The American Society of Clinical Oncology held its annual meeting at the start of June and reported several findings from a number of clinical trials investigating new targeted agents. Among these was a Phase III trial of an antibody, ipilimumab, which inhibits cytotoxic T lymphocyte antigen 4 (CTLA4). CTLA4 regulates T cell-mediated immune responses and guards against the development of autoimmunity; ipilimumab improved overall survival in patients with progressive melanoma. These results required the collaboration of several international cancer centres, and the trial was statistically powered to address overall survival. However, as we assess more and more targeted agents in clinical trials there is growing concern that the standard progression from Phase I to Phase III is not the best way to rapidly identify the most promising drugs.
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