A prevalent ideology in the oncology community holds that clinical trials represent the best treatment option for patients with cancer. This belief, which likely developed in response to concerns over the low proportions of adult patients with cancer who enroll in trials,1 the historical reluctance of third-party payers to cover trials' routine-care costs,2 and the psychological need to reconcile the simultaneous pursuit of scientific and therapeutic aims,3 finds expression in the National Comprehensive Cancer Network's assertion, reiterated in each of its guidelines for cancer treatment, that “the best management for any cancer patient is in a clinical trial.”4 That this viewpoint persists in authoritative, otherwise evidence-based guidance is surprising in light of accumulating data suggesting that patients treated within trials have outcomes that are on average neither better nor worse than those of comparable patients treated outside trials.5-8
Joffe S. Framing the Benefits of Cancer Clinical Trials. Arch Pediatr Adolesc Med. 2010;164(3):293–294. doi:10.1001/archpediatrics.2009.293
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