No Word on Prevention

This just seems to be the time to talk about carcinogens and cancer. The New York Times today discusses the problem of diminishing returns with drugs used for treating cancer. Few drugs are being marketed, have been very expensive to produce and test, and provide few of the expected benefits. Better methods for imaging and diagnosis are needed (X-rays in particular are identified as having questionable accuracy). The problem has been chalked up as an obsolete drug development process.

For example, the FDA just approved Nexavar, a drug described by its developer Bayer as the first approved treatment for advanced renal cell carcinoma in more than a decade. Nexavar has been shown to double the progression-free survival in patients with advanced RCC. Before getting too excited about that news, it’s important to note this meant the median progression-free survival doubled from 84 days (with the placebo) to 167 days (with Nexavar).

When you factor in the more common side effects, skin rashes, diarrhea, and hypertension, on top of the additional three months of life, you start to wonder how worthwhile Nexavar really is, in the overall quality of life department.

Also, not a word about prevention in the Times article. Maybe Sam Epstein has a point about the cancer orthodoxy.