Maurie Markman, MD

Maurie Markman, MD

Maurie Markman, MD, is president of Medicine & Science at City of Hope Atlanta, Chicago, and Phoenix

Articles by Maurie Markman, MD

The current status of clinical cancer research in the United States falls far short of what is necessary to effectively and efficiently change this amazing opportunity to improve both the quantity and quality of the lives of patients with cancer into an objective reality.

"Uncertainty" is a routine dilemma when discussing a prognosis with a patient with cancer and his or her family. The prognosis is, at best, a statistical probability—assuming the available objective data are somewhat representative of the individual patient.

Those responsible for developing and implementing governmental health policy have an extremely difficult job. Not only do they have to attempt to satisfy often highly unrealistic expectations of legislators for overall goals and timelines, but they also are frequently asked to accomplish a task with woefully inadequate funding.

Oncologists eagerly await clinical trial results that will permit them to provide additional strategies to their patients. However, the impact of such randomized trial results can be quite limited where preexisting beliefs, training, economic interests, or well-established practices conflict with what the "evidence" demonstrates.

Discussions with patients must carefully consider the understandable desire of patients for definitive and hopeful information while at the same time appreciating that poorly understood biology often makes definitive statements and declarations regarding prognosis problematic and not infrequently incorrect.

A phase III trial in ovarian cancer was allowed to continue even as the patients who received the experimental study drug were experiencing strikingly inferior outcomes compared with participants on standard therapy. The lack of answers about this trial remains a glaring example of shortcomings in the research paradigm.