positive cancers (IHC 3+ or FISH amplified) are eligible for targeted therapies including trastuzumab, pertuzumab, and T-DM1. HER2 testing is mandatory in breast and gastric cancer per NCCN and ASCO guidelines.
IMDC Risk Score (International Metastatic RCC Database Consortium)
A prognostic model for metastatic renal cell carcinoma incorporating six clinical and laboratory factors: Karnofsky performance status <80%, time from diagnosis to treatment <1 year, hemoglobin below normal, corrected calcium above normal, neutrophils above normal, and platelets above normal. Stratifies patients into favorable (0 factors), intermediate (1-2 factors), and poor-risk (≥3 factors) groups with distinct survival outcomes. Validated across multiple targeted therapy trials.
IPI (International Prognostic Index)
A widely validated prognostic tool for aggressive non-Hodgkin lymphomas (particularly diffuse large B-cell lymphoma) using five factors: age >60 years, elevated serum LDH, ECOG performance status ≥2, Ann Arbor stage III/IV, and >1 extranodal site. Scores 0-1 (low risk), 2 (low-intermediate), 3 (high-intermediate), and 4-5 (high risk) predict distinct survival outcomes. Essential for risk stratification in lymphoma clinical trials and treatment selection.
Karnofsky Performance Status (KPS)
A functional scoring scale from 0-100% measuring patient ability to perform daily activities and self-care. KPS ≥70% typically indicates ability to care for self, while <70% indicates need for assistance. Often used alongside ECOG in clinical trials and research, particularly in neuro-oncology. KPS is a validated prognostic factor across multiple cancer types and treatment modalities.
Khorana VTE Risk Score
A validated risk assessment tool predicting venous thromboembolism (VTE) in ambulatory cancer patients receiving chemotherapy. Incorporates cancer site (very high risk: pancreas, gastric; high risk: lung, lymphoma, gynecologic, bladder, testicular), pretreatment platelet count, hemoglobin level/ESA use, leukocyte count, and BMI. Scores categorize patients as low (0), intermediate (1-2), or high risk (≥3). Guides thromboprophylaxis decisions in clinical practice.
MASCC Score (Multinational Association for Supportive Care in Cancer)
A validated risk index for febrile neutropenia that identifies low-risk patients suitable for outpatient management with oral antibiotics. Incorporates burden of illness, hypotension, chronic obstructive pulmonary disease, solid tumor or lymphoma with no previous fungal infection, dehydration, outpatient status, and age. Score ≥21 indicates low risk with <5% risk of serious complications. Widely implemented in evidence-based guidelines.
MELD Score (Model for End-Stage Liver Disease)
A scoring system using serum bilirubin, INR, and creatinine to assess severity of chronic liver disease and predict mortality. Originally developed to predict survival in TIPS patients, now used to prioritize patients for liver transplantation. MELD scores range from 6 to 40, with higher scores indicating greater severity and transplant urgency. Updated MELD 3.0 incorporates sex and albumin for improved accuracy.
Microsatellite Instability (MSI)
A molecular phenotype resulting from deficient DNA mismatch repair, characterized by insertion/deletion mutations in repetitive DNA sequences. MSI-High (MSI-H) tumors occur in ~15% of colorectal cancers and subset of endometrial, gastric, and other malignancies. MSI-H status predicts excellent response to immune checkpoint inhibitors (pembrolizumab, nivolumab) across tumor types and is a FDA-approved biomarker for immunotherapy. Testing is recommended in colorectal and endometrial cancers.
Neoadjuvant Therapy
Treatment given before primary therapy (usually surgery) to shrink tumors, improve surgical outcomes, assess treatment response in vivo, and eliminate micrometastases. Demonstrated benefits include downstaging for organ preservation (breast, rectal, bladder), improving resectability (pancreatic, gastroesophageal), and providing prognostic information via pathologic response. Increasingly used across solid tumors with clinical trial evidence for improved survival in specific settings.
Neutropenic Fever
Fever (single oral temperature ≥38.3°C or ≥38°C sustained over 1 hour) occurring during severe neutropenia (ANC <500/μL or <1000/μL with predicted decline to <500/μL). A medical emergency requiring immediate empiric broad-spectrum antibiotic therapy due to high mortality risk from bacterial infections. Risk stratification using MASCC or CISNE scores guides management strategy (inpatient vs. outpatient, IV vs. oral antibiotics).
Oncotype DX
A 21-gene genomic assay analyzing tumor RNA expression to predict chemotherapy benefit and recurrence risk in early-stage, hormone receptor-positive, HER2-negative breast cancer. Recurrence Score (0-100) stratifies patients into low, intermediate, or high-risk groups. TAILORx trial demonstrated that patients with intermediate scores (11-25) can safely omit chemotherapy. Medicare-covered test integrated into NCCN and ASCO guidelines for treatment decision-making.
