All Is Not Well in the World of Academic Scientific Enterprise
April 28th 2018It is quite difficult for those not directly involved in the complex world of academic medicine to understand fully the process of individual professional advancement and the values that organizations place on the components required for achieving and maintaining tenure.
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HPV Vaccination Should Be Part of Oncology Cost-Reduction Strategy
April 3rd 2018The impact of staggering increases in the cost of individual antineoplastic agents for patients and the overall healthcare system cannot be overstated, and there appears to be no realistic solution to the current dilemma that is acceptable to the parties involved in this ongoing debate.
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Is the Median All We Should Offer Our Patients?
February 28th 2018Although median survival is a reasonable endpoint to highlight, it is only 1 of many relevant outcome factors to discuss, and, most important, this mathematical figure simply does not define the survival of any particular patient.
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Biomarkers Go Beyond "All or None" Equation
January 31st 2018The FDA’s recent approvals of novel anti-PARP agents as maintenance therapy for patients with previously treated advanced ovarian cancer highlight an issue that has received inadequate attention in the peer-reviewed oncology literature.
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Proving "Noninferiority" May Become Another Challenge in Oncology Studies
January 17th 2018Fewer than 4% of patients with cancer in the United States participate in clinical trials, the elderly and individuals with clinically relevant comorbidities are strikingly underrepresented in the research portfolio.
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Missing in Action: Patient Perspective on Cancer Trial Goal
January 14th 2018There is a critically important subject associated with the clinical trial experience that has had inadequate discussion within the medical literature, regarding the role of the patient beyond agreeing to serve as a research subject.
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Precision Medicine Can Help Reduce "Overdiagnosis" Problem
December 27th 2017In patients with common solid tumors, it is well-established that those with early-stage cancers have a statistically defined superior prognosis compared with those who present with and are required to be treated at later stages of the disease.
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Assumptions Regarding Cancer Risk Require Constant Reevaluation
October 1st 2017Oncologists are well aware that by the time a new antineoplastic drug or regimen first enters the pages of a traditional reference textbook, the data supporting its use, including doses, schedules, and clinical indications, may already be considerably out-of-date.
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Through the ASCO Lens: A Perspective on the Present and Future of Oncology
September 23rd 2017The clinical oncology community, along with patients, families, pharmaceutical companies, investors, and third-party payers, eagerly awaits the plenary session presentations at the ASCO annual meetings as representing the most important and impactful of the thousands of abstracts submitted each year.
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There's a Growing Need to Look Under the Hood of the Clinical Trial Model
August 30th 2017The decades-long argument over whether zinc lozenges can shorten the duration of the common cold is far removed from the arena of cancer medicine, yet the studies conducted to settle the debate help illustrate the shortcomings of the clinical trial model that has dominated the oncology sphere.
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Debate Over Randomized Trials: Necessary Versus Optional
July 14th 2017In the ongoing debate regarding the role of randomized trials in defining the standard of care in cancer management, adherents of this so-called gold standard acknowledge the problems associated with conclusions drawn from prospective nonrandomized studies or retrospective analyses of patients managed with different approaches.
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Hidden Baseline Clinical Factors Often Influence Study Results
June 8th 2017There is an intense and seemingly growing debate within the clinical, research, and regulatory arenas regarding what should be appropriately required to declare that a new or novel strategy be considered an acceptable standard-of-care approach to cancer management within a particular setting.
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Fresh Examples of Long Delays Highlight Need for Clinical Trial Reform
May 25th 2017Randomization designed to isolate the impact of a specific factor has enabled practitioners to understand the value, or lack of value of particular drugs, procedures, or processes in a given clinical setting.
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Resistance to Coverage for Molecular Testing Panels Illustrates Need for New Policies
May 12th 2017It is common for third-party payers to deny payment for N-of-1 molecular testing at the same time they continue to pay for multiple lines of chemotherapy, even though there is often little evidence that the particular patient's cancer will respond or that the quality of life will be improved.
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Patient's Role in Oncology Surgical Decisions Is Evolving
May 1st 2017In general, where surgery is a medically appropriate option, it is the surgeon who takes the leading clinical role in discussions with the patient and her or his family regarding the development of an optimal strategy for that individual.
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Clinicians Must Evaluate Evidence Needed in Real-World Practice
April 17th 2017Research on a scalp-cooling device to help patients with breast cancer avoid hair loss during chemotherapy illustrates this question: what level of evidence might individual clinicians require before they would suggest, recommend, or support the use of a particular approach in treating patients outside the realm of the mandates of governmental agencies or payers?
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Simplified Summaries of Trial Data Needed for Patients and Their Oncologists
April 7th 2017Despite the importance of clinical trial data, there are problems with the way these data are presented. There is a need to simplify what is being discussed so that it can be more easily understood or summarized by patients and their advisers in their decision-making process.
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