Intended for healthcare professionals


Why do cancer drugs get such an easy ride?

BMJ 2015; 350 doi: (Published 23 April 2015) Cite this as: BMJ 2015;350:h2068
  1. Donald W Light, professor1,
  2. Joel Lexchin, professor 2
  1. 1School of Osteopathic Medicine, Rowan University, Cherry Hill, NJ 08002, USA
  2. 2School of Health Policy and Management, York University, Toronto, ON, Canada
  1. Correspondence to: D W Light dlight{at}

Rushed approvals result in a poor deal for both patients and cancer research

Unlike most other diseases, cancer instils a special fear and “is treated as an evil, invincible predator, not just a disease.”1 The ability of drug companies to charge very high prices, even when most approved cancer drugs provide little gain for patients, drives much of the research, as desperate patients lead some governments and private insurers to pay whatever companies charge. Officials within the US Food and Drug Administration are enthusiastic about new cancer drugs. Richard Pazdur, who oversees oncology activities for the FDA says that new cancer drugs are so effective that “We don’t have a lot of questions on [these] drugs because they’re slam dunks. It’s not if we’re going to approve them. It’s how fast we’re going to approve them.”2

The methodological weaknesses in oncology trials do not support such enthusiasm. Researchers compared 8942 oncology clinical trials conducted between 2007 and 2010 with trials for other diseases.3 Trials for cancer drugs were 2.8 times more likely not to be randomised, 2.6 times more likely not to use a comparator (single arm), and 1.8 …

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