"First Do No Harm" and the Importance of Prediction in Oncology

Overview

Journal EPMA J

Date 2010 Dec 15

PMID 21151487

Citations 8

Authors

Dainius Characiejus

Jasmina Hodzic

John J L Jacobs

Affiliations

Soon will be listed here.

Abstract

Present cancer treatment strategies are based on the assumption that a therapy may work ("response") or not work ("no-response"). However, the existing evidence suggests that current cancer treatment modalities may also have a cancer-promoting effect in part of the patients. In this paper, some relevant data are reviewed suggesting that surgery, irradiation, chemotherapy and immunotherapy can stimulate tumor growth / metastatic spread and decrease survival of patients in certain subgroups. Thus, results of cancer treatment may be improved by detection and use of biomarkers that correlate with positive or negative therapeutic effects. Small trials based on groups with differing biomarkers rather than large phase III trials may aid the development and efficacy testing of new anticancer drugs. Moreover, ignoring biomarkers that correlate with positive or negative therapeutic effect may not be compatible anymore with the ethical principle "First Do No Harm".

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