All Cancer treatment is toxic, some more so than others. How much toxicity an individual patient experiences depends on interactions between the cancer, the treatment and the patient, but we don’t yet have very good predictive models for this. Research into toxicity has been hampered by lack of interest, by false beliefs that it wasn’t a core issue, and by difficulties with both trial funding and trial recruitment. However, it is not all bad, and real progress is being made in terms of pathobiology of toxicity, risk prediction, toxicity clustering, and even in treatment.

This talk will set out some guiding principles for toxicity management and review what is known about risk prediction and toxicity clustering. It will discuss the pathobiology of GI toxicity (particularly in relation to GI cancers), from mouth to anus, and how it can be prevented or treated using evidence-based clinical guidelines. Patient Reported Outcomes (PROs) are increasingly being used to assess the real impact of toxicity on patients.  Animal models also have a key role in toxicity research given the difficulty of obtaining sufficient data from clinical trials.

 Every new cancer treatment brings new toxicity, and the targeted anti-cancer therapies are no exception. As the science of cancer treatment evolves, so does the science of toxicity, and it is vital that lessons are learned and the focus kept on optimum outcomes for patients with minimal toxicity.