Conducting clinical trials is essential to the development of new cancer treatments, but there
are many pitfalls, and it takes knowledge and experience to get it right. Where do Europe's
young oncologists go to pick up the necessary skills? Until 1999, there was nowhere.
Ninety-six of every 100
adult cancer patients do
not enrol in a clinical
trial. One reason is that many trials are
shrouded in a veil of secrecy, and patients
find it hard to locate one that addresses
their specific condition. Existing
registries list only a small percentage of
trials in progress, the information they
contain is frequently inaccurate or
incomplete and not all of them are accessible
to the public.
Negative clinical-trial results are underreported. But this may soon change.
It took JosĂ© Baselga just a few years to build the oncology department at Barcelona's Vall
d'Hebron hospital from a few shabby consulting rooms to a leading centre for research into
targeted therapies. Europe has the edge in this type of research because we are better at
working together, says Baselga. But we still have a lot to learn from the US.
The European Union aims to become Â“the most competitive and dynamic
knowledge-based economy in the worldÂ”. Why then does it put so many
obstacles in the way of research? And why is a world-beating breast cancer
trial left short of funding and support?
A number of cancer vaccines are now entering the final stage of clinical development. Are
vaccines finally on their way to enjoying mainstream success in the oncology arena?
Survival data from phase III trials can be very misleading because patients are
not offered the best follow-up therapy argue Siegfried Seeber and Ada Braun in
CancerWorld's new Forum section. Emma Mason canvassed clinical trial leaders,
and presents their responses in the Debate section that follows.
Volker Diehl cultured the cells that characterise Hodgkin's disease when everyone else had
failed. He has high hopes that molecular medicine will throw light on many questions that
remain unanswered. But he stresses that it is the disciplined clinical work on the wards that
saves lives in this disease, where the line between cure and fatal damage can be very thin.
Advocates for early access to unproven treatments may believe they are helping patients,
but their actions can put current patients at risk and deny future patients the knowledge
they need to make evidence-based treatment decisions, argues Musa Mayer.
Patients, doctors, academic researchers and the World Health Organization all want industry
to be a lot more open about the drugs they are trialling. The industry is pleading commercial
confidentiality. The two sides are locked in an argument over the requirements of a proposed
WHO clinical trials registry. The question is: who will blink first?
Clinical research activity may be plummeting in the rest of Europe, but in France they're
determined to substantially increase the numbers of hospitals and patients involved in clinical
trials Â– starting with a strategic trial on Herceptin.
Selected reports edited by Hannah Brown
Patients are not scientists. But given the chance, they can help clinical researchers design
trials that patients want to join and stay with, and that answer questions they care about.
They want the culture of the consent form to be replaced by a genuine partnership between
researchers and patients.
Europe has money, human resources and a basic-science base that produces world-leading
cancer research. Why, then, aren't these assets being translated into clinical advances?
The bureaucratic obstacles that often prevent European cancer patients from joining clinical trials in other Member States came under the spotlight recently in the case of a young woman with melanoma.
Jaap Verweij, head of medical oncology and an early-phase trials expert at the Erasmus University Medical Centre in Rotterdam invites you to reappraise the way we are going about improving cancer therapies.
The potential for personalising lung cancer therapies is expanding rapidly. The challenge now is how to turn that potential into reality as fast as possible so patients can reap the benefits.
Many of the worst economic and bureaucratic burdens that have proved such a deterrent to multi-country clinical trials look set to be addressed with the overhaul of the EU Clinical Trials Directive, but should we sit back and wait for this to be done?
Journalists who write about their own cancer journeys are able to convey important insights in a language that people understand Â– and are eager to read
Since the concept of personalised cancer therapies first emerged, the picture has become so much more complex and challenging.