By Alice Park
There are more new drugs to treat cancer than ever before, but in some cases, they may not live up to their promise
There’s no denying that cancer treatments keep getting better, thanks in large part to ever more sophisticated and precise drugs that can target tumors exquisitely and eliminate them before they spread and cause serious disease.
The reason has to do with the many ethically questionable practices throughout the drug-development process, says Peter Wise, who was at Charing Cross Hospital and Imperial College School of Medicine in London at the time of the analysis. These practices range from research by pharmaceutical companies to the way new compounds are tested to the approval process by regulatory agencies and the way that doctors are incentivized to prescribe them. “There are different layers in the whole process and real problems all the way down the line,” he says.
For example, drugs used to be tested in academic centers by faculty researchers who were independent of the companies that developed them, and therefore were more likely to have unbiased perspectives in analyzing the data. But many are now tested by contract research organizations hired by pharmaceutical companies to conduct the trials. Because they are beholden to the companies, these groups may introduce biases in interpretation of their results, says Wise.
More important, the way trials are designed has changed considerably. Traditionally, scientists would evaluate new drugs based on how much they improved the death rate from disease. Now so-called surrogate endpoints — such as how the agent affects tumor growth or levels of certain tumor-related proteins — are used as ways to validate the effectiveness of a new drug. If approved, doctors and patients still don’t know for sure whether the drug will actually lengthen lives and improve their survival.