Cancer drugs, survival, and ethics

The BMJ

 Survival
A meta-analysis published in 2004 explored the contribution of cytotoxic chemotherapy to five year survival in 250 000 adults with solid cancers from Australian and US randomised trials.3 An important effect was shown on five year survival only in testicular cancer (40%), Hodgkin’s disease (37%), cancer of the cervix (12%), lymphoma (10.5%), and ovarian cancer (8.8%).....

 An unethical pressure to enrol is reflected by several studies showing that up to half of patients in cancer drug trials were led to believe that such participation was their only option.9

 More post-approval “real world” evaluation of cancer drugs would be an important step forward.