Rationale for treatment durations of targeted cancer agents.

摘要

In the current health-care climate, there is tension between health-care payers who want to ensure value for money, and drug developers who want to maximise return on research and development investment. For cancer, the drug-dosing schedules used in adjuvant clinical trials are determined by clinical trials in the metastatic setting, and by treatment practices in routine care. Maximum doses per treatment are ascertained by achievement of predetermined serum drug concentrations, and durations of therapy are determined by drug efficacy and patient tolerance to long-term administration.1 Understandably, drug developers are attracted to trial designs that use maximum-tolerated ratherthan minimum-effective doses.