Expanding the role of cancer prevention in clinical trials design and analysis

Author(s): Graham W Warren, James R Marshall

Survival for cancer patients has improved through the identification of potentially effective biologic targets and development of new clinical therapies directed at these targets. Significant advances over the past decades have resulted in improved survival for virtually all cancer disease sites resulting in an estimated 13 million cancer survivors in the USA [1]. However, the advances of ever increasingly complex cancer care may suffer from a 10,000 foot view: the perceived importance of expensive therapeutics may overshadow a clinically meaningful variable common to large groups of cancer patients while the absolute benefit of a clinically meaningful variable associated with many cancer patients may substantially overshadow the benefit of an expensive therapy