The gold standard for patients with cancer has long been overall survival, preferably delivered up with statistical significance through a randomized, phase III clinical trial. Yet the oncology research eld seems to have wrestled just as long with a companion question: overall survival at what price?
This question comes bubbling to the surface in several ways in the articles we present in this issue of OncologyLive. In our cover story, “Intensified Radiotherapy Emerging as New Standard,” experts detail research presented at the 2016 ASTRO Annual Meeting about newer strategies for radiation therapy that demonstrate equivalent or even marginally inferior survival benefits to conventional regimens but definitely deliver better outcomes in terms of patients’ cognitive function.
Similarly, quality of life may become an increasingly important factor when managing frontline tyrosine kinase inhibitor (TKI) therapy for patients with chronic myeloid leukemia (CML) now that generic imatinib is entering the marketplace.
There are 3 branded TKIs that the National Comprehensive Cancer Network (NCCN) recommends as frontline therapy for patients with CML and 2 additional agents in the class for later lines of treatment. Three generic forms of imatinib have gained the FDA’s approval.
This bounty makes for a complex stew of options, which we explore in “Generic Imatinib Complicates Frontline Therapy Choices in CML,” an article that is part of our cover- age of the recent NCCN 11th Annual Congress: Hematologic Malignancies.
Finally, the matter of clinical benefit versus overall survival emerges during the OncLive Peer Exchange panel discussion, “Experts Focus on New Ways of Attacking Resistance in ER+ Breast Cancer.”
In delving into clinical trial findings for the emerging CDK4/6 inhibitor abemaciclib, panelist Joyce A. O’Shaughnessy, MD, points out that overall survival might have been statistically lackluster but the clinical benefit rate and impact on brain metastases were noteworthy.
These are questions about what out- comes are truly important to patients that thoughtful people in the oncology eld have always explored. We hope you find these insights useful in your daily practice— and perhaps even reflective of matters with which you regularly grapple.