So a few key take home points
1) Watch and wait was historically based on ineffectiveness of therapy
2) Newer treatments have led scientists to revisit #1 but the answers are not in yet
3) One risk of treatment is the emergence of resistance but not all patients experience this
4) We may be able to begin measuring a patients risk for resistance based upon “subclonal driver mutations” soon
5) To date, we do not have much insight into what sorts of therapies influence emergence of resistance
6) Watch and wait is not crazy in appropriate patients – there may have been benefit to it for a long time that we are only just now starting to figure out.
7) Patients should not wait too long otherwise they just feel lousy when they could have been feeling better with treatment.