Overall Survival (OS)
The length of time from randomization or treatment initiation until death from any cause. Considered the gold standard endpoint in cancer clinical trials due to objectivity and lack of assessment bias. Regulatory agencies (FDA, EMA) prefer OS as primary endpoint for drug approval, though surrogate endpoints (PFS, ORR) are accepted in specific settings. Median OS and OS rates at specific timepoints are standard reporting metrics.
Partial Response (PR)
At least 30% decrease in the sum of diameters of target lesions compared to baseline per RECIST criteria, without appearance of new lesions or progression of non-target lesions. PR is a component of objective response rate (ORR = CR + PR), a common endpoint in phase II clinical trials and accelerated drug approvals. Duration of PR and time to response are important secondary endpoints.
PD-L1 Expression
Programmed death-ligand 1 expression on tumor cells and/or immune cells, measured by immunohistochemistry using validated assays (22C3, 28-8, SP263, SP142). PD-L1 expression (typically ≥1% or ≥50% tumor proportion score) predicts response to checkpoint inhibitors in NSCLC, urothelial, head and neck, and other cancers. Multiple companion and complementary diagnostic tests are FDA-approved for specific immunotherapy indications.
Performance Status
A standardized measure of patient functional capacity and ability to perform daily activities, critical for treatment eligibility, prognosis, and clinical trial enrollment. Two validated scales are widely used: ECOG (0-5) and Karnofsky (0-100%). Performance status is an independent prognostic factor across cancer types and strongly correlates with treatment tolerance, quality of life, and survival outcomes.
Progression-Free Survival (PFS)
Time from randomization or treatment start until objective tumor progression or death from any cause, whichever occurs first. A commonly used primary endpoint in oncology trials, particularly for advanced/metastatic disease. PFS advantages include earlier assessment than OS and freedom from crossover effects. FDA accepts PFS as primary endpoint when clinically meaningful benefit and acceptable safety profile are demonstrated.
Progressive Disease (PD)
At least 20% increase in the sum of diameters of target lesions (with absolute increase ≥5mm), appearance of new lesions, or unequivocal progression of non-target lesions per RECIST criteria. PD defines treatment failure and triggers change in therapy. Time to progression and PFS are key efficacy endpoints incorporating PD as an event in clinical trial analysis.
PSA (Prostate-Specific Antigen)
A serine protease produced by prostate epithelium, measurable in blood and used for prostate cancer screening, staging, and monitoring. Elevated PSA (>4 ng/mL traditional threshold) increases prostate cancer probability. PSA kinetics (PSA doubling time, PSA velocity) predict aggressive disease. Post-treatment PSA is sensitive for recurrence detection. Controversy exists regarding population-based PSA screening due to overdiagnosis concerns.
RECIST Criteria (Response Evaluation Criteria In Solid Tumors)
Standardized guidelines for measuring treatment response in clinical trials using imaging studies. RECIST 1.1 defines measurable target lesions (≥10mm), evaluable non-target lesions, and response categories (CR, PR, SD, PD) based on sum of target lesion diameters. Provides objective, reproducible assessment enabling cross-trial comparisons. Modified criteria exist for specific settings (iRECIST for immunotherapy, mRECIST for hepatocellular carcinoma).
R-ISS (Revised International Staging System)
An enhanced prognostic model for multiple myeloma incorporating serum beta-2 microglobulin, albumin, LDH, and high-risk cytogenetics [del(17p), t(4;14), t(14;16)] detected by FISH. Stratifies newly diagnosed patients into three risk groups (I, II, III) with distinct survival outcomes. Validated across multiple clinical trials and treatment eras. Essential for risk-adapted treatment strategies and clinical trial stratification.
Stable Disease (SD)
Neither sufficient shrinkage to qualify for partial response nor sufficient increase to qualify for progressive disease per RECIST criteria. Represents disease control and may indicate clinical benefit, particularly with targeted therapies and immunotherapy. Durable stable disease (typically ≥6 months) is increasingly recognized as clinically meaningful outcome and incorporated into disease control rate (DCR = CR + PR + SD) endpoint.
TNM Staging
The AJCC/UICC tumor-node-metastasis staging system describing anatomic extent of cancer. T describes primary tumor size/extent (T0-T4), N describes regional lymph node involvement (N0-N3), M describes distant metastasis (M0-M1). TNM classification combines into prognostic stage groups (I-IV). Updated every 6-8 years based on survival data. Essential for treatment planning, prognostication, and clinical trial eligibility. Current 8th edition incorporates molecular markers for some cancers.
Tumor Mutational Burden (TMB)
The total number of somatic mutations per megabase of DNA in tumor tissue, assessed by comprehensive genomic profiling. High TMB (≥10 mutations/megabase) predicts response to immune checkpoint inhibitors across multiple tumor types through increased neoantigen load and T-cell recognition. FDA-approved pembrolizumab for TMB-High (≥10 mut/Mb) solid tumors based on KEYNOTE-158 trial. Increasingly integrated into precision oncology and immunotherapy selection.
This glossary is for educational purposes. Always consult clinical guidelines and medical professionals for treatment decisions.