1. Great Blog.

I agree with Marcia Angell about quacks preying on vulnerable patients. Quite despicable.

Outta curiousity, what do think of Dr. Dueberg's anueploid challenge to the gene-mutation theory of cancer? Good piece at Scientific American, a couple years back.

Could have implications for this obscenely expensive treatment.

Posted at 5:22PM on Jul 11th 2006 by Hank Barnes

2. Hank -- I am not familiar with Dr. Dueberg's anueploid challenge to the gene-mutation theory of cancer. I will have to go track it down. But I do agree with your apt use of the word obscene. I worry about the rising costs and what that means for health care in the future. I don't see the prices going down.

Thanks for the comment. Dalene

Posted at 5:33PM on Jul 11th 2006 by Dalene

3. It's more than just the drug companies. According to NCI's official cancer information website, it is unclear whether single-agent or combination chemotherapy is preferable for treatment. At this time, no data support the superiority of any particular regimen.

So, while being faced with a large number of choices of otherwise equally acceptable therapies, it has been documented that oncologists select the treatments which generate the most income for private practices.

The needed change in the "war on cancer" will not be on the types of expensive drugs being developed, but on the understanding of all the drugs we already have (many of them rather inexpensive).

The system is overloaded with drugs (hundreds of them) and underloaded with the wisdom and expertise for using them.

A major obstacle in controlling cancer drug prices is the widespread inappropriate use of anti-cancer drugs. As the increasing numbers and types of anti-cancer drugs are developed, oncologists become more and more likely to misuse them in their practice.

The key to solving some of the problems confronting our cancer care system is seeking ways to best allocate available resources while accomplishing the critical task of matching individual patients with the treatments most likely to benefit them.

Many of the newer drugs do not work for everyone, they often have unwanted side effects, as well as being extremely expensive. Patients, physicians, insurance carriers, and the FDA are all calling for the discovery of predictive tests that allow for rational and cost-effective use of these drugs.

Posted at 7:48PM on Jul 11th 2006 by Gregory D. Pawelski

4. These so-called "smart drugs" focus their effects on specific, identifiable processes occurring within cancer cells. The new drugs are highly promising in that they "sometimes" provide benefit to patients who have failed traditional therapies. However, "they do not work for everyone, they often have unwanted side effects, and they are all extremely expensive." Patients, physicians, insurance carriers, and the FDA are all calling for the discovery of "predictive tests" that allow for rational and cost-effective use of these drugs.

There was a new EGFRx assay (a predictive test) developed that holds the key to solving some of the problems confronting this high-price healthcare system that is seeking ways to best allocate available resources while accomplishing the critical task of matching individual patients with the treatments most likely to benefit them. Not only is it an important predictive test, it is also a unique tool that can help to identify newer and better drugs, evaluate promising drug combinations, and serve as a "gold standard" correlative model with which to develop new DNA, RNA, and protein-based tests that better predict for drug activity.

But how does one get ASCO and others to understand this and allow its judicious use? They have single-handedly done more over the past 20 years to keep assay-testing (pre-testing) technology under a bushel basket and out of the public light. It has hurt literally hundreds of thousands of patients. We'd be much further along and technology would have improved, even more accurate. New treatments would have been discovered and targeted immediately to the people who could most benefit from them. This has been one great lost of opportunity in clinical cancer research.

Posted at 3:44PM on Jul 29th 2006 by Gregory D. Pawelski