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The Oncology Treatment Paradigm
More than one million new cases of solid tumor cancer are diagnosed each year in
the US. Although a given patient may be a candidate for several therapeutic
options, treatment is typically expensive and accompanied by a host of side
effects that decrease the patient's quality of life. Targeted therapies have
often been approved as third-line treatments, and they are effective in a relatively low
percentage (10%-20%) of patients in a general tumor category like lung cancer.
First- and second-line therapies typically involve more broadly acting
therapeutic agents, including various chemotherapies and radiotherapy, often
accompanied by serious side effects.
Newer, more targeted therapies usually are not tried until a patient has failed
these first- and second-line treatments, due to intolerable side
effects or because their cancer did not respond or has progressed. For patients
with a life-threatening, progressive disease, this sequential approach to therapy selection
is not optimal, but it is unavoidable given the limited predictive information
available to healthcare providers.
Despite many years of clinical studies, physicans still do not have enough
information to predict how a patient will respond to a given therapy. In
addition, many of the newer, more targeted drugs, which generally have less
severe side effects, have low response rates in the general disease population,
although they can be extremely effective in a subset of that population.
Ineffective or inappropriate therapies can lead to poor patient outcomes, due
both to side effects and lack of efficacy, as well as an economic burden on the
healthcare system arising from the cost of the healthcare provider's time,
wasted drugs and increased hospitalization.
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