Silence on Ovarian Cancer Trial Debacle Is Disheartening
July 22nd 2016A 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.
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We Need a New Way of Talking About "Conflicts of Interest"
June 13th 2016The debate over the confirmation of Robert M. Califf, MD, as FDA commissioner illustrates the need to change the way we talk about whether a medical professional has a "conflict of interest" rather than simply an "association of interest."
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Reason Versus Dogma: It's Time to Move Beyond the Phase III Trial Mantra
May 19th 2016Shouldn’t the goal of oncologists be to do what is best for their patients, regardless of the currently existing level of evidence and particularly when any timeline for obtaining that "gold standard" evidence will be irrelevant for the patient being cared for today?
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Germline Genetic Testing Raises Thorny Ethical Questions
May 3rd 2016If germline testing for a cancer-associated purpose reveals the risk of an unrelated illness like Alzheimer disease, should patients routinely be told—even if there’s nothing that can be done about that “incidental†finding?
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Oncologists Are Often Slow to Embrace Truly Novel Therapies
April 8th 2016The delivery of antineoplastic therapy via the intravenous route is a long-standing, critical, and well-coordinated component of oncology practice. But what happens when a novel treatment strategy is introduced into the oncology arena that challenges this traditional drug infusion paradigm?
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Keeping Doctors in the Dark May Heighten Risks of Off-Label Drug Use
February 26th 2016The appropriateness of off-label drug use in the management of patients with cancer in the United States is one of the most contentious issues confronting individual oncologists, patients, insurers, and governmental policy makers.
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Dr. DeVita Discusses "The Death of Cancer"
February 25th 2016In The Death of Cancer, written by Vincent T. DeVita Jr, MD, a pioneering oncologist reveals, after 50 years on the front lines of medicine, why the war on cancer is winnable, and how to get there. In an interview with OncLive hosted by Maurie Markman, MD, he speaks with DeVita on his book and his thoughts on how the field has evolved.
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Scientific Misconduct in Oncology: A Distasteful Subject That Requires Acknowledgment and Attention
February 5th 2016The greatest concern with the profoundly distressing episode that has unfolded at Duke University in recent years is whether it will truly serve as a learning experience that would help prevent future misconduct— events that have the potential to result in serious harm to highly vulnerable patients with cancer.
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Fresh Approaches and Open Minds Needed to Assess Unique Targeted Therapy Outcomes
January 8th 2016There is an objectively rational and scientifically valid alternative to evaluate N-of-1 experiences, and there is a critical need for the continued development of such approaches, which the oncology community increasingly recognizes as a necessary step to replace the established but untenable randomized clinical trial paradigm.
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It's Time for True Advances in Comparative Effectiveness Research
December 21st 2015It is simply unrealistic and highly counterproductive to the future of cancer care to believe that the only acceptable approach to determining the absolute or relative clinical utility of a specific drug, regimen, device, or procedure, is through the conduct of a so-called evidence-based randomized trial.
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Practicing Oncologists May Not Find Answers They Need in Clinical Trials
December 14th 2015Although legitimate questions have been raised over the years regarding the generalizability of clinical study results in the nonresearch setting, patients with cancer have benefited greatly from the appropriate conduct, completion, and ultimate reporting of such trials in the peer-reviewed medical literature.
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Value-Based Care: Why Include Factors Beyond Oncologists' Control?
September 14th 2015How can any analysis of the quality of cancer care being delivered by providers that focuses on a survival outcome as the ultimate measure of that quality-rather than on an evaluation of the optimization of the care process-be considered objectively valid and clinically meaningful?
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"N-of-1" Research Findings Belong in the Peer-Reviewed Publishing Realm
August 4th 2015A trend in the biomedical industry to bypass the rigors of scientific publishing was highlighted recently in a provocative commentary regarding the virtual absence of data in the peer-reviewed literature demonstrating the utility of a novel proprietary laboratory testing platform.
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Expanding Use of Oral Therapies Puts Challenges of Patient Compliance in Spotlight
May 22nd 2015Dr. Maurie Markman discusses how the transition to the new therapeutic paradigm of oral therapies necessitates that we consider unique aspects of this strategy that may negatively impact outcomes compared with an approach of systemic antineoplastic drug administration.
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Crossing Tumor Types: BRCA Experience Points Way to New Diagnostic Paradigm
April 1st 2015Patients with advanced cancers of the pancreas or prostate, or where progression to this state occurs later in the course of the illness, should have tumor or germline testing performed looking for the presence of a BRCA mutation.
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Controversies in Clinical Care: Questioning Research
March 23rd 2015Maurie Markman, MD, offers examples of clinical trials where the interpretation of study results is worthy of considerable additional discussion or where justification for the actual conduct of the study can be called into question.
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