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The NCI's recent clinical alert was intended to inform practicing physicians of the potential benefits of postoperative treatment for patients with node-negative breast cancer. These data could affect the lives of thousands of women before formal publications appear in a peer-reviewed journal. With every month's delay, 2000 to 5000 newly diagnosed patients could lose the chance to benefit. It has now been several months since manuscripts describing two of these trials were submitted to peer-reviewed journals; neither has been published yet.Perhaps predictably, the alert has engendered considerable controversy. Dr Feinberg cites the bypassing of peer review and the incompleteness of the mailing and of the data. We agree with some of these concerns and plan to improve the content and completeness of any such future mailing.The NCI did not undertake the mailing of the clinical alert without due process and, in retrospect, should have described this
Roper M, Wittes RE. Peer Review and the NCI's Clinical Alert on Node-Negative Breast Cancer-Reply. JAMA. 1989;261(5):695–696. doi:10.1001/jama.1989.03420050043016
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