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Editor's Choice

What you need to know about cancer drugs

BMJ 2017; 359 doi: https://doi.org/10.1136/bmj.j4585 (Published 05 October 2017) Cite this as: BMJ 2017;359:j4585

Rapid Response:

Re: What you need to know about cancer drugs

It is good to read Editor's Choice on "What you need to know about cancer drugs"

“Efficacy, Safety, Quality of life and Cost factors” are associated with Every Drug, and same is also true with Anticancer Drugs

Anticancer drugs should have proven efficacy. It is revealed from the study that during 2009-13, a total of 68 cancer drugs was approved by the European Medicines Agency (EMA) but 39 drugs with inadequate evidence entered the market (like mifamurtide, pomalidomide, bevacizumab, vinflunine, trastuzumab, and panitumumab). Because of the use of surrogate endpoints (such as response rate or progression-free survival) evidences was inadequate and there were methodological problems in conducting trials [1,2]. When approval is based on a surrogate end point, subsequent studies are mandatory (validation studies) to clarify the the drug’s effect on overall survival, otherwise week association exists between surrogate end points and survival [3].

There should be realistic expectations regarding benefits of cancer drugs. As cancer drugs are expensive, it should be the moral and social responsibilities of pharmaceutical companies to take appropriate measures to reduce cancer drug prices [4]. Cancer patients suffer most (no one wants to say no to a cancer drug) & pharmaceutical companies get a lot of financial benefit.

Once the drug is on the market, drug companies must conduct “confirmatory trial and validation studies" and the FDA must take appropriate action regarding its approval if the drug’s safety or efficacy results are questionable.

Regards,

References:
1. http://www.bmj.com/content/359/bmj.j4543
2. http://www.bmj.com/content/359/bmj.j4528
3. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2463590
4. http://www.mayoclinicproceedings.org/article/S0025-6196(15)00101-9/fulltext

Competing interests: No competing interests

18 October 2017
Dr. Rajiv Kumar
Faculty
Dept. of Pharmacology, Government Medical College & Hospital Chandigarh 160030. India.
DRrajiv.08@gmail.com