clinical research efficacyepithelial cancersgerm cell malignancieshematologic malignanciestrench warfare
Figures from the paper
Abstract (AI)
opening phase of the Allied offensive…that ultimately led to the end of World War I. Allied forces advanced over seven miles on the first day, one of the greatest advances of the war.”1 “The importance of this offensive in tactical terms was that it…provided a further example of the effectiveness of shifting from stagnant trench warfare to mobile multifaceted warfare.”2 THE PROBLEM After impressive victories against hematologic and germ cell malig-nancies, the battle against common epithelial cancers has evolved into a grinding war of the trenches, where statistical victories with P .05 are hailed as advances despite survival gains of mere weeks (Table 1).3-11 We feel that progress against cancer and most other diseases has been slowed substantially by the clinical research efficacy bar having been set too low and consequently the safety bar having been set too high. When little is to be gained, minimization of risks becomes
Key Findings
1
It contrasts major advances in hematologic and germ cell malignancies with limited clinical progress against common epithelial cancers.
2
The authors argue that clinical research efficacy standards have been set too low, allowing marginal benefits to be labeled advances.
3
The paper characterizes progress against common epithelial cancers as a stagnant “trench war,” despite statistical successes with P .05 and survival gains of only weeks.
4
The paper invokes the Allied advance toward Amiens to advocate shifting cancer research from incremental approaches toward more mobile, multifaceted strategies.
5
They contend that overly stringent safety expectations may substantially slow progress when potential therapeutic gains are already small.
Research Object
common epithelial cancers
Research Subject
clinical research progress and the balance between efficacy and safety thresholds in cancer treatment
Publication Details
Publication Date
2008-12-09
Journal
Publisher
ISSN
Open access PDF
Access Type
Author Information
Download PDF
Subscribe to digest