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February 23, 2005

The Case for Randomized Trials in Cancer TreatmentNew Is Not Always Better

Author Affiliations

Author Affiliations: Department of Radiation Oncology, St Barnabas Medical Center, Livingston, NJ, and the Department of Medicine and Herbert Irving Comprehensive Cancer Center, College of Physicians and Surgeons, and the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.

JAMA. 2005;293(8):1001-1003. doi:10.1001/jama.293.8.1001

Given a choice, most patients diagnosed with cancer would prefer the most recently discovered treatments, prompting them to seek out the latest innovation, even if it includes relatively untried medications that have not been thoroughly evaluated.1,2 In the mid 1950s, pioneering cancer researchers, anticipating the need for clinical trials, requested funds from the US Congress for the development of the first clinical research cooperative groups.3 A small network of institutions was formed to test new anticancer agents arising from the National Cancer Institute’s Drug Development Program. Eleven of the original groups remain and 3 are dedicated to specific areas of therapy such as the Radiation Therapy Oncology Group (RTOG), the American College of Surgeons, and the American College of Radiology Imaging Network. Nineteen hundred institutions are involved, with more than 60% of patients who participate in publicly or privately funded clinical cancer trials enrolled through the cooperative groups; more than 20 000 patients take part annually.3,4

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