TY - JOUR
T1 - When oncologic treatment options outpace the existing evidence
T2 - Contributing factors and a path forward
AU - van der Velden, Daphne L.
AU - Levit, Laura A.
AU - Chang, George J.
AU - Facktor, Matthew A.
AU - Goodman, Karyn A.
AU - Kaufman, Jeffrey
AU - Konecny, Gottfried E.
AU - Kwan, Sharon W.
AU - Mooney, Margaret
AU - Smith, Grace
AU - Solomon, Stephen B.
AU - Tam, Alda
AU - Waterhouse, David Michael
AU - Voest, Emile E.
N1 - Funding Information:
The authors have the following potential conflicts of interest to disclose: George J. Chang received research funding from the Patient Centered Outcomes Research Institute. Sharon W. Kwan received salary support from the National Institutes of Health, National Center for Advancing Translational Sciences (KL2 TR000421). Stephen Solomon received a research grant from GE Healthcare and consulting fees from Medtronic and AstraZeneca. Alda Tam received research support from AngioDynamics Inc. and Guerbet LLC, and consulting fees from Medical Monitor Galil Medical Inc. David Michael Waterhouse received honorarium and consulting fees from Bristol-Myers Squibb and speaker honorarium from Roche/Genentech, Celgene, and Lilly. These funders had no role in the design and conduct of the project; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.
Funding Information:
The authors have the following potential conflicts of interest to disclose: George J. Chang received research funding from the Patient Centered Outcomes Research Institute . Sharon W. Kwan received salary support from the National Institutes of Health, National Center for Advancing Translational Sciences ( KL2 TR000421 ). Stephen Solomon received a research grant from GE Healthcare and consulting fees from Medtronic and AstraZeneca . Alda Tam received research support from AngioDynamics Inc. and Guerbet LLC , and consulting fees from Medical Monitor Galil Medical Inc. David Michael Waterhouse received honorarium and consulting fees from Bristol-Myers Squibb and speaker honorarium from Roche/Genentech, Celgene, and Lilly. These funders had no role in the design and conduct of the project; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication.
Publisher Copyright:
© 2019
PY - 2019/6
Y1 - 2019/6
N2 - Oncology is one of the most multidisciplinary areas of medicine, with most patients encountering multiple treatment modalities during the course of their disease. Rapidly occurring innovations in cancer care are continuously expanding the number of treatment options available. However, substantial variation in the amount and quality of evidence supporting new drugs, devices, and surgical approaches exists, compromising evidence-based treatment decisions. To address this important issue, the professional societies representing cancer care providers appointed a multidisciplinary working group: American College of Surgeons Commission on Cancer, American Society for Radiation Oncology (ASTRO), American Society of Clinical Oncology (ASCO), Society of Interventional Radiology (SIR), and the Society of Surgical Oncology. In addition, the working group included a patient and National Cancer Institute (NCI) representative. This manuscript identifies five factors contributing to differences in evidence development for cancer treatment modalities: (1) research funding, (2) methodological challenges to conducting randomized controlled trials in many therapeutic options, (3) regulatory agency oversight, (4) payment policies, and (5) hierarchy and sociological factors in medicine. It makes a series of consensus recommendations that address the need for more cross-disciplinary research and wider adoption of observational research, pragmatic trials, and reimbursement strategies.
AB - Oncology is one of the most multidisciplinary areas of medicine, with most patients encountering multiple treatment modalities during the course of their disease. Rapidly occurring innovations in cancer care are continuously expanding the number of treatment options available. However, substantial variation in the amount and quality of evidence supporting new drugs, devices, and surgical approaches exists, compromising evidence-based treatment decisions. To address this important issue, the professional societies representing cancer care providers appointed a multidisciplinary working group: American College of Surgeons Commission on Cancer, American Society for Radiation Oncology (ASTRO), American Society of Clinical Oncology (ASCO), Society of Interventional Radiology (SIR), and the Society of Surgical Oncology. In addition, the working group included a patient and National Cancer Institute (NCI) representative. This manuscript identifies five factors contributing to differences in evidence development for cancer treatment modalities: (1) research funding, (2) methodological challenges to conducting randomized controlled trials in many therapeutic options, (3) regulatory agency oversight, (4) payment policies, and (5) hierarchy and sociological factors in medicine. It makes a series of consensus recommendations that address the need for more cross-disciplinary research and wider adoption of observational research, pragmatic trials, and reimbursement strategies.
KW - Comparative effectiveness of cancer treatment
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U2 - 10.1016/j.jcpo.2019.100188
DO - 10.1016/j.jcpo.2019.100188
M3 - Article
AN - SCOPUS:85065608262
SN - 2213-5383
VL - 20
JO - Journal of Cancer Policy
JF - Journal of Cancer Policy
M1 - 100188
ER -