Is the quality of cancer treatment better in clinical trials?
Didier Verhoeven, MD, PhD


Abstract
“Patients are better off when treated within the context of a clinical trial” is a generally accepted opinion in the oncological community.The American Society of Clinical Oncology (ASCO) and the US National Comprehensive Cancer Network (NCCN) have also taken the position that “the best management for any patient with cancer is in a clinical trial.1 “See http://www.nccn.org/patients/patient guidelines/breast/index.html#/40/. Is this really the truth or is it a political statement to increase accrual and third party payment? Our analysis support the vision that patients are treated well in clinical trials but that there is insufficient data to claim a “beneficial” trial effect. A new treatment may improve outcome but may also lead to increased toxicity and/or cost. Patients may feel they are regarded as research object and less attention may be given to supportive and palliative care. Patients must be enrolled in a clinical trial on the basis of improving treatment options for future patients.