Journal Outline Called Best Hope For Cancer
The Editor-in-Chief of Cancer Investigation, published by Informa Healthcare, has called for clarity, transparency and vision in the development and evaluation of better diagnostic, treatment and prevention options for cancer patients around the globe. Gary H. Lyman, MD, MPH, FRCP (Edin), has outlined the future of the fight against cancer in a detailed commentary piece, which focuses on comparative effectiveness research (CER) – a process for identifying and synthesizing the totality of available evidence on the effectiveness, safety and overall value of competing clinical strategies.
“Despite clear progress in both treating and preventing some cancers,” says Dr Lyman. “Our best hope – both in terms of further improving patient outcomes and spending money wisely - is to pool our global research resources, tools and data in order to develop useful recommendations for the optimal management of cancer patients.”
Rapid advances in molecular biology and genetics have led to the identification of a virtually limitless number of potential targets for improving the diagnosis, prognosis, treatment and prevention of cancer. Unfortunately, says Dr Lyman, this is set against a backdrop of rapidly rising healthcare costs which are threatening the economic stability of nations around the world.
“While few would argue that costs should drive decisions related to the availability and utilization of promising effective cancer interventions, it is vital that we consider all of the evidence available in order to spend our money wisely and with least risk to patients,” states Dr Lyman.
“Where the incremental benefit of using a new intervention is small, non-existent or completely unknown, the use of highly toxic therapies or the expenditure of considerable resources which could be more effectively applied elsewhere, means that CER becomes critical to the viability and success of cancer research efforts and the healthcare systems that support them.”
Dr Lyman advocates the acquisition, evaluation and synthesis of all relevant information related to the effectiveness, safety and overall value of comparative diagnostic, treatment and prevention strategies as offering the best opportunity of addressing important clinical and public health issues.
“We have a wealth of knowledge, and both technology and patients are leading us to a promising new era of personalized medicine,” explains Dr Lyman. “Targeted individualized interventions may have the potential for increasing the effectiveness of existing as well as new cancer fighting agents, while reducing the frequency of treatment-related complications by identifying patients at low or high risk and those most or least likely to benefit from treatment. These targeted interventions are designed to minimize toxicities while maximizing effectiveness and they provide us with a potential goldmine of information for further research and guiding optimal clinical care.”
CER is not, Lyman stresses, a poor man’s way to conduct clinical research and should never be used to replace large, well-designed randomized clinical trials, which remain the gold standard of CER. It should also not be considered an opaque strategy for rationing effective treatment options.
However, for the sake of patients and their loved ones – as well as for the wise use of valuable but limited resources – it would seem that joining forces, sharing knowledge and using it wisely is our best offense in the war against cancer.