The New York Times
As a medical student and later during my residency, I trained for some time in a medical center known for its research and clinical trials. Every week, patients with rare diseases and cancers that had not responded to standard therapy arrived from all over the country, eager to try something new, even if the efficacy of the treatments had not yet been proven.
But placed in the context of early-phase clinical cancer trials, unrealistic optimism results in a perfect ethical storm. “You have oncology, a field of medicine that is strongly evidence-based and research-intensive, and you have a population of patients who are experiencing an immediate threat to their lives,” said Dr. Neal J. Meropol, a researcher who has done extensive work on the ethics of early-phase cancer trials and chief of the division of hematology and oncology at University Hospitals Case Medical Center and Case Western Reserve University in Cleveland.
“Patients almost invariably take part in early-phase clinical trials because they believe they will personally benefit.”
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In an independent study led by co-author, Neal Meropol, University Hospital Seidman Cancer Center and Case Western Research University, results showed that clinical use of the Oncotype DX Recurrence Score to assess risk of recurrence in T3 stage II colon cancers with intact mismatch repair (MMR-P) is likely to improve quality-adjusted life expectancy and be cost-saving from a societal perspective. Patient age and adverse effects associated with chemotherapy are important considerations in adjuvant treatment decisions. The study, “Use of a multigene prognostic assay for selection of adjuvant chemotherapy in patients with stage II colon cancer: Impact on quality-adjusted life expectancy and costs” (N. J. Meropol et al, Abstract #491), will be presented in a poster on Saturday, January 22.
“Our data support the notion that use of a genomic test like the Recurrence Score Assay may potentially reduce chemotherapy use, improve quality adjusted survival, and save health care costs,” said Neal J. Meropol, M.D., Chief of the Division of Hematology and Oncology at University Hospitals Seidman Cancer Center and Case Western Reserve University.